Recent News
Read ArticleA large randomized rheumatoid arthritis (RA) clinical trial compared subcutaneous tocilizumab (TCZ) vs oral methotrexate (MTX) vs. the combination of subcutaneous TCZ and MTX, and showed that TCZ was superior to MTX, either given as TCZ monotherapy or in combination with MTX.
No Cancer Recurrence with Biologic DMARDs in RA
A prospective Danish rheumatoid arthritis (RA) registry study look at the risk of recurrence when a biological disease-modifying antirheumatic drugs (bDMARDs) was ued in patients with a a prior solid cancer (in remission) and found no increased cancer recurrence risk.
Infusion/injxn-reactions (IRRs) w/ biologics studied in 1,832 RA pts - IRRs seen in 9.7% & were signif more common w/ being younger (OR1.79), secondary Sjögren's (OR 2.17), prior leflunomide (OR 1.5); but less common w/ Abatacept (OR 0.26) & tocilizumab (OR 0.42), golimumab (OR https://t.co/aSaI5UuiDY
Dr. John Cush @RheumNow ( View Tweet)
NEW ACR 2024 POSTER: Phase 3 KEEPsAKE 1 and 2 post hoc analyses of time to first response with an IL-23i
View the latest data on time to first efficacy responses and PROs in patients with active PsA. Sponsored by AbbVie Medical Affairs + Health Impact. https://t.co/3QTurnvokp https://t.co/tfMmNLHZwZ
Dr. John Cush @RheumNow ( View Tweet)
Systemic sclerosis is a vasular disorder! Microvascular dysfunction, Endotheliopathy, & reduced vascular reserve account for most findings. Good review w/ literature references in Arthritis Research & Therapy. https://t.co/ULfwBy7ECb https://t.co/6uLkiTVDbP
Dr. John Cush @RheumNow ( View Tweet)
Is Lupus Just a B Cell Disorder?
I'm very happy to give you some insights entitled, “Is Lupus a B-Cell Disorder”. I will review some aspects, mainly pros and cons, but at the end you may forgive me, I will escape a little bit from a clear yes or no.
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Moving Targets in Lupus and Lupus Trials
Clinical trial data quality is a moving target. Lupus is also a moving target. Can we address the moving target of lupus pathology with the moving targets of quality clinical trials and scientific treatment selection?
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Pregnancy planning, contraception and safe drugs in Pregancy.
Featuring Dr. Megan Clowse, Durham NC
https://t.co/sZuq475VJv https://t.co/HZv9FuviaR
Dr. John Cush @RheumNow ( View Tweet)
If vagus nerve stimulation improves RA; then what if vagotomy? Danish study of vagotomy (1977-1995). 6070 vagotomy matched w/ 60,699 comparators. Truncal vagotomy was assoc w/ signif incr RA incidence (OR 2.62), but not superselective vagotomy (OR 1.05). NO diff in incident OA https://t.co/J2saSRmiNw
Dr. John Cush @RheumNow ( View Tweet)
SLE, Antiphospholipid Antibodies, and the Placenta
It is well established that women with SLE are at increased risk for adverse pregnancy outcomes, including preeclampsia, preterm birth, and pregnancy loss. However, the pathophysiologic mechanisms driving these complications https://t.co/f8Up1112m9
Dr. John Cush @RheumNow ( View Tweet)
Neutrophil alkaline phosphatase (NAP) elevated in active AOSD. 141 AOSD compared to Bcell lymphoma, SLE, aPL & controls. NAP pos. correl w/ Systemic Dz activity score (R=0.71), & 0.59 for CRP/ANC/ferritin. NAP scores higher in pre-MAS, but lower w/ MAS (w/lower WBC). NAP responds https://t.co/bANtWIhtDH
Dr. John Cush @RheumNow ( View Tweet)
Emerging therapies targeting the NLRP3-inflammasome (active in Autoinflammatory Dz, Gout, neurodegenerative Dz/Alzheimers). Currently no FDA approved drugs, but many in trials. eg, Oxidized DNA (DAMP) activates NLRP3 & may be blocked by repurposed glycosylase inhibitors to reduce https://t.co/tEdi5OH2fP
Dr. John Cush @RheumNow ( View Tweet)
CAR-T and cellular depletion therapies gone wild! Currently there are over 85 different therapeutic candidates aiming to reset the immune system in >380 clinical trials. Review article looks at indications, targets, modalities & outlook. https://t.co/yleR4B48IY https://t.co/tuCTOu5sxa
Dr. John Cush @RheumNow ( View Tweet)
Vitiligo affects up to 2% of people globally; more in blacks & hispanics than whites & more common in women > men. The prevalence has increased over time. Oral corticosteroids are most frequently prescribed, followed by other immunosuppressive drugs https://t.co/wNh6z3lKg1 https://t.co/hQo9sNn4kg
Dr. John Cush @RheumNow ( View Tweet)
Periprosthetic femoral Fx (PPFF): metanalysis of 36 studies found PPFF risk factors: Uncemented stems (OR 3.36), major teaching hosp (2.0), female (1.6), obesity (1.4), Hi comorbidity(1.4), RA (1.89), (1.67), revised THR (2.6). OA = protective (0.51) https://t.co/y2BpH8LUb6 https://t.co/EjX6R9QTK3
Dr. John Cush @RheumNow ( View Tweet)
Steroids in Lupus Nephritis: No Free Lunch
Today I'm here to talk with you about steroids in lupus nephritis. The impetus for this is the 2024 ACR guideline for the management of lupus nephritis.
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MTX works in pulmonary Sarcoid! NEJM reports Open label RCT of 138 un-Rx pulm. Sarcoid pts w/ either MTX or placebo. After 24 wks MTX was noninferior to PBO w/ mean change in FVC (-6.7 vs -6.1). AE: more Wt gain, insomnia w/ pred & more Nausea fatigue LFTs w/ MTX https://t.co/8XMCM2DitR
Dr. John Cush @RheumNow ( View Tweet)
Lupus QD Clinic - Rhupus
dsDNA+ SLE Plus CCP+ RA = Rhupus
https://t.co/lyV7fgd1vp https://t.co/IKkS0enQH9
Dr. John Cush @RheumNow ( View Tweet)
Vitiligo affects up to 2% of people globally; more in blacks & hispanics than whites & more common in women > men. The prevalence has increased over time. Oral corticosteroids are most frequently prescribed, followed by other immunosuppressive drugs https://t.co/wNh6z3lKg1 https://t.co/xy1eCjeOYs
Dr. John Cush @RheumNow ( View Tweet)
Periprosthetic femoral Fx (PPFF): metanalysis of 36 studies found PPFF risk factors: Uncemented stems (OR 3.36), major teaching hosp (2.0), female (1.6), obesity (1.4), Hi comorbidity(1.4), RA (1.89), (1.67), revised THR (2.6). OA = protective (0.51) https://t.co/y2BpH8LUb6 https://t.co/hX2lcjI4Kg
Dr. John Cush @RheumNow ( View Tweet)
MTX works in pulmonary Sarcoid! NEJM reports Open label RCT of 138 un-Rx pulm. Sarcoid pts w/ either MTX or placebo. After 24 wks MTX was noninferior to PBO w/ mean change in FVC (-6.7 vs -6.1). AE: more Wt gain, insomnia w/ pred & more Nausea fatigue LFTs w/ MTX https://t.co/9i4fxrZMl0
Dr. John Cush @RheumNow ( View Tweet)
From the blog
Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit.
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Podcasts
Panacea of Prednisone & Cannabis (5.16.2025)
Lupus Unlocked- Cutaneous LE - Tuesday Night Rheumatology-
Vitamin D Headlines (5.9.2025)
Lupus Unlocked - Journal Club
Therapeutic Updates
A Phase 3 Trial of a JAKi in Patients With Giant Cell Arteritis
Sponsored by AbbVie Medical Affairs + Health Impact
Listen as coinvestigator and rheumatologist Dr. Andrea Rubbert-Roth reviews this Phase 3 trial of a JAKi in patients with giant cell arteritis. Dr. Rubbert-Roth discusses the latest results, including efficacy and safety outcomes.
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Lupus Nephritis
Sponsored by RheumNow
View this perspectives series on Lupus Nephritis: new videos include a guidelines review and a Nephrologist's Approach to LN.
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Poster Hall
Sponsored by AbbVie Medical Affairs + Health Impact
Time to first musculoskeletal response of an IL-23i in PsA
Daily Gem
PETRI-isms: "You cannot be a rheumatologist if you are afraid of our medicines (for the fellow who wants to start an immunosuppressive at such a low dose that it doesn’t have a chance to succeed)." - Dr. Michelle Petri
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