Vasculitis

Avacopan - Is it Really a Win for ANCA-Associated Vasculitis? The NEJM has reported the results of a study showing that avacopan, a C5a receptor inhibitor, is as effective as steroids at treating patients with ANCA-AAV. https://t.co/vWmhEhX8Z3 https://t.co/omXpouPKoJ

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Dr. John Cush @RheumNow( View Tweet )
Feb 19, 2021
PAN AAV ANCA vasculitis

Avacopan - Is it Really a Win for ANCA-Associated Vasculitis?

Jack Cush, MD
Feb 18, 2021

The NEJM has reported the results of a study showing that avacopan, a C5a receptor inhibitor, is as effective as steroids at treating patients with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV).

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Among 335 AAV pts, 18% had venous thromboembolism (VTE). The incidence rate of AAV-related VTE was 2.4/100 PYs and was higher in the first 3 months post–AAV diagnosis (20.4/100 PY) and decreased over time. Age & BVAS were predictive of VTE.https://t.co/Arb2gk27B7

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Dr. John Cush @RheumNow( View Tweet )

Jan 28, 2021
Cutaneous manifestations of ANCA-assoc vasculitis studied in 1184 GPA, MPA, EGPA pts and found to assoc w/ more severe disease. Common were petechiae/purpura (15%); allergic Sxs such as pruritus, urticaria, were more common in EGPA https://t.co/cdoJPUnDiC

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Dr. John Cush @RheumNow( View Tweet )

Jan 26, 2021
Study of 147 Takayasu arteritis pts in UK (compared to 1,371 controls) shows all‐cause and CV mortality increased TAK (adj HR 1.88). While TAK had increased ischemic heart Dz, CVA, TIA, PVD, CVD; there was NO increase in HTN, CKD, CHF or diabetes. https://t.co/lanantCSXW

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Dr. John Cush @RheumNow( View Tweet )

Jan 25, 2021
Study of 52 pts w/ pericardial dz in GCA (44) & PMR (8) finds only 46% were >70 yrs. Manifest as pericardial effusion (85%), was initial Sx in 37%. 69% were symptomatic & classic cranial Sxs present in only 40%. Tamponade more likely w/ PMR https://t.co/B5IxBT9OO7

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Dr. John Cush @RheumNow( View Tweet )

Jan 13, 2021
Retrospective study of 171 GCA patients found that 32% had aoritis (by Sxs or AI murmur); hese pts were 6 fold more likely to have subsequent Aortic complications (aortic aneurysms or dissection) https://t.co/zRVzmnU7JH

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Dr. John Cush @RheumNow( View Tweet )

Jan 11, 2021
Study of 100 pts w/ Granulomatosis with polyangiitis finds 56% had elevated d-dimer levels and that d-dimer are associated with disease activity and inflammation rather than with the risk of venous thromboembolism. 23 had VTE not predicted by d-dimer https://t.co/zIYKXNl0oO

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Dr. John Cush @RheumNow( View Tweet )

Jan 06, 2021
#Bestof2020 Update on Polymyalgia Rheumatica and Giant Cell Arteritis https://t.co/8Kxts1X43H https://t.co/j06SFRxQ3m

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Dr. John Cush @RheumNow( View Tweet )
Jan 04, 2021
Plasmapheresis Indications : TTP, HUS, Cryoglobulinemia, Hyperviscosity, Myasthenia gravis, Goodpastures, Catastrophic APL Syn, Chr inflamm demyelinating polyneuropathy, Removal of drugs/toxins, Alveolar hemorrhage, ANCA vasculitis (questionable) https://t.co/8TBExIx0Kx

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Dr. John Cush @RheumNow( View Tweet )

Jan 02, 2021
GCA temporal artery

Update on Polymyalgia Rheumatica and Giant Cell Arteritis (Best of 2020)

Jack Cush, MD
Dec 31, 2020

JAMA has published a clinical update of recent studies on GCA. While PET/CT scanning are novel means of demonstrating activity, they have not changed the diagnostic approach to GCA or PMR and although there are no new proven treatment strategies for PMR beyond glucocorticoids, the FDA has

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#BestACR20Tweets RT @RichardPAConway : Really important study by @SattuiSEMD on high prevalence of frailty and its impact on QOL in PMR #ACR20 @rheumnow Abstr#422 https://t.co/QzDYGsqDeJ
Dr. John Cush @RheumNow( View Tweet )
Dec 22, 2020
Check out our latest article from Richard Conway ( @RichardPAConway) #ACR20 The tantalising prospect of glucocorticoid-free treatments for systemic vasculitis https://t.co/VG1ah3Nq5c https://t.co/js3l527VHg

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Dr. John Cush @RheumNow( View Tweet )
Dec 06, 2020
Imaging and Large Vessel Vasculitis: Dr. Alexa S. Meara interviews Dr. Kaitlin Quinn #ACR20 https://t.co/CWN2C1P6Fz https://t.co/yHg63VPkiW

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Dr. John Cush @RheumNow( View Tweet )
Dec 04, 2020
#BestACR20Tweets RT @RHEUMarampa : Novel predictors of early mortality in a cohort of GCA pts from Portugal: 🚩Older age at dx 🚩Tongue claudication 🚩Prior tx w/ anticoag BP treatment at dx - predictor of early survival. @RheumNow #ACR20 abs1935 https://t.co/vCi2gMCmKE https://t.co/HuTv1p8Yua

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Dr. John Cush @RheumNow( View Tweet )
Dec 04, 2020
#BestACR20Tweets RT @RichardPAConway :Dr Cid presents phase 2 trial of anti-GM-CSF agent mavrilimumab in combination with steroids in GCA. 70 patients. Sustained remission at week 26 in 83.2% of mavrilimumab vs 49.9% of placebo p=0.0038. @DrPujaMehta1 #ACR20 Abstr#L06 https://t.co/ynWbguXXzR
Dr. John Cush @RheumNow( View Tweet )
Dec 02, 2020
#BestACR20Tweets RT @SattuiSEMD :L06: Mavrilimumab in #GCA Efficacy+safety of MAV maintaining sustained remission 26w new and relapsing/ref #GCA Flare risk ➡️ 62% risk ⬇️ of flare w/ MAV Sustained remission➡️ 33% ⬆️ in MAV No diff in new/relapsing/ref pts, No diff in AE

Dr. John Cush @RheumNow( View Tweet )

Dec 01, 2020
pills-384846_640%20%281%29.jpg

The tantalising prospect of glucocorticoid-free treatments for systemic vasculitis

Nov 30, 2020

Glucocorticoids are a highly effective treatment in systemic vasculitis but are also a significant cause of long-term harm in the form of treatment related adverse events. Virtually every vasculitis patient treated with traditional glucocorticoid regimes suffers from these. These are not

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#BestACR20Tweets RT @doctorRBC : Mavrilimumab efficacious in maintaining disease remission in GCA pts. Phase 2 trial (n=70) Disease flare 19% in tx vs. 46% in PBO at 26wk Sustained remission 83% vs. 50% in PBO Similar AE in both groups Abs#L06 https://t.co/fsZxZVmDIu" https://t.co/j17naatAxX

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Dr. John Cush @RheumNow( View Tweet )
Nov 29, 2020
#BestACR20Tweets RT @drdavidliew : Mavrilimumab (anti-GM-CSF) in GCA, phase 2 GM-CSF upstream to both Th1 & Th17 pathways; potential for dx-modifying?? PNL induction then enrol+PNL taper GCA flare (ESR/CRP+Sx/imaging): mavrilimumab RRR 62% ABSTL06 https://t.co/xxjd2lTSUe https://t.co/uuBOnbk6Ab

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Dr. John Cush @RheumNow( View Tweet )
Nov 24, 2020
#BestACR20Tweets RT @DrPetryna: #ACR20 prosp cohort study of angiographic lesions in Takayasu’ GCA:new angio lesions more likely in TAK.Improvement possible in both conditions, more likely in TAK.Change in the branch arteries more dynamic than in the aorta https://t.co/iC0TJ08Tsr https://t.co/Y1hIDGJ9Ro

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Dr. John Cush @RheumNow( View Tweet )
Nov 23, 2020
#BestACR20Tweets RT @DrPetryna : @RheumNow #ACR20 abs1921 single center baseline & follow-up PET/CT scan study in pts w/ refractory LVV-GCA on TCZ: while 83.33%pts achieved clincial remission only 10% experiences normalization of Total vascular score. https://t.co/M97X8fLfLp

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Dr. John Cush @RheumNow( View Tweet )

Nov 22, 2020
#BestARC20Tweets "RT @drdavidliew : Great to sit down with @LCalabreseDO @Sarah_L_Mackie @RichardPAConway a few hours ago and chat about two very interesting GCA therapeutics abstracts: https://t.co/V3fzB0W3Ko great discussion! #ACR20 @RheumNow"

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Dr. John Cush @RheumNow( View Tweet )

Nov 20, 2020
Read our article titled: Best Imaging Techniques for non ANCA Vasculitis by Dr. Alexa Meara ( @lexmeara) as discussed at #ACR20 https://t.co/CyfC8bdq42 https://t.co/Ay7Sw0eMTY

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Dr. John Cush @RheumNow( View Tweet )
Nov 20, 2020
"The tantalising prospect of glucocorticoid-free treatments for systemic vasculitis" by Dr. Richard Conway ( @RichardPAConway) https://t.co/VG1ah3Nq5c https://t.co/jORhfQn3EC

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Dr. John Cush @RheumNow( View Tweet )
Nov 17, 2020

Recent Blogs

ACR20 Pearls Part 3: Pragmatic Applications for Managing Vasculitis

Kathryn H. Dao, M.D.
Feb 11, 2020
Giant-Cell_Vasculitis_6.jpg
While the ACR prepares to publish its new guidelines for the diagnosis and management of vasculitis in the Spring of 2020, Dr. John Stone presented his own perspectives on the practical management of vasculitis during the 2019 ACR meeting in Atlanta.  He acknowledged that what may be pearls one day, may be disproven with data in the future.  Read Post

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