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Vasculitis

Adrenal Dysfunction after Steroids in PMR and GCA Patients

JAMA has published a study of PMR and GCA patients who stopped glucocorticoid (GC) therapy and noted a low (1.2%) risk of GC-induced adrenal insufficiency after planned cessation.

GC are widespreadly and chronically used in rheumatology, often with the

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World Changers (3.14.2025)

Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.

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Glucocorticoid Toxicity Index

Dr. John Stone has led the effort to develop the GTI - glucocorticoid toxicity index. In this review article he acknowledges the need and benefit of steroids, but details a novel means to identify and limit the untoward effects of glucorticoids (GC).

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2024 Rheumatology Year in Review

2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians.  While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list

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A Case of IgA Vasculitis Presenting as Duodenal Perforation Presentation by Dr. Audrey Liu, at the Rheumatology Winter Clinical Symposia - Feb 2025 https://t.co/kZWgy1S0Wh https://t.co/9mJAzVRVpl
Dr. John Cush @RheumNow( View Tweet )

A Review of Relapsing Polychondritis

A current review in the Journal of Thoracic Disease on relapsing polychondritis (RP), suggests that while this rare disorder may have an uncertain pathogenesis, its diagnosis and therapeutical management has improved.

This review focuses on key features, with damage to

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AbbVie Receives Positive CHMP Opinion for Upadacitinib (RINVOQ®) for the Treatment of Adults with Giant Cell Arteritis https://t.co/WP8JGpHc6p https://t.co/x9m870mCJ4
Dr. John Cush @RheumNow( View Tweet )
Retrospect. study of 77 RA pts w/ +ANCA (age 62 yrs, 79%F. 65% RF+. 45% p-ANCA+; 42% MPO+. Diagnoses included: AAV (29%); GPA (45%), MPA (36 %); EGPA (5%). Renal (41%) & upper Resp (36%) were most freq. Pts w/ RA+AAV had more RF, MPO+, nodules, inflam eye Dz… https://t.co/NTvAhZY2y8 https://t.co/IAkWHtcTCo
Dr. John Cush @RheumNow( View Tweet )

Opioid Deaths are Down (2.28.2025)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  Opioid deaths are down, IL-33 levels are up and Weight loss is in the news again this week!

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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
Dr. John Cush @RheumNow( View Tweet )

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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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).

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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
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/f7OwxAggafhttps://t.co/PUuwo0MLso https://t.co/JBzokT9icx
Dr. John Cush @RheumNow( View Tweet )
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