The VALOR phase 3 trial shows that brepocitinib 30 mg daily — a selective TYK2–JAK1 inhibitor — significantly improves composite disease activity, skin involvement, and muscle strength while enabling steroid discontinuation in adults with treatment-refractory dermatomyositis, marking the first successful phase 3 RCT of an oral targeted agent in this disease.

Step through a 76-year-old woman’s diagnostic journey — palpable purpura, falling kidney function, a stroke, a new murmur — one finding at a time. Fourteen multiple-choice checkpoints test how you reshape the differential as each piece of data lands.

A contemporary NEJM review of idiopathic inflammatory myopathies — the five-subtype framework (IBM, IMNM, antisynthetase syndrome, overlap, dermatomyositis), the autoantibody revolution that now anchors classification, and the shift toward subtype-specific therapy with biologics, JAK/TYK2 inhibitors, and CAR-T.

In a 28,781-patient EMR phenome-wide study, a high ANA titer (≥1:640) without autoimmune disease was strongly enriched for non-AI liver disease (NAFLD/NASH, alcohol-related) and metabolic comorbidity — broadening the differential for an unexplained high-titer ANA beyond the usual autoimmune workup.

CD19 CAR-T cellular therapy delivers drug-free remission in 80–85% of refractory SLE patients in early-phase trials, with similar signals in IIM and SSc — the first credible attempt at true immunological reset in autoimmune rheumatic disease.

A new permanent home for Rheumatology Digest — daily clinical write-ups and interactive case-based learning, archived and searchable.