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Breaking the Rules: Dual-Advanced Combinations in Rheumatology

Jack Cush, MD

For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes. 

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Malignancies Not Increased with Biologic Therapies

Jack Cush, MD

The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo.

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JAMA Guideline on the Management of Crohn Disease

Jack Cush, MD

JAMA has published a current Clinical Guidelines Synopsis on the Management of Crohn Disease (CD) in Adults.

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AFFINITY Study - Combination Biologic Therapy in Psoriatic Arthritis

Jack Cush, MD

A pilot trial assessed the efficacy and safety of the guselkumab+golimumab (COMBO) combination versus guselkumab (GUS) monotherapy in active PsA (failing a prior tumor necrosis factor inhibitor (TNFi-IR) and showed superiority in ACR 50 responses but not minimal di

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Moral Distress (3.27.2026)

Jack Cush, MD

Dr. Jack Cush reviews the journal reports and news from RheumNow.com.  This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.

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Systemic Treatments for Chronic Plaque Psoriasis

Jack Cush, MD

JAMA Dermatology has published a review of the pharmacologic landscape on managing adults with moderate to severe plaque psoriasis.

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Rheumatology Pitfalls (3.20.2026)

Jack Cush, MD

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

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FDA Approves Icotrokinra for Plaque Psoriasis

Jack Cush, MD

Today the FDA approved an oral IL-23 inhibitor, icotrokinra (Icotyde), for use in moderate-to-severe plaque psoriasis in adults and children 12 years of age and older (who weigh at least 40 kg) who are candidates for systemic therapy or phototherapy.

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UBER Rheumatology Ride (3.6.2026)

Jack Cush, MD

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

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SATISFACTION (2.27.2026)

Jack Cush, MD

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

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Paradoxical Reactions, Target Selection & the Future of Imaging in Psoriatic Care

Audrey Gibson, PA-C

From paradoxical psoriasis to IL-23 vs IL-17 to imaging in PsA, speakers in RheumNow Live's "Decisions in Psoriatic Arthritis" pod delivered valuable, clinically relevant education.

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ANA Pollution (2.06.2026)

Jack Cush, MD

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

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https://t.co/4UQlqwujiR 2026 brought together leading rheumatology experts for two days of practical, clinically focused education. Now you can watch the full program On Demand. Highlights include: • RA mortality trends and the mucosal hypothesis • IL-23 vs IL-17 inhibitor https://t.co/YMfxa7PDXF

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Dr. John Cush RheumNow ( View Tweet)
FDA has accepted the supplemental biologics license application for use of interleukin-23 inhibitor tildrakizumab (Ilumya; Sun Pharma) in active psoriatic arthritis (PsA) in adults. https://t.co/cwqz9DoWsL https://t.co/ut0A4MwqW7

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Dr. John Cush RheumNow ( View Tweet)
FDA Approves Icotrokinra for Plaque Psoriasis The FDA approved an oral IL-23 inhibitor, icotrokinra (Icotyde), for use in moderate-to-severe plaque psoriasis in adults and children 12 years of age and older who are candidates for systemic therapy or phototherapy, according to a https://t.co/q5b3TceFHx
Dr. John Cush RheumNow ( View Tweet)
SOLSTICE: phase 3b RCT of IL-23i, guselkumab vs PBO in 451 active PsA pts (GUS q4wk vs q8wk vs PBO). @wk 24 GUS signif better than PBO-ACR20 (59%/62% vs 35%), ACR50 (31%/32% vs 12%), ACR70 (17%/17% vs 2%), PASI 90 (49%/45% vs 12%), MDA (19%/24% vs 5%) ction) https://t.co/QDMCnGdN6J
Dr. John Cush RheumNow ( View Tweet)
FDA has accepted the supplemental biologics license application for use of interleukin-23 inhibitor tildrakizumab (Ilumya; Sun Pharma) in active psoriatic arthritis (PsA) in adults. https://t.co/cwqz9DoWsL https://t.co/fN8pbWtmfT

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Dr. John Cush RheumNow ( View Tweet)
IL-23i fails in GCA? Small RCT of 53 GCA pts (age 71 yrs; 60% new; 40% relapsing GCA) 35 given Guselkumab vs 18 on PBO. Wk 28 GC free remission in 40% vs 33% (P .64), also w/ similar flare rates (31% v 39%). results didnt supportguselkumab use in GCA. https://t.co/AMTmiDBc94 https://t.co/4AQe8HbwQp

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Dr. John Cush RheumNow ( View Tweet)
IL-23i fails in GCA? Small RCT of 53 GCA pts (age 71 yrs; 60% new; 40% relapsing GCA) 35 given Guselkumab vs 18 on PBO. Wk 28 GC free remission in 40% vs 33% (P .64), also w/ similar flare rates (31% v 39%). results didnt supportguselkumab use in GCA. https://t.co/AMTmiDBc94 https://t.co/KdWTX9K2Bo

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Dr. John Cush RheumNow ( View Tweet)
RT @gibson_RheumPAC Axial PsA remains an area of active investigation. IL-17 inhibitors show consistent benefit, while IL-23 data are emerging—highlighting nuances when axial symptoms drive treatment choice. #RNL26 https://t.co/XFL3Sf8iK4
Dr. John Cush RheumNow ( View Tweet)
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