Predicting Infection in Lupus Nephritis

Machine learning (ML) models were applied to 3 cohorts of lupus nephritis (LN) patients and established algorithms to predict co-infection in LN.

buff.ly/3QnErcy

Our final TNR for the month of April will take place on 4/30 at 6:30pm ET.

Mastering SLE
Rethinking Pre-Clinical Disease in Lupus - David Karp, MD
Biology and Rx of Lupus Flares - Michelle Kahlenberg, MD
Current/Future Biomarkers in SLE - Andrea Fava, MD

buff.ly/3Qp0nEl

Predicting CKD Outcomes in Lupus Nephritis

An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class.

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In biologic-naïve active PsA pts Rx w/ guselkumab & achieving enthesitis (ER) or dactylitis resolution (DR), had better PRO outcomes. GUS - ER or DR was assoc w/ minimal pain (p < 0.001), normalized HAQ-DI (p < 0.001), , better FACIT-Fatigue responses buff.ly/3w3eetb

In 530 #GCA pts, relapses seen in 46%; but severe relapse (ischemi/aortic events) in 3%. Severe GCA relapse pts more likely to be younger at Dx(P=0.02), w/ more limb claudication(< 0.0001), fewer GCA-related cranial Sxs (<0.0001); but not higher mortality buff.ly/3xX3Jbm

With the FDA's approval of its 50th biosimilar - they have published 'A Milestone in Facilitating the Development of Safe and Effective Biosimilars'. Since biosimialrs were approved in 2015, they saved the health care system $23.6 billion. buff.ly/3w4jhto

Venous thromboembolic event Risk study in 1854 SLE pts vs controls (12,107) from 1985–2015 in W Australia. VTE affected 12.8% SLE pts; 6 fold higher than controls (RR 6.6). Risk factors: aPL(aHR 4.24), serositis (2.7), nephritis (1.75), low Plts (1.65) buff.ly/3QmAzsG

JAMA review of ILD; that affects 650,000 in USA, leading to 25,000-30,000 deaths/YR. Types reviewed. Key Symptoms: dyspnea and cough, w/ chest CT being diagnostic tool. Antifibrotic & immunomodulatory may slow disease progression. buff.ly/3JAFAd8

Is Colchicine Rx a problem? Retrospective study of UK Clinical Practice registry, 13945 gout initiated allopurinol with colchicine (64yrs; 78% male). 26% on 1+ meds interacting w/ colchicine. Diarrhea & MI more freq w/ comorbidities & more severe CKD buff.ly/3JDJIcp

'Drug Rediscovery for Rare Immune Mediated Inflammatory Diseases’ - a 6 center consortium will study if JAKi (filgotinib) is effective and safe in 3 rare disorders -- Behcets, inflammatory myositis & IgG4 related disease. buff.ly/4dh7XL2

Articular Findings Sarcoidosis:
- Acute arthritis: Lg Jt Oligoarthritis; Loffgrens syndrome (hilar LN, arthritis, E. nodosum)
- Acute > Chronic arthritis
- Chronic arthritis: tenosynovitis, oligo- &polyarthritis, dactylitis, erosions or Jaccouds arthritis

Hyperpigmentation from Hydroxychloroquine. From 316 HCQ pts, 26% got hyperpigmentation; delayed onset of 12 mos (6–30mos) after median cum. dose of 108 g. Seen on face (602%), Legs (36%) & hands (20%). Daily sun exposure decrease in the incidence (P=0.02) buff.ly/4a1eiaC

Predicting CKD Outcomes in Lupus Nephritis

An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class.

buff.ly/4bfwajd

1/3 of lupus nephritis patient classified as ''complete responders'' continued to accrue progressive renal damage despite resolution of proteinuria over 1 year.
Dr. Andrea Fava reviews GFR trajectories after renal bx at #RNL2024 Dr. John Cush buff.ly/3xSICHa

#RNL2024
David Karp
Incomplete lupus is heterogeneous term
''Stage 2'' pre-classification stage as ILE/UCTD

Stage 1: non-specific antibodies, dysregulation
2: incomplete features
3: classified, multi-system disease
4: irreversible tissue damage buff.ly/4aNqFID

Urine proteomics in lupus nephritis
IL-16 and CD163 are urinary biomarkers most correlated w/ histologic activity
Myeloid &amp; degranulation sign ass w histo activity -&gt; PR3+cells abundant in LN
Andrea Fava #RNL2024 Dr. John Cush buff.ly/4aWvwra

Venous thromboembolic event Risk study in 1854 SLE pts vs controls (12,107) from 1985–2015 in W Australia. VTE affected 12.8% SLE pts; 6 fold higher than controls (RR 6.6). Risk factors: aPL(aHR 4.24), serositis (2.7), nephritis (1.75), low Plts (1.65) buff.ly/3vYMo1e

Our final TNR for the month of April will take place on 4/30 at 6:30pm ET.

Mastering SLE
Rethinking Pre-Clinical Disease in Lupus - David Karp, MD
Biology and Rx of Lupus Flares - Michelle Kahlenberg, MD
Current/Future Biomarkers in SLE - Andrea Fava, MD

buff.ly/3UdXgAf

Prospective look at 25 280 older adults (mean 74yrs) w/ incident fracture, shows impact of multimorbidity by Charlson Comorbid Index (CCI). If CCI =2-3, Incr risk of subseq Fx (16-25%) & death (HR ~2); If CCI=4+, Fx Risk ^33-48%, death HR~4. buff.ly/4bttP4n

Prevalence of MSK presentations in practice = 21.1%, based on UK practice cohort. Most common: pain in LS spine (18%) & knee (17%). Re-presentations of existing Dx made up 74% all MSK consultations. Steroid injx given to 1/3 of knee consults buff.ly/3UcGoK3