Recent News
In most mammals, uricase catalyzes the oxidation of uric acid to allantoin, a highly soluble compound easily excreted by the kidneys. But humans lack functional uricase, leaving xanthine oxidase inhibitors (allopurinol/febuxostat) as first-line urate-lowering therapy (ULT). Uricase-based biologics are reserved for uncontrolled/refractory gout patients with gouty flares, active synovitis, and/or non-resolving tophi despite optimized oral ULT.Read Article
Genetic Risk Loci in Fibromyalgia
Researchers examined genetic data drawn from 11 different worldwide cohorts, that included from more than 2.5 million adults, of which 55,000 had been diagnosed with fibromyalgia. They identified DNA sequence variants in 26 regions of the genome that affect the risk of developing fibromyalgia. Many of the genes implicated in these regions are involved in brain and nerve function. This is the largest fibromyalgia GWAS to date.
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Pragmatism in Gout: How therapeutic choices can have multiple benefits
Drugs prescribed to calm flares or lower uric acid are designed with one primary goal in mind, yet many also produce meaningful effects beyond the joints. Some of those secondary effects are unwelcome; such https://t.co/QvXAwFM7LJ
Dr. John Cush @RheumNow ( View Tweet)
Retrospective study of 2187 RA pts initiating menopausal hormone Tx (MHT) vs 8,205 unexposed controls. VTE incidence higher among MHT users (6.49 vs 3.3/1000PY). MHT use was associated with a 92% signif increased risk of VTE in RA (adj HR: 1.92), mostly DVT risk (aHR: 2.26)
Dr. John Cush @RheumNow ( View Tweet)
Psoriasis = Myocardial Dysfunction (unrelated to Cardiometabolic Risk Factors) 1010 PsO pts vs controls w/o skin dz, assessed clinically & by ECHO. PSO pts (even w/ controlled dz) had signif more myocardial dysfunction (17% vs 6%). Higher BMI & DM independently assoc w/ https://t.co/MjcRmgyCWX
Dr. John Cush @RheumNow ( View Tweet)
The Wider Implications of Dactylitis
Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis. This review article discusses the wider implications of dactylitis in rheumatology and medicine underscores the diagnostic and prognostic significance of this manifestation.
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When Gout Flares, So Does the Cardiovascular System
We have spent decades teaching that a gout flare is a joint problem: a hot, swollen, painful joint that we treat with anti-inflammatory drugs and move on from (i.e., the treat to avoid symptoms strategy). The campaign title says it well — gout is more than flares. I would add that a flare is more than a joint problem. It is a transient, systemic inflammatory event and we should consider it as such.
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STOP-HZ trial - 30 #RA pts going on tofacitinib given Shingrix (RZV) on day 1 & wk 8 & started Tofa on d1 or wk8. @wk 12 VZV responses incr in both (2.66 & 2.91 fold incr). @wk 4, d1 Tofa had fewer ≥1.5-fold VZV vs wk8 (44.8% vs 80%); BUT can you wait 8wks to start JAKi? https://t.co/tH0zPgBbHQ
Dr. John Cush @RheumNow ( View Tweet)
Calcium Pyrophosphate Deposition Dz new terminology from 2026 G-CAN consensus. Preferred:
- acute CPP crystal arthritis
- Chronic CPP crystal arthritis
- Chronic CPP crystal arthritis
- OA w/ CPP
- Chondrocalcinosis (xray)
* Pseudogout is obsolete
https://t.co/L95N2ObHr3 https://t.co/ST7RkJa8BR
Dr. John Cush @RheumNow ( View Tweet)
An AI model trained from routine electronic health record data of 3.7 million individuals predicted cancer 1 year before clinical onset, no less promoted accuracy in detection, staging, treatment response, and prognosis
https://t.co/ORrpJ2vIcR https://t.co/ymJWRAYOSw
Links:
Eric Topol @EricTopol ( View Tweet)
UTSW observational study of labs (n 14,199) changes w/ MTX use in 2,439 pts (13% RA, 11% PsO/PsA, 15% inflam arthritis) - found no difference in labs q3 vs q6 mos. No signif correlation betw monitoring intervals & changes in ALT, AST,WBC, HCT, MCV, PLT, FIB-4. Small https://t.co/gKwA7juexG
Dr. John Cush @RheumNow ( View Tweet)
RHEUMS! FINAL GOUT SURVEY ON NEW THERAPIES>> Which biologic is FDA-approved for gout? Answer here>> https://t.co/MWSnCZEDdR
Dr. John Cush @RheumNow ( View Tweet)
Fibrosis-4 (FIB-4) Index for Liver Fibrosis is calculated from age, AST, ALT, Plts. Study of 174 RA, PsA, PsO pts on MTX find 11% w/ fibrosis (by elastography). FIB-4 AUC for fibrosis =0.68 (weak). Fibrosis was signif assoc w/ FIB-4 >1.62, DM, obesity, advanced steatosis https://t.co/GYrhs2U1s3
Dr. John Cush @RheumNow ( View Tweet)
The Hidden Cost of Gout
For many people, gout is viewed as an episodic disease: a painful flare, a short course of treatment, and then life returns to normal. However, as rheumatologists, we know that recurrent attacks can lead to joint damage and tophi if left untreated. https://t.co/BfZFBZ8YrU
Dr. John Cush @RheumNow ( View Tweet)
Primary biliary cholangitis is a chronic cholestatic disease characterized by autoimmune-mediated destruction of bile ducts, leading to fibrosis, cirrhosis, & liver failure. Ursodeoxycholic acid is 1st line Rx. New Rx include elafibranor & seladelpar (activates peroxisome https://t.co/tKloXvJYek
Dr. John Cush @RheumNow ( View Tweet)
UK primary care database (2000–21) gout study of new colchicine initiators (n 31,478) vs noninitiators (mean 60 yrs, BMI 30), follow-up of 4.5 yrs. Colchicine use had a signif. 12% lower risk of Joint Arthroplasty (HR 0.88); 23% lower TJA in knee/hip OA (HR 0.77) https://t.co/bT07lUYBB2
Dr. John Cush @RheumNow ( View Tweet)
GI dz & malnutrition in scleroderma (SSc) is common, assessed by BMI. Among 450 SSc (F/U 5.3 yrs), lower BMI were significantly assoc w/ pseudoobstruction, smaller oral aperture, higher Medsger vascular severity scores. Defines those at risk https://t.co/JY9YFOWE5C https://t.co/xFZ0rCXjQv
Dr. John Cush @RheumNow ( View Tweet)
Persistence of education and monitoring is crucial to optimal gout management
Optimal gout care is dependent on having a well-informed health care provider who recognizes and follows the ACR gout management recommendations. It is important that the misconceptions and myths held https://t.co/XYSwvuihjJ
Dr. John Cush @RheumNow ( View Tweet)
Expert Perspective on Calcium Pyrophosphate Deposition Disease
A current perspective article by Dr. Sara Tedeschi tackles many unresolved issues around CPPD diagnosis, classification, and management, including the lack of clinical trials or FDA approved treatments. https://t.co/zxJ9aQweNl
Dr. John Cush @RheumNow ( View Tweet)
Video
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
Chikungunya Club Meeting (7.24.2026)
Upgrading & Maximizing the Classics (Colchicine, Allopurinol, etc.)-
Seronegative RA Disease Activity (7.17.202)
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What Lies Beneath - Uric Acid Deposition & Imaging
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. Videos include: Gout Management in Patients with CKD, Gout and CVD, and Gout & Obesity.
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Poster Hall
Daily Gem
Weight loss helps gout, but extreme weight loss (bariatric surgery, ketogenic diets) may trigger gouty attacks. (Not seen with GLP-1 agonist weight loss)
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