Vasculitis

Urticarial Vasculitis Overview Urticarial vasculitis is rare and the causes often go undiagnosed. A Medscape recent overview highlights key features in the diagnosis and management of this rare disorder. https://t.co/TUlCw76asZ https://t.co/HwDQpsAtws

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Dr. John Cush @RheumNow( View Tweet )
Immunomodulatory Prevention of Uveitis Relapse in Behçet's The results of a randomised, open-label, head-to-head trial shows that adalimumab was superior to ciclosporin in preventing uveitis relapses in patients with severe Behçet's disease. https://t.co/12fpuIZFmA https://t.co/iDJJq29JMA

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Dr. John Cush @RheumNow( View Tweet )
urticaria

Urticarial Vasculitis Overview

Jack Cush, MD

Urticarial vasculitis is rare and the causes often go undiagnosed. A Medscape recent overview highlights key features in the diagnosis and management of this rare disorder.

Urticarial vasculitis is often chronic, or recurrent, accompanied by a painful or burning sensation. The wheals or

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iritis-uveitis-e1333867439592.jpg

Immunomodulatory Prevention of Uveitis Relapse in Behçet's

Jack Cush, MD

The results of a randomised, open-label, head-to-head trial shows that adalimumab was superior to ciclosporin in preventing uveitis relapses in patients with severe Behçet's disease.

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ANCA-associated vasculitis analysis of 6 European registries, 3868 pts (2434 GPA, 1434 MPA), age ~57 yrs. Identified 5 clusters: 3 w/ renal dz a) variable ANCA, Hi CRP & Cr; b) MPO+; c) PR3+ & 2 extrarenal 1) PR3+ multisystem; 2) ENT w/ low CRP. Clusters better predicted outcomes… https://t.co/XZcSZ6lGjH https://t.co/yEg64YGTrA
Dr. John Cush @RheumNow( View Tweet )
IV Methylprednisolone in Giant Cell Arteritis A retrospective study in giant cell arteritis (GCA) patients suggests there is no added value using higher dose, intravenous methylprednisolone (IVMP) in early GCA. https://t.co/5udYabU5z5 https://t.co/5FHhBnAX2j

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Dr. John Cush @RheumNow( View Tweet )
GCA,Black

IV Methylprednisolone in Giant Cell Arteritis

Jack Cush, MD

A retrospective study in giant cell arteritis (GCA) patients suggests there is no added value using higher dose, intravenous methylprednisolone (IVMP) in early GCA.

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ANCA-associated vasculitis analysis of 6 European registries, 3868 pts (2434 GPA, 1434 MPA), age ~57 yrs. Identified 5 clusters: 3 w/ renal dz a) variable ANCA, Hi CRP & Cr; b) MPO+; c) PR3+ & 2 extrarenal 1) PR3+ multisystem; 2) ENT w/ low CRP. Clusters better predicted outcomes… https://t.co/20O58AAYAa https://t.co/KF6PTVfcRw
Dr. John Cush @RheumNow( View Tweet )
Retrospective study of 919 RTX-treated GPA pts shows TMP-SMX prophylaxis (given to 31%) assoc w/ reduced serious infections (adj HR 0.5) and less outpatient infections (aHR 0.8). All 13 pneumocystis infx (PJP) occured in those not Rx w/ TMP-SMX. https://t.co/bO6oAHv7Lr https://t.co/fPntW75hnY

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Dr. John Cush @RheumNow( View Tweet )
Pulse Steroids with Tocilizumab in Giant Cell Arteritis A pilot study assessed pulse methoprednisolone with weekly subcutaneous TCZ in patients with large vessel-GCA (LV-GCA) and showed that a sizeable minority will relapse after the TCZ is discontinued. https://t.co/gGrSY3U1t9 https://t.co/zuspadaY9t

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Dr. John Cush @RheumNow( View Tweet )
GCA,woman

Pulse Steroids with Tocilizumab in Giant Cell Arteritis

Jack Cush, MD

A pilot study assessed pulse methoprednisolone with weekly subcutaneous tocilizumab (TCZ) in patients with large vessel-GCA (LV-GCA) and showed that a sizeable minority will relapse after the TCZ is discontinued. 

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IgG4-related disease Nearly any organ can be affected ▶️Salivary glands ▶️Lacrimal glands ▶️Orbit ▶️Pancreatobiliary system ▶️Lung ▶️Kidney ▶️Retroperitoneum 👉🏽https://t.co/758F5iuYwT via @RheumJnl https://t.co/ipONrygHmc

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Dr Ai Lyn Tan @DrAiLynTan( View Tweet )
New! 📣Best Practice Guidelines for the management of Haemophagocytic Lymphohistiocytosis (HLH) aka Macrophage Activation Syndrome (MAS) from @NHSGIRFT @RheumatologyUK Remember the 3Fs Fever, Falling Counts, Ferritin and follow the HLH pathway to guide management… https://t.co/8oDyUbsm9W https://t.co/S0MDi3TkNk

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Dr. Antoni Chan @synovialjoints( View Tweet )
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Higher Cancer Rates (8.16.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.

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Relapses with RTX Maintenance in ANCA-associated Vasculitis A real-world study on ΜPA and GPA patients found that RTX maintenance had a 25% relapse risk, with lower rates when combined with cyclophosphamide treatment. https://t.co/bD6u5JWVqS https://t.co/CSotJt4in1

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Dr. John Cush @RheumNow( View Tweet )
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Depends on Where You’re Looking (8.9.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week.

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Prospective Vasculitis Study of Takayasu’s Arteritis - 236 pts, 92% women, mean age 36 yrs, Dz duration 2.6yrs. Damage present in >80% at baseline (75% vascular, 40+% cardiac), even with recent Dx and >40% pts accrue new, mainly disease-specific damage https://t.co/DKZQdH4HuZ https://t.co/LVjqAZYnOZ

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Dr. John Cush @RheumNow( View Tweet )
ANCA, vasculitis, test

Relapses with Rituximab Maintenance in ANCA-associated Vasculitis

Jack Cush, MD

Real-world, retrospective study of microscopic-polyangiitis (ΜPA) and granulomatosis-with-polyangiitis (GPA) patients shows that rituximab (RTX) maintenance was associated with 25% risk of relapse and that lower relapse rates was seen with RTX plus cyclophosphamide treatment.

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PEXIVAS: Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis Patients The PEXIVAS study found potential benefits of plasma exchange and glucocorticoids for AAV patients with DAH, but the results did not reach statistical significance. https://t.co/m7BxMfj04W https://t.co/A9SKAWd1s5

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Dr. John Cush @RheumNow( View Tweet )
alveolar hemorrhage acute

PEXIVAS: Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis Patients

Jack Cush, MD

A secondary analysis of the PEXIVAS study showed antineutrophil cytoplasmic antibody–associated vasculitis (AAV) patients complicated by diffuse alveolar hemorrhage (DAH) may have improved with plasma exchange and glucocorticoids, the results did not achieve significance. 

Diffuse

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From LG cohort of myeloid neoplasms (861 MDS, 640 AML, 112 MDS/MPN, 89 MPN) autoimmune Rheum Dz (AIRD) found in 7.7% (lit suggests 8-30%), less in AML (4.7% vs 9.5% others). Common: RA (42%), CTD(18%), PMR (14%), vasculitis (12%), AxSpA (7%). https://t.co/ZXxOrZBunZ https://t.co/m5nIgrhohw

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Dr. John Cush @RheumNow( View Tweet )
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Best Rheumatologists (7.19.2024)

Jack Cush, MD

This week on the RheumNow Podcast, Dr. Jack Cush reviews the news and journal reports of interesting, including irAE, pollution and Psoriasis, microwave therapy, scleroderma without scleroderma that only the best rheumatologists could discern.

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AbbVie has submitted regulatory applications to both the FDA and the European Medicines Agency for Rinvoq (upadacitinib) to treat adult patients with giant cell arteritis (GCA) https://t.co/LqRcm2FEFV https://t.co/XEjjSNnOGt

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Dr. John Cush @RheumNow( View Tweet )
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Pollution and Autoimmunity (7.12.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

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PMR - a Risk Factor for Recalcitrant Giant Cell Arteritis? Despite the clinical similarities and treatment differences between giant cell arteritis (GCA polymyalgia rheumatica (PMR), confusion exists regarding the impact of overlapping disorders. https://t.co/Slnq68YQgh https://t.co/nCYswGmlCk

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Best of 2023: PMR: glad or bad tidings?

Sarah Mackie, MRCP, PhD
Smile feedback opinion yes no good back opinion
Please don’t tell your patient that PMR “typically” lasts two years. According to real-world data from the UK, one in four patients with PMR is prescribed steroids by their primary care physician for over four years. But nobody tells them this at the start, and that causes big problems later on. Read Post

When PMR Strikes Young, It Hits Hard

Sarah Mackie, MRCP, PhD
figure pushing a ball uphill
Narratives around polymyalgia rheumatica (PMR) often centre around “older people” or even “elderly”. And, indeed, the peak of the age distribution is in the mid-70s – not that everyone that age considers themselves old. Treating “young PMR” can be a very different proposition to treating someone in their seventies or eighties. It’s worth taking time to think this through. Read Post

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