Valentine RNL 2025 Review (2.14.2025)
Dr. Jack Cush reviews highlights from RheumNow Live 2025 held in Dallas, TX on Feb. 8-9, 2025.
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Livedoid vasculopathy (LV) is a rare chronic microvascular thrombosis dz w/ hypercoagulability and inflammation. Lit Search found 15 articles, 41 LV pts Rx w/ biologics & JAK inhib. 88% w/ positive responses & pain relief. TNFi were most used, then JAK inhibitors… https://t.co/3ugGdUlYcI https://t.co/0aXRKRi5RA
Dr. John Cush @RheumNow( View Tweet )
EGPA in 2025
Eosinophilic Granulomatosis with Polyangiitis (EGPA), the artist formerly known as Churg-Strauss syndrome, remains somewhat of a rogue agent among the vasculitides.
https://t.co/4ofjQRYsMH https://t.co/PoVhaQ9QiZ
Links:
Dr. John Cush @RheumNow( View Tweet )
EGPA in 2025
Formerly classified as an ANCA-associated vasculitis, EGPA is both most commonly ANCA negative and clinically different to the other two ANCA-associated vasculitis conditions, GPA and MPA. The management of EGPA has frequently fallen into the trap of being copied from its more common and well-
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Dr Rhee @RennieRhee mimics of medium/large vessel vasculitis. Increase in cross-sectional imaging use has increased the number of these we get referred. Segmental arterial mediolysis also pops up a fair bit. @RheumNow #RNL2025 https://t.co/yozRGE9Ncl
Richard Conway @RichardPAConway( View Tweet )
#RNL2025 @RheumNow
Dermatomyositis is VASCULAR disease
-IVIG may help DM by blocking complement deposition on endomysial capillaries
-CK levels not reliable
Pruritus common in up to 86% of DM patients
Dr. Charles-Schoeman, UCLA
Eric Dein @ericdeinmd( View Tweet )
Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C)
A nationwide cohort study of patients with multisystem inflammatory syndrome in children (MIS-C), a life-threatening complication of COVID-19 infection, showed that many had severe disease during the acute phase, but most recovered quickly and had a reassuring midterm prognosis.
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BACHELOR Trial - Baricitinib in Early Polymyalgia Rheumatica
Lancet reports a French study demonstrating the efficacy of baricitinib in patients with polymyalgia rheumatica (PMR).
RheumThoughts: Overlap Syndrome with ILD
How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?
https://t.co/4RyV1zkphe https://t.co/qTZ4JYlJmW
Dr. John Cush @RheumNow( View Tweet )
Systematic review of 208 pts w/ IgG4–related disease & pachymeningitis - mean age 52 yrs; 2/3 male. HA & cranial nerve dysfunctions were most common Sxs. nearly half had systemic Dz. Abnl imaging of cavernous sinus and middle fossa. Incr. IgG4 in 65% w/ CSF pleocytosis in 52%… https://t.co/0TberfIXsH https://t.co/6k5QgGTnkw
Dr. John Cush @RheumNow( View Tweet )
🚨 Just 4 weeks until #RheumNowLive 2025! 🚨
📅 Feb 8-9 | Dallas, TX
Don’t miss 1.5 days of cutting-edge #rheumatology education, interactive sessions, and unmatched networking!
🧠 Expert insights:
🔹 EGPA care innovations (Dr. Wechsler)
🔹 Vasculitis imaging… https://t.co/ObHBj1dQoK https://t.co/UuDZxBhdLr
Dr. John Cush @RheumNow( View Tweet )
Alive in 2025 (1.10.2025)
Dr. Jack Cush brings in the new year with a review of the latest from RheumNow.com
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Spanish registry ARTESER, looked at GCA outcomes from 2013 to 2019. In 1200 GCA pts ~ 2 yrs F/U, The 5-Yr mortality 37.9/1000 pt/yrs; higher in males vs females (59 vs 29 p<0.001), but was same as gen population . Incr mortality w/ age & male sex. HA & Hgb were protective… https://t.co/idnuUL9Kog https://t.co/2MsOxuTtCd
Dr. John Cush @RheumNow( View Tweet )
Retrospectively review of 165 #EGPA pts, GI manifestations were assoc w/ Eosinophils > 19.5%, weight loss, & myalgia; & included abdominal pain (78%), diarrhea (40%), N/V (33%); GI hemorrhage (27%), ulcers (17%), obstruction (10%), & pancreatitis (6%) https://t.co/EzsGcFs2l2 https://t.co/mQrgjTG6NV
Dr. John Cush @RheumNow( View Tweet )
A Modifiable Vascular Risk in SLE
MedPage Today
Atherosclerosis progression was more than twice as common in younger people with SLE than in healthy controls in a prospective study from Greece, but the rate difference narrowed substantially with sustained SLE remission and conventional cardiovascular risk factor management.
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Upadacitinib in GCA. Merkel et al. SELECT-GCA study. Sustained remission week 52 Upa (+26 week steroid) 46% vs PBO (+52 week steroid) 29%. Reduced flare rates with UPA (see picture). Similar to GiACTA results. @RheumNow #ACR24 Abstr#0770 https://t.co/f7OwxAggaf… https://t.co/PUuwo0MLso https://t.co/JBzokT9icx
Dr. John Cush @RheumNow( View Tweet )
TAPIR study of continuing vs stopping steroids in ANCA vasculitis in remission. Relapse at month 6 in 16% vs 4%. OR 4.22, but low rate in either group. If treated Rituximab, no difference! Merkel et al. @RheumNow #ACR24 Abstr#0774 #ACRbest https://t.co/F9DOBLrjVq https://t.co/BtphAuEopA
Dr. John Cush @RheumNow( View Tweet )
To Behcet’s or not to Behcet’s?
-Aphtous ulcers have unique features(broad ddx)
-Oral+Genital ulcers=CAP not necessary BD.
-Pathergy test ⬆️specific and not limited to skin!
-Pulmonary arterial aneurysms=almost pathognomonic.
-Do not get confused by HLAs. #ACR24 @RheumNow… https://t.co/3nWgILNVYw
Dr. John Cush @RheumNow( View Tweet )
Tocilizumab Efficacy in Giant Cell Arteritis Phenotypes
A Spanish Collaborative Group study of Tocilizumab (TCZ) in Giant Cell Arteritis (GCA) demonstrated high efficacy regardless of the different vascular phenotypes treated.
https://t.co/8wvSy8555Z https://t.co/vaGt1AylBr
Dr. John Cush @RheumNow( View Tweet )
Metanalysis of 41 studies, & 5343 AAV pts showed 55% (2890) had infection; 36% w/ severe infxn. This included PJP, aspergillosis, candidiasis, HZ, CMV, etc. Pulmonary most common. Risk factors included older, ESRD, DM, smoking, Renal or lung involvement https://t.co/yHo5BNlbiL https://t.co/R2je32YYGy
Links:
Dr. John Cush @RheumNow( View Tweet )
Bah Humbug Vitamin D (12.20.2024)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Tocilizumab Efficacy in Giant Cell Arteritis Phenotypes
A Spanish Collaborative Group study of Tocilizumab (TCZ) in Giant Cell Arteritis (GCA) demonstrated high efficacy regardless of the different vascular phenotypes treated.
https://t.co/nwCU3qW4PT https://t.co/uhvFDrW5Zz
Dr. John Cush @RheumNow( View Tweet )
Best of 2024: Vasculitis Pearls
Once again RheumNow Live 2024 really delivered with high impact learning packed into short sessions. As someone with an interest in vasculitis it was fantastic to see four of my favorite speakers in the Vasculitis Mavens and STEP talks. They gave us what we really want from these talks –
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Steroids do NOT hamper muscle Bx dx of ANCA vasculitis. Tokyo study of 126 pts w/ suspected vasculitis had Quad muscle Bx; 71 (+) w/ Dx of AAV. Bx yield in 56 and 15 pts w/ off or on steroids, respectively, was similar (59% vs 53%). https://t.co/Xpt01Wksd3 https://t.co/NSBclcEgwq
Dr. John Cush @RheumNow( View Tweet )
Tocilizumab Efficacy in Giant Cell Arteritis Phenotypes
A Spanish Collaborative Group study of Tocilizumab (TCZ) in Giant Cell Arteritis (GCA) demonstrated high efficacy regardless of the different vascular phenotypes treated.
Multicentre study of 471 GCA patients treated with TCZ, assessed outcomes according to vascular
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