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Read ArticleA few years ago, when I would see a patient with rheumatic disease and increased BMI, I would often document it as obesity as a comorbidity, recommend weight loss and exercise, and then move on. However, in the last few years as there is emerging evidence about the role of obesity disease in rheumatic diseases and also that it can be modified now, my approach has changed.
🔥A post hoc analysis of SELECT-SWITCH from EULAR 2026: A JAKi vs second TNFi in patients with RA stratified by primary or secondary nonresponse or intolerance to a first TNFi.
See the poster: https://t.co/ThWUHspGFm
Sponsored by AbbVie Medical Affairs + Health Impact. https://t.co/ASsvTqZln1
Dr. John Cush @RheumNow ( View Tweet)
RHEUM Survey> Is the inflammation of knee osteoarthritis augmented by obesity? Answer here> https://t.co/Zovqan2QoD https://t.co/o62rAqpXlo
Links:
Dr. John Cush @RheumNow ( View Tweet)
Chinese 52 wk study of XKH004, a novel, SC, humanized anti-17A/F in 323 active AS pts Rx q4 wks vs PBO. @ Wk 16, XKH004 was superior for ASAS40 (45.4% vs 19.4%; P<0.001), improved to 66% by wk 52. https://t.co/f7w41m4QZy https://t.co/5MPm388kau
Links:
Dr. John Cush @RheumNow ( View Tweet)
In 2022, Overweight & obesity affect 65.8% of Swiss PsA pts (vs gen pop.= 43%) and has increased since 2007. Obesity was assoc w/ elevated CRP (56% vs 37%), Inc Pt global assess (3.2 vs 2.8), & MD global (2.5 vs 2.1) & lower EQ-5D-3L(0.7 vs 0.8). https://t.co/xPoy4dgvlD https://t.co/aeB5N6LgCd
Dr. John Cush @RheumNow ( View Tweet)
Early RA Referral Clinics Work!
An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals.
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Bariatric Surgery in the Era of GLP-1RA
Weight loss with lifestyle changes alone is difficult to sustain for most people. One reason for this is the weight loss associated endocrine milieu, which can decrease energy expenditure and increase the drive to eat. Therefore, we frequently use medications and/or bariatric surgery.
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JAMA: Review of Adult Rheumatoid Arthritis
This JAMA narrative review is a follow-up to their 2018 publication, informed by 123 articles (46 RCTs, 28 cohort studies, 11 systematic reviews/meta-analyses, 15 guidelines) covering epidemiology, pathogenesis, diagnosis, and https://t.co/6Fiu9iLF5I
Dr. John Cush @RheumNow ( View Tweet)
Obesity in Axial Spondyloarthritis: what are we missing beyond the scale?
Obesity in axSpA is not a minor comorbidity.
While obesity is more often discussed in psoriatic arthritis (PsA) due to the psoriasis-adipose tissue link which is mechanistically better studied and https://t.co/bFkoPmc0pC
Dr. John Cush @RheumNow ( View Tweet)
FDA Grants Priority Review to Zasocitinib for Plaque Psoriasis. Regulatory decision expected 1st quarter 2027. Supported by phase 3 RCTs, 3000 pts -- LATITUDE PsO 3001 and 3002 clinical trials. https://t.co/o7oqxSXHSw https://t.co/evzPtaTWI4
Dr. John Cush @RheumNow ( View Tweet)
JAMA Surgery analysis showed that between 2022-2024 bariatric surgery fell 34.1%, While GLP-1 use rose more than 140% over the same period. (SELECT trial showed semaglutide reduced major adverse cardiovascular events by 20% in overweight or obese adults without diabetes.) https://t.co/s3NRFY2R5w
Dr. John Cush @RheumNow ( View Tweet)
TriNetX retrospective EHR study showed VTE in #RA not incr by taking JAKi. Pts undergoing THA/TKA Rx w/ JAKi (n 284) vs TNFi (n 288). VTE- 17 JAKi (6%) vs 11 TNFi (3.8%)- nonsignif incr (RR 1.57) https://t.co/OM5ipieQtr https://t.co/ng8b9EkWmT
Dr. John Cush @RheumNow ( View Tweet)
Together PsA 52 wk data (n 271): ACR50 plus >10% wt loss - 39.2% w/ Taltz & Zepbound vs 1.7% w/ Taltz alone. Together PsO trial results (n 274): PASI100 plus >10% wt loss - 30.6% w/ Taltz & Zepbound vs 4.4% w/ Taltz alone. https://t.co/27TBZyL8l1 https://t.co/VdQJALdoJt
Dr. John Cush @RheumNow ( View Tweet)
Waist size matters! Using NHANES data (1999-2018) the weight-adjusted waist index (WWI) calculated on 5582 CKD pts. WWI was signif assoc w/ all-cause mortality (adj HR  1.17) & CV (1.24); these assoc partially mediated by NLR (inflammation) ~6.6%, showing both central adiposity https://t.co/kNf4nqiD2a
Dr. John Cush @RheumNow ( View Tweet)
True or False: A meta-analysis of hidradenitis suppurativa patients showed IL-17 inhibitors significantly increased IBD risk compared to placebo.
See if you got it right in this week's RheumIQ quiz at https://t.co/UaXqHKWizt.
Dr. John Cush @RheumNow ( View Tweet)
Obesity isn’t just a comorbidity—it can influence inflammation, disease activity, and treatment response.
Join our second Tuesday Night Rheumatology webinar this month as leading experts explore the biology of fat and its impact on rheumatic disease.
Register: https://t.co/OIQUZqANEP
Dr. John Cush @RheumNow ( View Tweet)
Sobi Receives US FDA Fast Track Designation for pacritinib in VEXAS Syndrome. Pacritinib (Vonjo) is a kinase inhibitor (JAK2, FLT3) that is approved to treat adults with intermediate or high-risk myelofibrosis https://t.co/V7duJPyJpG https://t.co/Dn5DgeaX7N
Dr. John Cush @RheumNow ( View Tweet)
RheumIQ: In axial spondyloarthritis, obesity reduces TNF inhibitor responses by how much?
Test your knowledge at https://t.co/UaXqHKWizt.
Dr. John Cush @RheumNow ( View Tweet)
Osteoarthritis, Obesity and GLP-1s
https://t.co/SGnWksQBpT https://t.co/ILP3weScxh
Dr. John Cush @RheumNow ( View Tweet)
Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/JDvVZ1KEIY
Dr. John Cush @RheumNow ( View Tweet)
Video
From the Blog
Dr. Al Kim, St. Louis, discusses the effects of obesity on lupus activity, organ damage, complement levels and mTor activation.
Podcasts
A Day of Infamy (9.11.2026)
Obesity Journal Club-
Treating Obesity is Disease-Modifying (9.4.2026)
A Day in the Life of a Rheumatology APP: A Focus on Interstitial Lung Disease” (hosted by Amanda Mixon, PA-C)
Therapeutic Updates
The Four Pillars of Weight Loss
RheumNow
Watch our 'Four Pillars of Weight Loss' series as part of this month's The Obesity Imperative campaign. Videos include: Introducing Weight Loss and Pharmacologic Treatment of Obesity.
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Label update: Structural damage progression in active PsA
Sponsored by Johnson & Johnson Medical Affairs
Listen to Dr. Catherine Bakewell’s review of clinical data from a recent label update.
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Poster Hall
Sponsored by AbbVie Medical Affairs + Health Impact
Real-World Joint Outcomes With an IL-23i vs TNFi or IL-17i in PsA
Rheumnow Survey
Have you ever prescribed a weight loss drug (e.g., tirzepatide, semaglutide) for your arthritis patient?
Daily Gem
Obese RA patients are less likely to reach remission on biologics
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