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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Best of 2024: Vasculitis Pearls
https://t.co/3gE4VvXkby https://t.co/8qDiuGOHMc
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/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
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 )
ICYMI: Are Emulation Trials a Fantasy?
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)
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?
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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Drug-Free Remission in Giant Cell Arteritis is Uncommon
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
ICYMI: SELECT-GCA suggests JAKis may be the new kid on the block
Clinicians treating giant cell arteritis (GCA) have long had to contend with a disappointingly limited selection of drugs from which to select. A new group of drugs is finally showing promise in the treatment of GCA.
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Full Read Review of the Pulmonary Manifestations in Antisynthetase Syndrome (good reference!) https://t.co/gBLYRmHKE4 https://t.co/pUWmQCHk0N
Links:
Dr. John Cush @RheumNow( View Tweet )
ACR24: Rheumatology Roundup
Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.
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#ACR24: What I learned in Sjogren's, Takayasu's and CAR-T
Dr. Janet Pope reviews abstract 2527 and abstract 1696.
https://t.co/rrrGnOhfIV https://t.co/Ht1UTtYOLI
Dr. John Cush @RheumNow( View Tweet )
SELECTing the right patients: upadacitinib in GCA
Dr. Brian Jaros reports on abstract 1695, presented at #ACR24.
https://t.co/x8lLTviOKk https://t.co/yXwwrdgIyu
Dr. John Cush @RheumNow( View Tweet )
🌟IgG4RD: Lessons from the first 20 years🌟by Prof John Stone
⭐️Lesson 1- IgG4RD is a variable vessel vasculitis
✨Can cause small vessel vasculitis of the skin
✨One of few vasculitis causing coronary arteritis in adults
⭐️Lesson 2- IgG4RD is more common and severe in males… https://t.co/PvFXyOl5bp https://t.co/hAMelBoZvB
Links:
Darpan Thakare @darpan06T( View Tweet )
A new score to quantify GCA inflammation?
The treatment paradigm for Giant Cell Arteritis (GCA) has been a binary approach to the presence or absence of vasculitis. When GCA is present, we institute high doses of glucocorticoids for treatment of the inflammatory process. #ACR24… https://t.co/b5H7KOtZPC https://t.co/AvrwHcXI7r
Dr. John Cush @RheumNow( View Tweet )
JAK inhibitors in GCA?
We have a phase 3 trial in giant cell arteritis back on the opening day plenary stage. The SELECT-GCA study, looking at upadacitinib in GCA, was scheduled to anchor the #ACR24 opening plenary for a reason - it is highly notable and badly needed.… https://t.co/aJ3uao1wD7 https://t.co/6ao2OoODHg
Dr. John Cush @RheumNow( View Tweet )
ANCA Vasculitis "Eye": Can rituximab help?
Dr. Janet Pope discusses abstract 0726 at #ACR24
https://t.co/KzYcmjon8D https://t.co/KDIi1vJE4P
Dr. John Cush @RheumNow( View Tweet )
Hypoxia seems to exacerbate neutrophil activation by ANCA
- enhanced F-Actin polymerization
- enhanced NET formation
Could hypoxia predilection in certain tissues (kidney, lung) lead to the AAV phenotypic disease patterns?
@RheumNow #ACR24 https://t.co/KxaeMvkd2t
Links:
Brian Jaros, MD @Dr_Brian_MD( View Tweet )
Hydralazine - known culprit of drug-induced AAV
How does hydral (H) AAV differ from primary (1) AAV?
💥 High dual positivity MPO/PR3
💥 DAH / pleuritis more common in H-AAV
💥 ENT, constitutional, nervous, ILD in 1-AAV
💥 More 6mo remission in H-AAV
@rheumnow #ACR24 Abst 2496
Brian Jaros, MD @Dr_Brian_MD( View Tweet )
SELECT-GCA suggests JAKis may be the new kid on the block
Clinicians treating giant cell arteritis (GCA) have long had to contend with a disappointingly limited selection of drugs from which to select.
https://t.co/vtJzwFZMBq https://t.co/dikMRwjIZY
Dr. John Cush @RheumNow( View Tweet )
A new score to quantify GCA inflammation?
The treatment paradigm for Giant Cell Arteritis (GCA) has been a binary approach to the presence or absence of vasculitis. When GCA is present, we institute high doses of glucocorticoids for treatment of the inflammatory process. This approach is not well individualized to the patient as we do
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