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    ACR, guidance, guidelines
    Written by Lisa Sammaritano, MD, of the Hospital for Special Surgery in New York City, and a committee of nearly 50 other experts, the new guideline also stipulates that corticosteroids are OK for gaining symptom control in newly diagnosed patients and when flares erupt, but the duration should be kept as short as possible.
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Genetic Risks and Severe Cutaneous Reactions to Allopurinol

A matched cohort study shows that HLA-B*58:01 and HLA-A*34:02 are strongly associated with allopurinol-induced severe cutaneous adverse reactions (SCARs), these alleles were absent in more than one-third of those affected, suggesting these are strong but incomplete indicators of SCAR risk. 

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In 2024, 77 pts referred to Rheum for possible PMR were ultimately Dx w/ B19 viral infx. 96% had arthralgia & 7% had PMR-like features (5/5 w/ BL shoulder/neck. prolonged AM stiff, fever & Hi CRP/ESR - none had hip pain. 4/5 were male, w/ mean age of 55 yrs. None were RF/CCP+ https://t.co/AiK2K9whBH
Dr. John Cush @RheumNow (  View Tweet)
There is a growing burden of #OA among middle-aged adults, rising by 123.7%, from 11.8 million in 1990 to 26.4 million in 2021. 56.5% of incident cases & 38% of prevalent cases occur in middle-aged group (70% higher than the elderly (>60 years) population). Highest in hi-income. https://t.co/JVpZ96qe0E
Dr. John Cush @RheumNow (  View Tweet)
20-40% of Autoimmune hepatitis (AIH) is associated with other autoimmune diseases - lead by autoimmune thyroiditis, type 1 DM, ulcerative colitis, Crohn disease, & celiac (but less so for RA, PBC, SLE, Sjögren syndrome, vitiligo). AIH Dx Abs include ANA, ASMA, LKM1. https://t.co/I3ZPHiRgqZ
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Sjogren’s disease: two drugs with positive trials Sjogren’s disease: two drugs with positive trials After several failures of therapies in Phase 3 trials of Sjogren’s disease (SjD) over many years, all hope is not lost! At #ACR25, not one but two drugs presented their efficacy https://t.co/kTTdZnVUtj
Dr. John Cush @RheumNow (  View Tweet)
RETREAT study was a 12 wk RCT of Tai Chi in 178 knee OA pts Rx w/ online OA info vs same plus free web based tai chi video program. Tai Chi group had signif improved knee pain (−2.7 v -1.2); (−12 v −6.9) & achieved a minimal pain & function (73% v 47%); and Its free! https://t.co/WLzQ9YHrcu
Dr. John Cush @RheumNow (  View Tweet)
Off the Shelf: CAR-T Dr. Akhil Sood reports on abstract 0663 (iPSC-Derived Off-the-Shelf anti-CD19 CAR T cells Deliver Improved Clinical Outcomes in Lupus with Reduced or No Conditioning Chemotherapy) presented at#ACR25. https://t.co/mj4b5cCInC https://t.co/s34atFCMlx
Dr. John Cush @RheumNow (  View Tweet)
AI in Fellow Recruitment: A New Dawn in Medical Education? Drs. Mrinalini Dey and Bharat Kumar abstract 2174 (Using Natural Language Processing to Identify Character Strengths in Rheumatology Fellowship Candidate Applications: A Feasibility Study) presented at #ACR25. https://t.co/gGx4zZlfAm
Dr. John Cush @RheumNow (  View Tweet)
Beyond the Breakthrough: Equity and Access in CAR-T Cell Therapy for RA At #ACR25, abstract 1039, "Global Cost-Effectiveness and Equity in CAR-T Cell Therapy for Rheumatoid Arthritis," highlights the critical economic and ethical dimensions of CAR-T cell therapy in autoimmune https://t.co/Rci0dL7THj
Dr. John Cush @RheumNow (  View Tweet)
“It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change." – Charles Darwin

Dr. John Cush @RheumNow (  View Tweet)

Are we putting the CAR-T before the horse? CAR T-cells have been a revolutionary development in rheumatology. We have seen a population of patients with severe refractory autoimmune conditions almost overnight presented with the prospect of not just improvement, but of a cure. https://t.co/gF9FXjAZ7F
Dr. John Cush @RheumNow (  View Tweet)
B Cell Depletion: Check the Lymph Node Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25. https://t.co/bvZMGWNzfe https://t.co/dB6iQlgoYx
Dr. John Cush @RheumNow (  View Tweet)
900,000 vs 9 It takes about 900,000 minutes to become a board-certified dermatologist. At that point, you might be very skilled and well-informed. It takes less than nine minutes to make your patient feel seen, understood and reassured. If you skip the 9 minutes, you wasted the https://t.co/o7BaWjS4HB
Dr. John Cush @RheumNow (  View Tweet)

The Interview (11.7.2025)

I've done thousands of interviews; mostly for medical school admissions or medical and research employment.  They’re all the same. I'm looking for the “right one” and the interviewee is somewhere between apprehension, uncertainty and hope.  From all this experience I’ve developed my own perspective on interviews and interviewing that has been amended in the digital/virtual era.

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IL-23 Blockade Goes Oral A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the interleukin-23 receptor (IL-23R), is showing encouraging efficacy and safety across a range of psoriasis (PSO) and https://t.co/7awBk16ZrQ
Dr. John Cush @RheumNow (  View Tweet)
Stopping therapy in GCA At #ACR25 we saw the SELECT-GCA extension data presented in the first plenary session, looking at the second year after the 52 week original study, comparing upadacitinib versus placebo in GCA. In this second year, patients in remission on upadacitinib https://t.co/GaYNWr3Sjq
Dr. John Cush @RheumNow (  View Tweet)
Weight Loss as a Therapeutic Goal in PsA PsA is a complex inflammatory disease often complicated by obesity, which not only worsens disease activity but also impairs treatment response. At #ACR25, 3 compelling studies spanning pharmacologic, lifestyle, and longitudinal https://t.co/Q6IFGn5zCI
Dr. John Cush @RheumNow (  View Tweet)
IgG4: Rare, but new treatments on the horizon IgG4 is a rare autoimmune disease with excessive IgG4 immunoglobulins that can affect multiple organs yielding plasma cell deposition (inflammation) and fibrosis. https://t.co/v07Kp5tQXg https://t.co/rIvOF0mrM1
Dr. John Cush @RheumNow (  View Tweet)
Do Patients with Rheumatic Diseases 'Weather' the Storm? Dr. Janet Pope reports on abstract 0164 (Online Patient Survey on the Impact of Extreme Weather Events on Autoimmune and Rheumatic Diseases) presented at #acr25. https://t.co/rY3T6tWsgu https://t.co/vdgT2DB5lH
Dr. John Cush @RheumNow (  View Tweet)
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