Occult Strongyloides stercoralis infection is an under-recognized safety problem in rheumatology and autoimmune care because clinically silent infection may accelerate into hyperinfection after glucocorticoids or other potent immunosuppression. STRONGY-GUARD is an executable Python skill that converts this bedside problem into a transparent 0-100 risk-context score using endemic exposure, eosinophilia, positive serology, positive stool/larvae, glucocorticoid intensity and duration, pulse methylprednisolone, rituximab/cyclophosphamide exposure, HTLV-1, compatible symptoms, gram-negative sepsis, current immunosuppression, and recent ivermectin treatment.
Vaccination planning around rituximab is a recurring clinical problem in rheumatic and autoimmune disease because clinicians must balance infection-prevention urgency against expected vaccine blunting after B-cell depletion. RTX-VAX is an executable Python skill for transparent readiness stratification before non-live vaccination.
Adult-onset Still disease activity is often described narratively despite major variability in systemic burden and MAS risk. AOSD-ACTIVITY is an executable Python skill that computes a transparent 12-item systemic feature score rooted in published Still disease literature, then layers practical MAS warning heuristics using ferritin, fibrinogen, platelet count, transaminases, and triglycerides when available.
AXSPA-MODEL is an executable clinical skill for axial spondyloarthritis follow-up. It combines BASDAI, ASDAS-CRP, ASDAS-ESR, BASFI, BASMI, ASQoL, EQ-5D VAS, and ASAS20/40 response into a transparent longitudinal treat-to-target framework.
Pegloticase can produce major improvement in uncontrolled gout, but safe use depends on recognizing G6PD deficiency, urate rebound, prior infusion reactions, weak monitoring setups, and danger symptoms before harm occurs. We present PEGLOTI-GUARD, an executable Python skill for transparent pegloticase infusion-safety risk-context stratification.
Medication-related osteonecrosis of the jaw (MRONJ) is uncommon in routine osteoporosis care, but when it occurs it is clinically disruptive, difficult to reverse, and often amplified by avoidable dental and host-level cofactors. ONJ-GUARD is an executable Python skill for transparent MRONJ risk-context stratification that integrates antiresorptive exposure type, therapy duration, invasive dental procedures, periodontal disease, oral trauma, glucocorticoids or immunosuppression, diabetes, smoking, prior MRONJ or exposed nonhealing bone, and active jaw symptoms.
We present ALLO-SAFE, a transparent executable clinical skill for relative risk stratification before or during very early allopurinol initiation. The model integrates HLA-B*58:01 status, ancestry-linked pretest concern, chronic kidney disease, planned starting dose, thiazide exposure, prior rash history, age, chronic liver disease, urgency pressure to start therapy, and baseline monitoring readiness.
NSAID-associated acute kidney injury remains a common and preventable clinical problem, especially in older adults, chronic kidney disease, heart failure, cirrhosis, volume depletion, and the classic ACE inhibitor or angiotensin receptor blocker plus diuretic setting. We present NSAID-AKI, an executable Python skill for transparent NSAID-associated AKI risk-context stratification.
# COLCHI-MYO: Transparent Colchicine-Associated Neuromyopathy Risk-Context Stratification Before or During Therapy
**Authors:** Dr. Erick Zamora-Tehozol, DNAI, RheumaAI
**ORCID:** 0000-0002-7888-3961
## Abstract
Colchicine remains an important anti-inflammatory drug in gout, calcium pyrophosphate disease, pericarditis, and selected autoinflammatory disorders, but clinically meaningful toxicity can emerge when exposure rises because of renal failure, dialysis, interacting drugs, or prolonged treatment.
ALLO-SCAR is an executable clinical skill for transparent allopurinol severe cutaneous adverse reaction risk-context stratification before initiation or during early toxicity assessment. The model integrates HLA-B*58:01 status, ancestry context, chronic kidney disease, allopurinol dose, diuretic exposure, cardiovascular comorbidity or hypertension, prior rash, timing since start, and early warning signs including fever, facial edema, mucosal involvement, eosinophilia, transaminitis, and creatinine rise.
Febuxostat is an important urate-lowering option when allopurinol is not tolerated, contraindicated, or ineffective, but cardiovascular safety remains a real bedside concern in patients with gout and high cardiac comorbidity. We present **FEBUX-CV**, a transparent executable skill for cardiovascular risk-context stratification before or during febuxostat exposure.
TNF-HF is an executable Python clinical skill for transparent heart-failure decompensation risk stratification before or during TNF inhibitor therapy in rheumatic and autoimmune disease. The model integrates TNF agent, NYHA class, left ventricular ejection fraction, prior heart-failure hospitalization, NT-proBNP, loop diuretic use, ischemic heart disease, uncontrolled hypertension, chronic kidney disease, diabetes, congestion symptoms, and recent TNF start or escalation timing.
MTX-PNEUMO is an executable Python clinical skill for transparent methotrexate-associated pneumonitis risk stratification in rheumatic and autoimmune disease. The model integrates age, time since methotrexate initiation, weekly dose, pre-existing ILD/fibrosis, abnormal baseline chest imaging, prior DMARD lung toxicity, diabetes, hypoalbuminemia, CKD, dyspnea, dry cough, fever, hypoxemia, eosinophilia, diffuse interstitial or ground-glass imaging pattern, and whether infection has been excluded.
We present CYCLO-OVA, an executable Python skill for transparent ovarian-failure risk stratification before or during cyclophosphamide exposure in rheumatic and autoimmune disease. The model integrates age, planned cumulative dose, oral daily versus pulse exposure, prior cyclophosphamide exposure, baseline low ovarian reserve or prior amenorrhea, expectation of repeated treatment cycles, other gonadotoxic exposures, fertility goals, GnRH agonist mitigation planning, and availability of less gonadotoxic alternatives.
Leflunomide-associated interstitial lung toxicity is uncommon but clinically important because presentations can be abrupt, severe, and difficult to separate from rheumatoid arthritis-associated interstitial lung disease or pulmonary infection. The bedside problem is not merely whether the adverse event is rare.
Lower gastrointestinal perforation during IL-6 blockade is uncommon but clinically serious, and tocilizumab has repeatedly been associated with higher rates of diverticulitis-related lower-GI perforation than several alternative biologic strategies in rheumatoid arthritis cohorts. We present TCZ-PERF, an executable Python skill for transparent risk stratification before or during tocilizumab use in rheumatic and autoimmune disease.
MMF-PREG is an executable clinical skill for transparent reproductive-safety triage around mycophenolate use in rheumatic and autoimmune disease. It addresses a real bedside problem: fetal-teratogenic exposure risk and preconception transition failure when patients remain on mycophenolate during possible conception, stop it without completed washout, or lack a pregnancy-compatible maintenance plan.
RTX-IGG is an executable clinical skill for transparent monitoring-oriented risk stratification of rituximab-associated hypogammaglobulinemia and infection vulnerability in rheumatic and autoimmune disease. The model integrates baseline and current IgG, IgM, rituximab course count, recency of dosing, maintenance intent, cyclophosphamide and glucocorticoid exposure, lymphocyte count, prior serious infection, chronic lung disease, kidney disease, and persistent B-cell suppression.