Vasculitis

Covid lung pneumonia corona (keep)

Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C)

Jack Cush, MD

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

Jack Cush, MD

Lancet reports a French study demonstrating the efficacy of baricitinib in patients with polymyalgia rheumatica (PMR).

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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

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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 )
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Alive in 2025 (1.10.2025)

Jack Cush, MD

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

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Dr. John Cush @RheumNow( View Tweet )
CV,risk,MI,heart,cardiac

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

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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

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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

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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

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Dr. John Cush @RheumNow( View Tweet )
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Bah Humbug Vitamin D (12.20.2024)

Jack Cush, MD

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

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Dr. John Cush @RheumNow( View Tweet )
Seo RNL

Best of 2024: Vasculitis Pearls

Richard Conway, MBBChBAO, PhD

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

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Dr. John Cush @RheumNow( View Tweet )
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Tocilizumab Efficacy in Giant Cell Arteritis Phenotypes

Jack Cush, MD

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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Avacopan, a C5aR antagonist, for Rx of ANCA-Assoc GPA & MPA. Main warning for liver AE. In RCTs, abnl LFTs seen in 11.6-13.3% and 4.2% D/C drug for liver probs. Recent Japanese report of 22 AAV pts with AVACO Liver injury seen in 9 pts - Severe, incr total bilirubin in 4, 1 pt… https://t.co/LyuIQhwOoQ https://t.co/TAmQ9vph4V
Dr. John Cush @RheumNow( View Tweet )
Review of IgA Vasculitis (Henoch–Schönlein Purpura) - the freq of glomerulonephritis is higher in adults than children and tends to present more severely. Rx w/ 1st line steroids, Other agents: Colchicine, dapsone, MTX (Minor dz), CsA, tacrolimus, MMF (steroid sparing)… https://t.co/tB5fll3RfN https://t.co/knc7KesyRj
Dr. John Cush @RheumNow( View Tweet )
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ICYMI: Are Emulation Trials a Fantasy?

Janet Pope, MD, MPH, FRCPC

Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?

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54K Peptic Ulcers Annually (12.13.2024)

Jack Cush, MD

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

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ICYMI: Say Goodbye to Methotrexate in PMR?

Patricia Harkins, MD

For decades, glucocorticoids (GCs) have formed the backbone of polymyalgia rheumatica (PMR) management. Whilst previously there was a sense that a “low” GC dose with limited duration was used, we now appreciate just how heterogenous the disease course of PMR can be, with many

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GCA temporal artery

Drug-Free Remission in Giant Cell Arteritis is Uncommon

Jack Cush, MD

A Spanish retrospective registry study of patients with giant cell arteritis (GCA) found that 3-4 years after diagnosis, only 21% of patients with GCA successfully reached the sustained drug-free remission (SDFR). But if SDFR was achieved, the likelihood of experiencing recurrence was

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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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