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3 x IL-23 = IL do Better (11.6.2026)
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Jack Cush, MD

Nov 06, 2026

Dr. Jack Cush reviews the FDA approvals and news reports from this past week on RheumNow.com. This week we discuss playing the numbers in rheumatology, playing the long game with stem cell transplants, and a=the Positive spin on seronegative RA.

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The Concern about Seronegative RA A current review of seronegative RA (SNRA) by D’Onofrio, et al in npj Autoimmunity shows the diverse fate of seronegative RA - which can resolve, persist or become refractory. Clearly dedicated trials of SNRA are needed to better predict. https://t.co/6OQhYemkUX

FDA Approves Tildrakizumab for Psoriatic Arthritis Sun Pharmaceuticals announced Friday that the FDA has approved its IL-23 inhibitor, tildrakizumab (Ilumya) for use in patients with active psoriatic arthritis. https://t.co/9vJoJ35iso https://t.co/KeA3Xh8QG9

FDA Approves Tildrakizumab for Psoriatic Arthritis | RheumNow

-AZA is safe in pregnancy but can cause risk of ICP. -Monitor pts on AZA closely for ICP symptoms. #ACR26 @RheumNow https://t.co/v9mNKVNKcm

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Emergence of systemic autoimmune rheumatic diseases can occur in menopause and difficult to differentiate from "MS syndrome of Menopause" HRT: Safe in Non-SLE autoimmune disease/SLE with negative APL+ use with caution/Not recommended in APL+/APS #ACR26 @RheumNow https://t.co/6al61n1ck3

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-Biologic DMARDs are generally safe for pregnancy: ETA and CZP safer compared to others. -B cell depletion can be used in pregnancy but caution about neonatal cytopenias for first 6m if dosed in 2nd half og pregnancy. -Counsel on vaccination for biologic exposed babies. #ACR26 https://t.co/byQgPpAveT

After stopping TCZ in GCA (~2 yrs exposure), over HALF of pts still flared w/in 72 weeks, even among pts w/imaging remission Most flares 3-6 mos post stopping Good evidence for continuing longer; I continue many pts on TCAZ up to 5 years post dx @RheumNow #ACR26 Ab#0186 https://t.co/yq0rXv1l3S

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Nice RWE study of UPA in GCA Refractory cohort w/multiple prior biologics; 22/34 evaluable pts had clinical remission at 6 months; 7/63 stopped for severe adverse events. Useful real-world signal, overall corroborates SELECT-GCA @RheumNow #ACR26 Ab#0184 https://t.co/hGRFAoV6B4

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Exercise is essential for pts w/myositis Improved fatigue and reduced disability among pts with myositis who engaged with structured exercise programs No comparator & small, but important message to pts who are often nervous about working out @RheumNow #ACR26 Ab#0652 https://t.co/c4tejsWQYk

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Beyond Chondrocalcinosis - What’s New in CPPD Disease An overview of calcium pyrophosphate deposition (CPPD) disease by Sara Tedeschi presents our evolving understanding of CPPD with advances affecting nomenclature, classification, imaging, genetics, long-term outcomes and https://t.co/YrFjGJZDph

Tocilizumab is effective in glucocorticoid-resistant adult-onset Still’s dz. 40 AOSD pts rx w/ TCZ (4-8 mg/kg q4wks). @12 mos clin remission 55%, 6 mos CID 62%, signif drops in CRP, ESR, ferritin & daily pred decr 91% (50 to 4.4 mg; p<0.001). TCZ retention 65%; MAS 7.5% & https://t.co/Olynr7VfhE

Japanese retrospective cohort systemic sclerosis study shows adjunctive tofacitinib improved ower esophageal sphincter pressures (LESP). 50 SSc pts w/ esophageal Sxs Rx w/ Tofa or PBO x 24 wks. Tofa assoc w/ signif LESP increases & lower mRSS & IL-6 levels https://t.co/NNREBddiOi https://t.co/acVOfoorRP

Tofacitinib and esophageal-related manifestations in systemic sclerosis: a retr…

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Ode to Our Editor: Honoring Dr. Jack Cush

Christopher Ritchlin, MD, MPH Artie Kavanaugh, MD Nov 06, 2026

For someone who has spent so much of his career recognizing the work of others, it is fitting that Dr. John J. “Jack” Cush should have his own moment in the spotlight.

Women's Health and Reproductive Issues: APLAR 2026 https://t.co/E3IjKP91qL https://t.co/imOGOjce83

Women's Health and Reproductive Issues: APLAR 2026 | RheumNow

Autologous HCT in Severe Systemic Sclerosis An international study reports 60% progression-free survival at 10 years after autologous bone marrow transplantation, adding important evidence on sustained positive clinical outcomes and long-term safety in patients treated for early https://t.co/2YhuAwMsXe

Three Tips to Stay on Muscarinic Agonists in Sjögren's Disease Resolution of dryness remains a key unmet need for patients with Sjögren disease (SjD), as highlighted by the Sjögren SIG session “How to treat SjD” on the final day of APLAR 2026. https://t.co/WrG8UF8Sne https://t.co/QMmZfUYWLq

Three Tips to Stay on Muscarinic Agonists in Sjögren's Disease | RheumNow

Big meeting. Plenty to talk about. Join RheumNow’s daily ACR 2026 recaps for standout data, thoughtful debate and clinical takeaways. Sunday, Nov. 8–Wednesday, Nov. 11 6 PM ET / 5 PM CT / 3 PM PT Watch LIVE on X, YouTube, Facebook or LinkedIn. https://t.co/SX6sSX9Tbe

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ACR Responds to Final Medicare Payment Rule from CMS

ACR Nov 05, 2026

The American College of Rheumatology (ACR) today issued the following statement in response to the final Medicare Physician Fee Schedule (MPFS) for calendar year 2027 (CY27) from the Centers for Medicare & Medicaid Services (CMS).

Medscape overview of Fibromyalgia Therapies. Only four FDA approved FM drugs in the USA - pregabalin (2007), duloxetine (2008), milnacipran (2009) & sublingual cyclobenzaprine (2025) but none approved by the EMA in Europe. https://t.co/QHFSmcozT0 https://t.co/oiVjf4GZGX

Four Fibromyalgia Drugs Are Approved in the US, None in Europe. What Are Regula…

APLAR 2026: Who can reduce DMARDs in RA? https://t.co/npUC1hjlYT https://t.co/ExnNEe9gZQ

APLAR 2026: Who can reduce DMARDs in RA? | RheumNow

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Therapeutic Updates

Individualized PsA Treatment With an IL-23i or a JAKi

Sponsored by AbbVie Medical Affairs + Health Impact

Nov 01, 2026

In Part 2 of our PsA management series, Saakshi Khattri, MD, and Lindsay Tom, PA-C, discuss tailoring treatment for patients with multidomain PsA and how IL-23i and JAKi data guide their decisions

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