Recent News
At the end of June, Sobi was awaiting an FDA decision on its Biologics License Application (BLA) for NASP (nanoencapsulated sirolimus plus pegadricase) for the treatment of adult patients with uncontrolled gout. On June 26, 2026, SOBI received a Complete Response Letter from the U.S. FDA that will delay a decision on NASP, pending the company's answer to questions regarding the drugs manufacturing at a 3rd party facility in China.Read Article
Problems with treatment adherence in the management of gout
Compared to common medical conditions such as hypertension, type 2 diabetes, hyperlipidemia or osteoporosis, where the reported drug adherence rates are between 50% to 70%, the drug adherence for gout is 37%.
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How should imaging guide the diagnosis and management of gout?
Hear from Dr. Nicola Dalbeth, Dr. John Fitzgerald, and Dr. Sarah Tedeschi, moderated by Dr. Jack Cush, as they discuss ultrasound, DECT, crystal identification, and more.
đź“… Reserve your seat today.
Link: https://t.co/GySPzyVc1b
Dr. John Cush @RheumNow ( View Tweet)
Gout is more than an episodic arthritis, it's a systemic inflammatory disease.
Watch Dr. Robert Terkeltaub discuss 3 New Things it Pays to Know About Gout Pathobiology, including emerging insights that are shaping how we understand and manage gout.
Watch now on RheumNow: https://t.co/nri3WDz7kS
Dr. John Cush @RheumNow ( View Tweet)
The global Chronic Refractory Gout Market is projected to grow from ~$2.94 billion USD in 2022 to nearly $10.07 billion USD by 2036, reflecting introduction of innovative therapies. Chronic Refractory Gout in the 7Major Markets exceeded 400,000 pts in 2025 (>200K in USA) https://t.co/MSzBNTXTPj
Dr. John Cush @RheumNow ( View Tweet)
ICYMI: Updated CRA/SPARCC Recommendations for Axial Spondyloarthritis
In 2024, the Canadian Rheumatology Association (CMA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) published a comprehensive set of 56 treatment recommendations for the management of axial https://t.co/ax0zwNcxYX
Dr. John Cush @RheumNow ( View Tweet)
NEJM Retracts Pivotal ADVOCATE Trial of FDA-Approved Avacopan
MedPage Today
The New England Journal of Medicine (NEJM) retracted the pivotal study supporting FDA's approval of avacopan (Tavneos) for severe forms of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis.
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DMARD Efficacy in RA-ILD
A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional, low-certainty recommendations.
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New research shows synovial lining enriched in macrophages expressing SPP1 (encoding osteopontin) in proximity to fibroblasts and fibrin deposits. SPP1+ macrophages degrade fibrin & promote fibroblast proliferation that deposit collagen & does the damage, joint remodeling. A new https://t.co/hrJoQXpAH8
Dr. John Cush @RheumNow ( View Tweet)
Whats the BEST FIRST Rx in DMARD-Naive #RA - Tofacitinib or MTX. RCTs (ORAL Start, RA-BEGIN, SELECT-EARLY, FINCH 3) prove JAKi > MTX. A recent 116 RCT from China also shows Tofa > MTX by SDAI50 (94% v 75%) @3 mos & Tofa was more cost effective. https://t.co/KL2qlDgF6D https://t.co/wNVBgQkaMI
Dr. John Cush @RheumNow ( View Tweet)
EULAR26: ANCHOR-RA Study of RA-ILD
People with rheumatoid arthritis are at risk of developing interstitial lung disease (RA-ILD), which is associated with high mortality. ANCHOR-RA is a large, international cross-sectional prospective study that will enable the development of a https://t.co/tsOpA4SAZP
Dr. John Cush @RheumNow ( View Tweet)
Prosthetic Jt Infections after prior Septic Arthritis? Systematic review of 35 retro studies/7,447 pts (4,896 TKA, 2,564 THA). PJI rate = 2.6%, more after TKA (9.8%) than THA (1.1%). Lower rates w/ longer intervals between TJA and septic arthritis. 2 stage procedures increased https://t.co/M425Xuc7Z4
Dr. John Cush @RheumNow ( View Tweet)
Long term F/U of Gout (CARES) trial (febuxostat vs allopurinol) shows remission increased from 37% (1,593/4,259) 1st Yr to 63% (322/510) at year 6. Over the 6 years, ~60 achieved remission at least once; more likely based on age, race, dz severity, comorbidities, & febuxostat
Dr. John Cush @RheumNow ( View Tweet)
A federal judge has blocked the Department of Education new rule restricting graduate school loans for NPs and PAs. DEA plan does not qualify NP & PA degrees as "professional", & loans were to be limited to $20,500 annually ($100K lifetime) https://t.co/5eIcFgbbx6 https://t.co/xuik5TWjVU
Dr. John Cush @RheumNow ( View Tweet)
American Gastroenterological Association announced the launch of AGA APP GI Readiness and Credentialing, a professional development initiative fir advanced practice providers throughout their careers. Establishes structured professional pathways for APP https://t.co/k3pC7HazMt https://t.co/8wT4ltIsSC
Dr. John Cush @RheumNow ( View Tweet)
The Power of Self-Management with Chronic Low Back Pain
EurekAlert!
Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the workforce.
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Chinese target trial emulation of 2092 adults with stage G3–G4 CKD & asymptomatic hyperuricemia starting ULT. At 3 yrs, renal progression (ESKD or ≥40% eGFR decline) was 33.3% in T2T vs 35.8% in non-T2T (risk ratio 0.93; 0.83–1.08). https://t.co/lAT0noE1uA https://t.co/mFVpvvFcsN
Dr. John Cush @RheumNow ( View Tweet)
Cochicine overdose still occurs & can be deadly. There is no antidote. From 2011-2021, there were 57 pediatric cases (median 7 yrs)(0.41 /million kids/year. 52% started w/ GI Sxs, 12% multiple organ failure &4 deaths (7%). Ingested doses ranged from 0.01 to 1.45 mg/kg. https://t.co/RULmdBX0Qj
Dr. John Cush @RheumNow ( View Tweet)
RHEUM SURVEY>> Which Gout drugs lower the risk of cardiovascular death? Answer here: https://t.co/1OY1B3ET7B https://t.co/MRJP5OOtXb
Links:
Dr. John Cush @RheumNow ( View Tweet)
JAMA HBV review - Worldwide, HBV affects ~254 million, causing 1.1 million deaths. In 2022, 14k new HBV infx in the US. HBsAg = ongoing infxn; HBsAb indicates immunity; HBcAg=ongoing or past infection. Do HBV DNA for virus-replication activity https://t.co/Yvdx09DrQ5 https://t.co/88VsTEgFev
Links:
Dr. John Cush @RheumNow ( View Tweet)
From the Blog
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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Podcasts
Gout Journal Club
Podcast Replay: Is it Time to Transition MOAs in RA?
ICYMI: Great Lectures; Great Presentations-
Generic Tofacitinib (6.26.2026)
Therapeutic Updates
Fundamentals of CAR T Cell Therapy and Its Investigational Use in Autoimmune Diseases
Sponsored By Bristol Myers Squibb
Learn more about the fundamentals of CAR T-cell therapy and its investigational use in autoimmune disease
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Watch our 'Systemic Burden of Gout' series as part of this month's Gout More than Flares campaign. Now available: 3 New Things It Pays to Know About Gout Pathobiology, Outcomes of Tophaceous Gout & Subclinical Inflammation in Intercritical Gout.
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Poster Hall
Daily Gem
15-20% of Americans (38-44 million adults) have hyperuricemia. Less than 25% will ever develop gout.
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