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Double Trouble (10.23.2026)
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Jack Cush, MD

Oct 23, 2026

Dr. Jack Cush reviews the journal articles and regulatory announcements from this past week on RheumNow, including: two crystals in one joint, twice the cryptococcus risk in JAKs; Myositis and Scleroderma; and Sjögren’s plus early damage = >> 2 fold risk lymphoma. Double trouble week on the RheumNow podcast.
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"We really need to ask every patient who has psoriasis about their joints” – Dr. Ahmad Amin, Dermatologist Watch Dr. Amin and Dr. Saakshi Khattri discuss the link between skin and joints in PsA. Sponsored by AbbVie Medical Affairs + Health Impact. https://t.co/rp2e5oknVF https://t.co/rrWGQeaIxi

PsA Beyond the Joints: Rheum, Derm, and Gastro Perspectives | RheumNow

Monogenic Inflammatory Disorders Go Unrecognized Lancet Rheumatology published a large cohort analysis using a genome-first approach with whole-exome sequencing, finding a prevalence of 1 in 4026 (159/640092) for monogenic disorders, half with inflammatory features. Only one https://t.co/4v1PP41rii

Joint Disease in SLE Reconsidered A new Frontiers in Immunology review from Ong, Wincup and colleagues, shows that lupus arthropathy is not a single uniform entity and it is biologically under-studied and clinically mismeasured, Moreover, the biology of lupus arthritis may https://t.co/M5m6TMZr3x

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van Vollenhoven’s Treatment Advances in Lupus

Jack Cush, MD Oct 22, 2026

Professor van Vollenhoven has compiled a state-of-the-art review on lupus treatment advances – current and future. SLE management is entering an unprecedented phase.

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EBR Journal Club: Secukinumab in Polymyalgia Rheumatica (REPLENISH)

Michael Putman, MD, MSCI Oct 22, 2026

This edition: REPLENISH (secukinumab in polymyalgia rheumatica). The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal to an important RCT in rheumatology. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How great are the benefits and harms? And what didn’t they show me?

RheumNow Live 2027 registration is NOW OPEN. GLP-1s in your clinic. CAR-T in lupus. Rheumatology experts vs. AI, with your vote. Jan. 30–31 | Onsite + virtual Early Bird Pricing through 12/15/2026. See the agenda. Register: https://t.co/zYYC2350tE https://t.co/QeSxDPlIpv

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Using Global Burden of Disease study data, an economic evaluation of 204 countries & territories, osteoarthritis & Alzheimers/dementias had highest health burden, but largest economic losses observed for combinations involving osteoarthritis, particularly osteoarthritis and https://t.co/0JgRgJAWy7

150 #Gout pts (56 yrs old; 33wks F/U; 21% drank EtOH, 29% obese, 5% MASLD) on allopurinol followed w/ labs. 30y (20%) had incr AST/ALT (87% mild, none severe). Allopurinol was cont 18/10 without change in AST/ALT. Allopurinol was not the primary cause of LFT elevation https://t.co/nBCACpvr5W

The FDA is reviewing Sun Pharma’s tildrakizumab (Ilumya), an IL-23 inhibitor, for use in active psoriatic arthritis, with an October 29, 2026 action (PDUFA) date. Decisons to be based on PsA INSPIRE-1 and INSPIRE-2 Phase 3 Studies https://t.co/iDWhub0k91 https://t.co/j8wQLxNCdA

Sun Pharma Announces US FDA Acceptance of Supplemental Biologics License (sBLA)…

RHEUMATOLOGIST Survey Q: How do you assess cutaneous lupus activity or treatment responses? CLICK HERE> https://t.co/PZDVpkqR1q https://t.co/bAQ7qNqGIA

Survey Result | RheumNow

Tis the Season for Vaccination Vaccination is essential for all rheumatologic patients, but particularly for patients on glucocorticoids and immunosuppression who face increased risk from infectious diseases. https://t.co/hHx1okkwHD https://t.co/nzRa9pzQ1X

‘Tis the Season for Vaccination | RheumNow

Novel Imaging of Skin Disease in Scleroderma An emerging technique called spatial frequency domain imaging (SFDI) proved its mettle for evaluating skin fibrosis in systemic sclerosis (SSc), also called scleroderma, in an early clinical study. https://t.co/vHmxD1cHRR https://t.co/BWW6Te9FFI

Novel Imaging of Skin Disease in Scleroderma | RheumNow

Impact of Myositis in Scleroderma Patients Systemic sclerosis (SSc) may have overlap features such as myositis. When present, myositis in SSc is associated with an increased risk of cardiac involvement and a shift in mortality away from ILD towards a greater cardiac risk. https://t.co/dsGOXvdEuK

Prospective RCT of 39 refractory carpal tunnel pts (63 wrists) were injx w/ 1) US hydrodissection w/ normal saline (NS); 20 steroid injx; 3) US saline + steroid. Wk 24: Improved 86% & 90% grps 1 & 3; Saline superior to steroid; & adding steroid to NS yielded no benefit https://t.co/vCAB7Hojlo

I saw an AARP article on the "best mattresses for Fibromyalgia"!! A mattress (unless you have a really bad, saggy one) will not fix FM. Focus on sleep habits, sleep aids, pain at night and everything but the mattress!! IMHO https://t.co/MIwxpKMRih https://t.co/11J2HsL0ai

6 Best Mattresses for Fibromyalgia

Tokyo study of 107 pts (age: ~86y) on synov. aspiration found to have CPPD crystals - MSU crystals also seen 17 pts (16%), where CPPD crystals predominated. 7/17 had Hx of gout or hyperuricemia. None were Rx for gout. https://t.co/lDnBhd5EFA https://t.co/9DjaLHygMc

Prevalence and Clinical Characteristics of Patients With Pseudogout and Concomi…

Scleroderma Research Foundation Raises Nearly $1.1 Million At This Year's Cool Comedy • Hot Cuisine event hosted by Jeff Ross & included Fortune Feimster, Matt Friend, Ron Funches, Jay Pharoah, Lisa Ann Walter, Seth Green, Howie Mandel, and John Mayer https://t.co/ktgaNNinXa https://t.co/7RhaB9li9B

The Scleroderma Research Foundation Raises Nearly $1.1 Million At This Year's C…

THIS SATURDAY IS National Prescription Drug Take Back Day - October 24, 2026, 10AM to 2PM (safe disposal of prescription drugs) FIND a center near you >> https://t.co/gle5p0G3fC https://t.co/OBjRaTPa9B

National Take Back Initiative :: Session Timed Out

FDA has approved NDA for Evoxac, granting Cosette right to sell oral, liquid Evoxac as an alternative treatment option for managing dry mouth symptoms in Sjögren’s patients. NA until end of 2026. https://t.co/jTySNljXMv https://t.co/PCnfAmIB2W

Cosette lands FDA approval for Evoxac liquid in Sjögren’s disease

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From the Blog

Treatment for Obesity and Inflammation, but at what Cost?
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Jonathan Kay, MD

Sep 29, 2026

The costs of GLP-1 agonists must come down in order to make these treatments available to the people who need them - including many people with rheumatologic diseases.

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Podcasts

Double Trouble (10.23.2026)
Oct 23, 2026
Troubles with ‘Gut Feelings’
Oct 16, 2026
Don’t Hold the JAK (10.9.2026)
Oct 09, 2026
PsA Beyond the Joints: Rheum, Derm, and Gastro Perspectives
Oct 06, 2026

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Therapeutic Updates

PsA Beyond the Joints: Rheum, Derm, and Gastro Perspectives

Sponsored by AbbVie Medical Affairs + Health Impact

Oct 01, 2026

Dr. Saakshi Khattri hosts dermatologist Dr. Ahmad Amin and gastroenterologist Dr. Joshua Steinberg to discuss multidisciplinary care in PsA and other immune-mediated inflammatory diseases. Learn how signals in the skin and gut may prompt the need for collaboration across specialties to support better patient outcomes that extend beyond the joints.

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