Yhojan Rodríguez

Internista - Epidemiólogo.

Equipado con sus 5 sentidos, el hombre explora el universo que lo rodea y a sus aventuras las llama ciencia. E.P.H

[R3 | Rheumatology Rapid Review @BodhibrataB]

⭐ Anifrolumab in SLE

[Aravind Palraj @Rheumat_Aravind]

PMR is often not a short steroid course.

In a nationwide 2026 cohort of 51,401 patients:
28% were still on prednisolone at 5 years
22% at 10 years

And most late-onset GCA developed within the first year after PMR diagnosis.

PMR deserves long-term follow-up—not just a taper plan.

#PMR #GCA #Rheumatology @DurgaPrasannaM1 @IhabFathiSulima #Glucocorticoids #Vasculitis

[reUNma2023 @reUNma2023]

Gammagrafìa osea en reumatologìa

-Razones para no usar de manera regular👇👇

#gammagrafiaUN
#visualabstracsUN

[Walter Suárez Carmona @a_fisiolog57853]

SISTEMA DE COMPLEMENTO

Baño de humildad para quienes piensan que la inmunología es sencilla. En este caso, centrado en el sistema de complemento.

¡¡¡A leer, zagales!!!

Link en mi bio

o
https://t.co/aLH80XB2qW

[Leonardo Santos @Leo_Santo5]

💊📉Cómo Retirar los Corticoesteroides de Forma Segura?

⏱️Duración del Tratamiento
💉Reducción Rápida-Gradual-Lenta
🧠Supresión del Eje HPA
🚨Insuficiencia Suprarrenal

📖Indian Journal of Endocrinology and Metabolism

Artículo Completo👇🏼✅🆓
https://t.co/aR5SFK2xfj

[ACR_Journals @ACR_Journals]

Survey study investigated characteristics of patients reporting myositis pain (n=552):
•most painful areas were back, neck, & upper legs (mean pain intensity 4.6/10)
•~60% met fibromyalgia criteria and reported persistent & widespread pain
•pain intensity was highest in overlap myositis & lowest in inclusion body myositis

ACROR
https://t.co/JnfWuUOFW0

[R3 | Rheumatology Rapid Review @BodhibrataB]

⭐ When a positive ANA truely matters?

[Aravind Palraj @Rheumat_Aravind]

🚨 2026 ACR Axial SpA guideline update — 5 points worth remembering

1️⃣ Imaging differs by age
Adults → AP pelvis radiograph first
Children/adolescents → SI-joint MRI without contrast preferred initially

2️⃣ NSAIDs remain first-line for active adult axSpA.

3️⃣ TNFi, IL-17i and JAKi are effective targeted options — but TNFi/IL-17i are preferred over JAKi initially.

4️⃣ Extra-musculoskeletal disease should drive drug choice
👁 Recurrent uveitis → monoclonal TNFi
🧬 IBD → monoclonal TNFi
🩹 Psoriasis → IL-17i

5️⃣ After targeted-therapy failure, consider switching mechanism and reassess the diagnosis, adherence and nociplastic pain after multiple class failures.

Also important:
🚫 IL-23 inhibitors are strongly recommended against in adult axSpA.

A useful update for everyday rheumatology practice.

Source: 2026 ACR/SAA/SPARTAN Recommendations for the Treatment of Axial Spondyloarthritis in Adults and Children/Adolescents.

#Rheumatology #AxialSpA @docakx @IhabFathiSulima #Spondyloarthritis #ACR #MedEd

[Aravind Palraj @Rheumat_Aravind]

GPA, MPA, and EGPA can all present as ANCA-associated vasculitis—but the clinical phenotype often tells you where to look.

GPA → destructive ENT disease + pulmonary nodules/cavitation + GN
MPA → RPGN + pulmonary capillaritis/DAH, without granulomatous ENT disease
EGPA → asthma + eosinophilia + neuropathy; ANCA status often tracks phenotype

The overlap is real. The pattern is the clue.

#Vasculitis #Rheumatology #AAV #ANCA #MedEd @IhabFathiSulima @docakx

[Aravind Palraj @Rheumat_Aravind]

Not every Sjögren’s advance is a new biologic.

RepurpSS-II (n=46): leflunomide + HCQ improved ESSDAI versus placebo at 24 weeks (difference −4.14; p=0.0012).

Small phase 2b trial. Systemic disease—not isolated sicca. #Sjogrens #Rheumatology #MedTwitter @IhabFathiSulima @docakx

[reUNma2023 @reUNma2023]

#RodnanSkinScore
#mRSS
#visualabstracsUN

[Aravind Palraj @Rheumat_Aravind]

PsA is often an inflammatory–metabolic disease.

TOGETHER-PsA (n=271): adding tirzepatide to ixekizumab improved ACR50 (33.5% vs 20.4%) and the combined ACR50 + ≥10% weight-loss endpoint (31.7% vs 0.8%).

Treat both. #PsoriaticArthritis @IhabFathiSulima #Rheumatology

[Abdul Muqtadir Abbasi @AbbasiMuqtadir]

Residents and medical students !!!!

So why platelets go low in Immune thrombocytopenia aka ITP?

#x #itp #platelets #medtwitter #foamed

[ACR_Journals @ACR_Journals]

Transcriptomic analysis of B cell subsets from SLE patients revealed that CASTOR1 expression is associated with disease activity. Consistently, Castor1-deficient mice developed SLE-like autoimmunity, demonstrating CASTOR1 may contribute to the pathogenesis of autoimmune diseases such as SLE

A&R
https://t.co/jjmki8m3FY
@UTokyo_Rheum

[Ahmed S. A. @guidelinesMed]

Simplified diagnostic criteria for autoimmune hepatitis

[Aravind Palraj @Rheumat_Aravind]

1/10
🚨 ANCA-positive pulmonary–renal syndrome: the positive ANCA may be the beginning of the diagnosis—not the end.

A strongly positive MPO-ANCA can tempt us to immediately label the patient as MPA.

That is exactly where diagnostic anchoring begins.

A rheumatology thread 🧵
@IhabFathiSulima @docakx #MedTwitter

[Abdulhamid @abdulhamid_199]

مهما كان تخصصك الطبي
بشري او اسنان او تمريض

هذه الصورة تختصر لك ال Vitamins

مع ذكر الامراض اللي تصير لكل واحد منهم

والاحتياج اليومي ايضا

[Aravind Palraj @Rheumat_Aravind]

FDA has approved oral brepocitinib 30 mg daily for adult dermatomyositis.

In VALOR, mean TIS at Week 52 was 46.5 vs 31.2 with placebo, alongside skin and steroid-sparing benefits.

Serious infections: 10% vs 1%.

A major advance—with JAK-class cautions.

#Myositis #Rheumatology

References: Phase 3 VALOR trial—NEJM⁠ | FDA prescribing information⁠

[Dr.Mukesh , MD , DM @dr_immuno29]

🩺 Low Back Pain (LBP): Evidence-Based Essentials | JAMA 2026

Low back pain is the #1 cause of Years Lived with Disability (YLD) worldwide. While imaging is often overused, ~90% of cases are nonspecific and respond to conservative care.

🔑 Clinical Pearls
• Don’t image routinely—treat the patient, not the MRI.
• Always exclude red flags (cancer, infection, fracture, cauda equina syndrome, axial spondyloarthritis).
• Distinguish mechanical from inflammatory back pain.

✅ Management

Acute NSLBP
• Reassure & educate
• Stay active; continue work
• Avoid bed rest
• Superficial heat
• NSAIDs (first-line, if appropriate)
• Short-course muscle relaxant may be considered for selected patients

Chronic NSLBP
• ⭐ Exercise is the cornerstone (aerobic, core, resistance, flexibility)
• Cognitive behavioural therapy (CBT)
• Multidisciplinary rehabilitation
• NSAIDs as adjuncts
• Duloxetine (especially with central sensitization, fibromyalgia overlap, depression, or neuropathic features)
• Reserve tramadol only when other options fail

❌ Avoid / Not Recommended

• Routine MRI (without red flags)
• Bed rest
• Acetaminophen monotherapy
• Benzodiazepines
• Routine opioid use
• Gabapentin/Pregabalin for nonspecific LBP
• Systemic corticosteroids

📚 Reference: Cashin AG, JAMA. 2026.
DOI: 10.1001/jama.2026.9631

Take-home message:
Acute LBP → Reassure • Keep moving • Heat • NSAIDs (± short-course muscle relaxant).
Chronic LBP → Exercise first; CBT and multidisciplinary rehabilitation form the foundation. Drugs are adjuncts—not the treatment.

#LowBackPain #BackPain #Rheumatology #PainMedicine #PrimaryCare #Spine #EvidenceBasedMedicine #JAMA #FOAMed #MedicalEducation #AxialSpondyloarthritis

[Aravind Palraj @Rheumat_Aravind]

Deucravacitinib may do more than control symptoms in PsA.

POETYK PsA-1 showed ACR20 benefit at Week 16 and inhibition of radiographic progression through Week 52.

But the Week-52 imaging analysis was post hoc, descriptive and had no placebo comparator.

Promising—not definitive.

#PsA #Rheumatology @DurgaPrasannaM1 @IhabFathiSulima @docakx

Reference: POETYK PsA-1 Week-52 results⁠ | Trial registration: NCT04908202⁠