The Obesity Imperative 

Recent News

  • ACR Updates Osteoarthritis Guidance

    ACR
    ACR, guidance, guidelines
    The American College of Rheumatology (ACR) has released updated clinical guidance for the treatment and management of osteoarthritis (OA) of the knee, hip, and hand. The evidence-based recommendations update the 2019 ACR/Arthritis Foundation guideline and are designed to support individualized, shared decision-making between patients and clinicians.
    Read Article
HLA-B%2A2705.png

Review of HLA-B27

Jack Cush, MD

HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint trafficking point to new plausible, targetable pathways.

Read Article
QD Clinic: Bariatric Surgery "Curing" Arthritis? Dr. Richard Conway, Dublin, presents this QD Clinic as part of RheumNow's "The Obesity Imperative" campaign, presented in September 2026. https://t.co/M6nKr9EShU https://t.co/6JX5bCYzfo

Links:

Dr. John Cush @RheumNow (  View Tweet)
Obesity Journal Club: Tuesday Nite Rheumatology The Obesity Journal Club explores the TOGETHER PsA and STEP 9 trials and what emerging evidence tells us about the relationship between obesity, weight loss, and rheumatic disease. Panelists discussed the results of these trials, https://t.co/3C1RLyRj0b
Dr. John Cush @RheumNow (  View Tweet)
Discussing Weight Loss: 3 Minute Script Dr. Jack Cush's 3 Minute Script as discussed in his Introducing Weight Loss video. https://t.co/JRWAPc5if5 https://t.co/NUpxPT4bdo

Links:

Dr. John Cush @RheumNow (  View Tweet)
Indian study of 85 #RA pts in LDA or better (DAS28-ESR ≤ 3.2). W/ 6 mos F/U, 39 (46%) had 1+ RA flare (DAS28 > 3.2); time to flare 12 wks (8–18) unrelate to Dz activity. Predictors: seropositivity (HR 2-2.3) https://t.co/ifqeoPtxpx https://t.co/ltx64X55fd

Links:

Dr. John Cush @RheumNow (  View Tweet)
Data presented at 2027 ASMBS meeting showed betw 2020-2024, wt loss surgeries dropped 23%, from 230,000 in 2022 to 177,000 in 2024. Less than 1% of eligible pts are now having weight-loss surgery https://t.co/UnYIIBDdnz https://t.co/FuwnOuBUeY

Links:

Dr. John Cush @RheumNow (  View Tweet)
infusion.biologic.jpg

Added IVIG is Effective in Myositis

Jack Cush, MD

A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly diagnosed idiopathic inflammatory myopathies (IIMs). 

Read Article
Weight Loss Improves Psoriatic Disease Substantially! Even before the introduction of incretin therapy and bariatric surgery, many randomized and interventional studies (2019–2026) have consistently showed that weight loss produces clinically meaningful, dose-dependent https://t.co/BWeW7fzSC8
Dr. John Cush @RheumNow (  View Tweet)
A Day of Infamy (9.11.2026) Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. https://t.co/gzaqNz3i5k https://t.co/c8ShScutqC

Links:

Dr. John Cush @RheumNow (  View Tweet)
Metanalysis 11 studies & 104277 gout & hyperuricemic pts shows erectile dysfunction is signif. increased (RR1.37; 1.14-1.65) related to lower testosterone & estradiol. Other factors: obesity, age, DM, CVD. https://t.co/1ufih2E3UN https://t.co/NgQuHt4vR1

Links:

Dr. John Cush @RheumNow (  View Tweet)
Single center study of FALLs in 124 ambulatory RA females ≥50 yrs.(age 68 yrs, DAS28 2.6, sarcopenia 16%, prior fall 25%). 27.4% had falls; predicted by prior fall hx (OR 2.76, hypnotics/anxiolytics (3.92), not steroids or sarcopenia (NS trend) https://t.co/J62RPF9rQs https://t.co/OKxdPl5Oev

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

Links:

Dr. John Cush @RheumNow (  View Tweet)
undifferentiated,arthritis,early,RA

Early RA Referral Clinics Work!

Jack Cush, MD

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.

Read Article
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

Links:

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

Links:

Dr. John Cush @RheumNow (  View Tweet)

From the Blog

rheumthought

Obesity in Rheumatic Diseases: More than just a Comorbidity

Marina Magrey, MD
Magrey RT cover image

A 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.  

Read Article

Podcasts

  • Obesity & Inflammation: Understanding the Impact on Rheumatic Disease
  • A Day of Infamy (9.11.2026)
  • Obesity Journal Club
  • Treating Obesity is Disease-Modifying (9.4.2026)
Ask Cush Anything

Submit your Rheumatology question or case here

Therapeutic Updates

The Four Pillars of Weight Loss

RheumNow
What are the four pillars?
Watch our 'Four Pillars of Weight Loss' series as part of this month's The Obesity Imperative campaign. Videos include: 'What are the four pillars of obesity management?' and 'Building A Multidisciplinary Program for Obesity and Arthritis Management'.
Read Post

Label update: Structural damage progression in active PsA

Sponsored by Johnson & Johnson Medical Affairs
J&J RX Update
Listen to Dr. Catherine Bakewell’s review of clinical data from a recent label update.
Read Post
How well do you know this week's rheumatology news?
Take the rheumIQ quiz
Take the RheumIQ Quiz

Rheumnow Survey

Vote

Daily Gem

Weight loss lowers serum uric acid two ways: less production, better renal clearance.

--

×