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pregnancy,embryo,fetal

Can I Use JAK Inhibitors During Pregnancy?

Jack Cush, MD

In 2020, the ACR Recommendations on Reproductive Health notably avoided firm guidance on the use of JAK inhibitors (JAKi) during pregnancy stating, "There is no available evidence regarding use or safety of the new small- molecule agents, tofacitinib, baricitinib, and apremilast, during pregnancy."

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Emergencies, Independence & Hemorrhage (1.23.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com

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Lindsay Tom

Hidden in Plain Sight: IBD

Lindsay Tom PA-C

As a PA with six years of experience in rheumatology and a background in gastroenterology, today I'm discussing the clinical overlap between inflammatory arthritis—particularly psoriatic arthritis and spondyloarthropathies—and inflammatory bowel disease.

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Turkey Tryptophan (11.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

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Cush and Kavanaugh

ACR 2025 Rheumatology Round Up

Jack Cush, MD

Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.

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microbiome,blue

Microbiome may hold key to methotrexate response in RA

Mrinalini Dey, MD

Methotrexate (MTX) remains the cornerstone of rheumatoid arthritis (RA) treatment, yet it remains unclear as to how to predict who will respond to it. Two studies presented at ACR (Abstracts 2639 and 2643) suggest the answer may be hiding in the gut.

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Diacerin, an IL-1β blocker, compared to placebo in a 262 pt RCT of knee pain, Knee #OA w/ inflammation. After 24 wks, 88% completed the trial & (vs PBO) diacerein did not improve knee pain (−19.9 vs −18.6 mm). 42% had AE/ GI Sxs were more w/ diacerein (42% vs 25% PBO https://t.co/P2d6IhFw2I
Dr. John Cush RheumNow ( View Tweet)
Diacerin, an IL-1β blocker, compared to placebo in a 262 pt RCT of knee pain, Knee #OA w/ inflammation. After 24 wks, 88% completed the trial & (vs PBO) diacerein did not improve knee pain (−19.9 vs −18.6 mm). 42% had AE/ GI Sxs were more w/ diacerein (42% vs 25% PBO https://t.co/QabS3xLN85
Dr. John Cush RheumNow ( View Tweet)
Antimitochondrial antibodies (AMA)in systemic sclerosis? Retro study of 165 SSc pts (20% diffuse, 33% ILD, 7% PAH); 51% centromere AB+; 29% topoisomerase I+, 12% RNA polymerase III+)-- 22% AMA-positive: assoc w/ GI vascular dz(OR 13.3), gastric antral vascular ectasia (OR 8) & https://t.co/FRhn9qIfOW
Dr. John Cush RheumNow ( View Tweet)
Antimitochondrial antibodies (AMA)in systemic sclerosis? Retro study of 165 SSc pts (20% diffuse, 33% ILD, 7% PAH); 51% centromere AB+; 29% topoisomerase I+, 12% RNA polymerase III+)-- 22% AMA-positive: assoc w/ GI vascular dz(OR 13.3), gastric antral vascular ectasia (OR 8) & https://t.co/epMgfbj5uW
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC Helicobacter pylori Update: H. Pylori remains the most common chronic bacterial infection worldwide, acquired in childhood and lifelong if untreated. Its clinical impact spans far beyond dyspepsia—from ulcers to malignancy. #RNL26 tis

Dr. John Cush RheumNow ( View Tweet)

Hidden in Plain Sight: IBD As a PA with six years of experience in rheumatology and a background in gastroenterology, today I'm discussing the clinical overlap between inflammatory arthritis—particularly psoriatic arthritis and spondyloarthropathies—and inflammatory bowel https://t.co/Aatc4jkbpH
Dr. John Cush RheumNow ( View Tweet)
Study of 177 #SSc pts (116 w/ SSc-ILD vs 61 without ILD). SSc-ILD had more dcSSc, Raynaud’s & GI Dz. SSc-ILD predicted by triad of elevated NLR, PT, anti-SCL-70 (AUC of 0.879; sensitivity 82.6%; specificity 85.0%). NLR: neutrophil to lymphocyte ratio; PT: prolonged prothrombin https://t.co/iI6ZnZgJE7
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/FphWZwwohx
Dr. John Cush RheumNow ( View Tweet)
Fighting fire with butyrate 🔥🚒 ♦️probiotics and prebiotics Dr. Nisha Manek on inflammation and butyrate - it reduces gut inflamm thru the NFKB pathway #ACR25 @RheumNow https://t.co/19XTrKn1iN

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sheila RHEUMarampa ( View Tweet)
Gut microbiome on Urate metabolism study- 1500 men and women. From 3 cohorts- Framingham, nurses health and men's lifestyle with blood and stool data Focused on 5 urate metbolizing genes Abst#2590 #ACR25 @RheumNow https://t.co/YxBb3WfcbB

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Bella Mehta bella_mehta ( View Tweet)
Dr. John Stone on IgG4RD ⬆️ common in males ⬆️internal organ involvement 🔸Mimics cancer 🔸Indolence makes it dangerous —-> organ complications Diagnosis highly dependent on the rheumatologist based on clinical features, serologies, imaging & pathological data #ACR25 @Rheumnow https://t.co/St4EbA7Dcj

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sheila RHEUMarampa ( View Tweet)
In case you have a (gut) feeling something’s off… Abstract 2315: The gut microbiome in #SpA 🔬 ⬆️ Proteobacteria (incl. Escherichia spp) ⬇️ Firmicutes (“good” bacteria) Higher disease activity ↔️ lower alpha diversity @RheumNow #ACR25

Akhil Sood MD, MS AkhilSoodMD ( View Tweet)

In a cohort of 269,304 IBD patients, NSAID use showed a small increase in IBD-related hospitalisation (HR 1.08), meeting non-inferiority threshold (HR <1.2). No risk in UC (HR 0.96); modest risk in Crohn’s (HR 1.16). Relooks at the current paradigm of blanket NSAID avoidance in https://t.co/O8MWg1BP50

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Mayer et al. NSAIDs in IBD. Retrospective cohort study. 250000 individuals. Non-inferiority study. No increased IBD-related hospitalisation in UC, but an increase in all-cause hospitalisation. @RheumNow #ACR25 Abstr#1434 https://t.co/he2Xmcqslk

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Richard Conway RichardPAConway ( View Tweet)
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