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Scleroderma/Raynauds

👌Superb review of #SSc ILD by @sclerodermaUM #ACR21 👉EARLY/SUBCLINICAL is NOT Mild ILD 👉MMF 1st 👉TCZ in combination for progressive phenotype/progression 👉Nintedanib:start slow, uptitrate for GI tolerability 👉Early HSCT referral (early dcSSc, FVC&DLCO 45-80%, Normal🫀) https://t.co/MUOhc3PakH
Ashima Makol MD @AshimaMakol( View Tweet )
Nov 09, 2021
Prof. Ami Shah: Patients with #scleroderma have an ⬆ risk of #cancer vs. general population 📌Data from 3 recent meta-analysis: Scleroderma pts have 1.4 to 1.8 fold increased risk of cancer @RheumNow #ACR21 https://t.co/4uQN6y3tIn
Nov 09, 2021
Dr. Ami Shah shares her approach to cancer screening in patients with #scleroderma👇 @RheumNow #ACR21 https://t.co/chmlGe4iyl
Nov 09, 2021
Who declines most with #scleroderma #ILD - early dcSSc, ⬆️CRP, ⬆️mRSS all w more ⤵️FVC. Results verified in SENSIS trial of SSc ILD where #nintedanib was superior to placebo abst#1846 #ACR21 @RheumNow https://t.co/eckUj0qwch
Nov 09, 2021
Dr Ami Shah - Scleroderma & Cancer: 🛑 ⬆️ risk of ca around the time of dx in SSc patients with RNA-pol-III (especially first 5 years after dx), anti-Th/To protective? 🛑Her approach for ca screening in newly diagnosed with SSc pts and red flags as below #ACR21 #ACRambassador https://t.co/2VcWn2UInm
Didem Saygin, MD @didemsayginmd( View Tweet )
Nov 09, 2021
What if a celebrity had #Scleroderma? Would that ⬆️attention & funding for this rare disease? See what Big Bird says @RheumNow #ACR21 ?affected #PetsofACR @RheumNow @scleroderma @SclerodermaCAN audio-13.m4a
Nov 09, 2021
#ACR21 Thieves: SLE and SSc with worsening cytopenia and hematuria despite treatment: Maria Powell - presents overlap case with PNH, responded to eculizumab @Rheumnow https://t.co/CGvHEMA3lI
Nov 09, 2021
Interesting thoughts from Dr. Distler re:nintedanib & MMF in SSc-ILD Agree we should look into MMF-nintedanib combo, but this graph makes me think MMF > NIN Why would that be? Unlike NIN, MMF pts were NOT randomized, which likely favors NIN for a few (speculative) reasons: https://t.co/ZHBD8x74PM
Mike Putman @EBRheum( View Tweet )
Nov 08, 2021
🔥Continued, More Clinically Meaningful data in #SSc #ILD from #Nintedanib in >52 wk SENSCIS & SENSCIS-ON(open-label ext)#ACR21 Dr Distler ✨MMF likely to stay 1st line, then Nintedanib ❓Is it time for MMF + Antifibrotic upfront?? Await SLS-III;Data so far seems supportive https://t.co/JWXMlsJgmc
Ashima Makol MD @AshimaMakol( View Tweet )
Nov 08, 2021
Lab work

Infection or Disease Flare: What Tools Can Help Differentiate?

Nov 08, 2021

Differentiation between a flare of disease and infection in patients with autoinflammatory (AI) conditions, where fever is the hallmark, can be extremely difficult. Few studies have evaluated potential differentiators; and having such tools would meet a huge unmet need. 

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#ACR21 Abs#1367. Scleroderma pts with absent contractility (AC) associated with diffuse cutaneous disease, cardiac involvement, more severe Raynaud's. ⭐️14/67 AC pts died during study (21%), none without AC ⭐️15/16 Ro52+ pts had AC (p=0.06)https://t.co/GAuOiV5ScC @Rheumnow
Nov 08, 2021
#ACR21 #pedsrheum juvenile localized scleroderma Polypositive profile 3 or more autos correlated with more severe skin score, more activity https://t.co/vVXV4jjLvG
Dr. Laura Lewandowski @LauraLewMad11( View Tweet )
Nov 07, 2021
✨Great Pearls when screening patients for clinically suspect #Scleroderma or #Juvenile #Dermatomyositis 📌 Don’t Stop Work Up at Negative ANA if strongly suspect SSc 📌 #Myositis Specific Antibodies have different phenotypes in kids than adults (MDA-5, TIF-1g, NXP-2) #ACR21 https://t.co/KrkkzA5bkV
Ashima Makol MD @AshimaMakol( View Tweet )
Nov 07, 2021
Clinical Pearl at #ACR21 by Dr. John Stone: ⭐️Patients w/ RNAPIII positive SSc do not always have puffy hands, Raynaud's phenomenon, or ANA positivity! #ACRBest @RheumNow @SChatterjee https://t.co/9J6OBibi4l
Meral K. El Ramahi, MD @MeralElRamahiMD( View Tweet )
Nov 07, 2021
ACR Best

ACR21 Best Abstracts - Day 1

Nov 07, 2021

The RheumNow faculty have been glued to their monitors all day, watching video, and running down abstract presentations to find the best – several of these stood out as #ACRBests. Here is a listing of “Best” they saw on Day 1.

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Blacks with Systemic Sclerosis May Have More Severe Disease

ACR
Nov 02, 2021

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that Black people living with systemic sclerosis may have more severe disease and worse prognosis than patients in other racial or ethnic groups, and these worrying disparities may

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Nationwide 2 yr F/U study, 11 centers, 300 pts with early (1.2 yrs) systemic sclerosis shows, despite most (2/3) on immunosuppressives, 71% progressed to diffuse SSc, 21% worsen Skin, 23% worse FVC & 6.6% died (cardiac, GI, ILD) https://t.co/UfagmX2S16

Dr. John Cush @RheumNow( View Tweet )

Oct 29, 2021
Methotrexate is the most often-studied treatment and has best clinical outcomes in children and adults with localized scleroderma en coup de sabre. Metanalysis of 34 articles, only 4 RCTs, but 24 case reports. More research needed. https://t.co/fSEvDw2pge

Dr. John Cush @RheumNow( View Tweet )

Oct 27, 2021
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RheumNow Podcast – #ACA: Ask Cush Anything (10.8.2021)

Oct 08, 2021

Arthritis numbers are rising, and people are finally talking about osteoarthritis. Also, ACR 2021 is just a few weeks away - are you ready? Finally, I'll review cases and questions submitted by viewers in Ask Cush Anything (#ACA). This, and nearly a dozen news items and reports, are discussed in

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Having both Cancer & Systemic sclerosis (SSc) is rare. Study of 1481 SSc pts saw cancer Dx w/in 2, (1.35), 3 (2.1%) & 5 yrs (3.5%;mostly breast, GYN, Heme CA). Higher 2 yr risk w/ topoisomerase I Ab (OR 3.43), U1-RNP (5.54), but not RNA polymerase III) https://t.co/dVuchv8Afv https://t.co/azGmJYifrj
Dr. John Cush @RheumNow( View Tweet )
Oct 07, 2021
PSS.scleroderma.arthritis.contractures

IL-6 Inhibition in Refractory Systemic Sclerosis

Sep 22, 2021

A small, single-center cohort analysis of difficult, refractory systemic sclerosis (SSc) patients showed that treatment with tocilizumab (TCZ), an interleukin-6 inhibitor, resulted in significant improvement in joint and skin involvement, regardless of SSc disease duration or subtype. 

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RheumNow Podcast – Do More DMARDs Mean More Switching? (9.17.2021)

Sep 16, 2021

Smartphones and diet; COVID-19 and the numbers - reassuring or not, and what about masks?; and do more drugs mean more switching, less persistence, and patient adherence goes up...or down? All this and more news and journal reports in this week's episode.

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ICYMI:https://t.co/wM1iRxtHvkThe interleukin-6 inhibitor, tocilizumab (TCZ), was studied in a cohort of difficult systemic sclerosis (SSc) and was shown to be effective in refractory joint and skin disease with good long-term retention rates and disease stabilization. https://t.co/A8dfCksp3b
Dr. John Cush @RheumNow( View Tweet )
Sep 12, 2021
A retrospective study of systemic sclerosis patients shows that acute hospitalization and mortality were not uncommon and were often linked to SSc-related lung disease. #RheumNowhttps://t.co/s5wSlndTrt https://t.co/KHz9LYZVAK
Dr. John Cush @RheumNow( View Tweet )
Sep 10, 2021
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Risk Factors Associated with Systemic Sclerosis Hospitalization

Sep 09, 2021

A retrospective study of systemic sclerosis patients shows that acute hospitalization and mortality were not uncommon and were often linked to SSc-related lung disease.



Record review of 95 SSc patients from a single-centre cohort seen between 2010 and 2020 found that over half (53

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