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    As GLP-1/GIP receptor agonists become standard co-management tools for obese patients with RA, PsA, axSpA, and gout, this JAMA Insights perspective by Kushner, et al. reframes lifestyle counseling as an adjunct to pharmacotherapy - a reversal of the traditional model. This has with direct implications for how we counsel obese patients we start or co-manage on these agents.
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Endocrine Society - State of Obesity Science and Management

The Endocrine Society has published a scientific statement reframing obesity as a heterogeneous, chronically dysregulated fat-mass disorder, the biology of which is being tested effectively by GLP-1/GIP receptor agonists. Is this precision-medicine? We await long-term safety data, while assessing the outcomes in rheumatic and musculoskeletal disorders.

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Rheum Survey: Do You Have to be Overweight for GLP-1s to Work Best?

Dr. John Cush @RheumNow (  View Tweet)

True or False: The TriNetX retrospective study found that JAK inhibitors significantly increased VTE risk in rheumatoid arthritis patients undergoing hip or knee replacement compared to TNF inhibitors. Check your knowledge in the latest RheumIQ quiz at https://t.co/LHFv1P6XZe.

Dr. John Cush @RheumNow (  View Tweet)

CLOAK study: 3 mos DBRPCT of Colchicine vs PBO (no NSAID) in 120 symptomatic KOA (KL gr 2/3) shows no benefit in VAS pain index knee after 3 mos. (but COL pts had signif change in some biomarkers hsCRP, β-NGF (p < 0.05); PGE2, IL-1ra, IL-8, and VEGF (p < 0.16). https://t.co/MPgLpr7LPP
Dr. John Cush @RheumNow (  View Tweet)
Rheum Survey>> Which obesity treatment has the greatest safety concern(s)? Click here to respond>> https://t.co/jDpVe7u9Pu https://t.co/RNftdQlU1N
Dr. John Cush @RheumNow (  View Tweet)
17 Sept EMA CHMP recommended marketing authorisation for secukinumab (Cosentyx) in the treatment of polymyalgia rheumatica. BUT- not yet EMA approved in the EU. https://t.co/ZGUSbw06vX https://t.co/EqRwpT8Sxo
Dr. John Cush @RheumNow (  View Tweet)
Join us for Tuesday Nite Rheumatology on September 22 for: 🔴 Obesity Treatment & Safety Experts will tackle: • GLP-1/GIP therapies • Lifestyle & bariatric interventions • Treatment selection & safety • Cost & compounding concerns • Sarcopenia & bone health • The future https://t.co/YNEsGofRR9
Dr. John Cush @RheumNow (  View Tweet)
Observational study of 63,215 neuropsychiatric (NP) pts showed semaglutide signif lowered NP events over 2yrs (vs metformin, SGLT2 inhibitors, DPP-4 inhib);unrelaed to wt loss. Less substance, mood anxiety, CNS atrophies, neuromuscular, eating/sleep & personality/impulse-control https://t.co/tbuvLRK3QE
Dr. John Cush @RheumNow (  View Tweet)
EBR Journal Club: Obexelimab in IgG4-Related Disease (INDIGO) The EBR Journal Club Companion applies my adapted JAMA approach to critical appraisal to an important rheumatology RCT. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How https://t.co/rH7BY21FvF
Dr. John Cush @RheumNow (  View Tweet)
Added IVIG is Effective in Myositis A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly diagnosed IIMs. https://t.co/XLrvLSoOic https://t.co/xhjPBXLxiC
Dr. John Cush @RheumNow (  View Tweet)
True or False: According to a metanalysis of 87 studies, higher BMI and smoking were linked to reduced methotrexate efficacy in rheumatoid arthritis. Check your knowledge in the latest RheumIQ quiz at https://t.co/LHFv1P6XZe.

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/jI65VzTIfs
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/LELo52zUb7
Dr. John Cush @RheumNow (  View Tweet)
Obesity and Rheumatic Disease Presented as part of RheumNow's "The Obesity Imperative" campaign. https://t.co/d2fl4EJX8Q https://t.co/AZGfKRvZrx
Dr. John Cush @RheumNow (  View Tweet)

Early RA Referral Clinics Work (9.18.2026)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com

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Join us for Tuesday Nite Rheumatology on September 22 for: Obesity Treatment & Safety Experts will tackle: • GLP-1/GIP therapies • Lifestyle & bariatric interventions • Treatment selection & safety • Cost & compounding concerns • Sarcopenia & bone health • The future of https://t.co/BCSOUot5FL
Dr. John Cush @RheumNow (  View Tweet)
Review of HLA-B27 What’s New? 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 https://t.co/13hbXlAvCr
Dr. John Cush @RheumNow (  View Tweet)
Added IVIG is Effective in Myositis 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). https://t.co/uNNJ9sHU8M
Dr. John Cush @RheumNow (  View Tweet)
Bariatric Surgery in the Era of GLP-1RA Overweight/obesity is a chronic multi-system disease that can impair physical and mental health. It now affects almost 1 in 3 Canadians. Multiple recent guidelines have therefore suggested using waist measurements, in addition to BMI, to https://t.co/RaXnQ2d9Yr
Dr. John Cush @RheumNow (  View Tweet)
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