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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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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
Dr. John Cush @RheumNow( View Tweet )

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.

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

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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.

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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
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.

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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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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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Pulse Steroids with Tocilizumab in Giant Cell Arteritis

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
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
Dr. Antoni Chan @synovialjoints( View Tweet )

Higher Cancer Rates (8.16.2024)

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
Dr. John Cush @RheumNow( View Tweet )

Depends on Where You’re Looking (8.9.2024)

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
Dr. John Cush @RheumNow( View Tweet )

Relapses with Rituximab Maintenance in ANCA-associated Vasculitis

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
Dr. John Cush @RheumNow( View Tweet )

PEXIVAS: Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis Patients

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
Dr. John Cush @RheumNow( View Tweet )

Best Rheumatologists (7.19.2024)

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
Dr. John Cush @RheumNow( View Tweet )

Pollution and Autoimmunity (7.12.2024)

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
Dr. John Cush @RheumNow( View Tweet )