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Trends in Rheumatoid Arthritis Mortality
A recent study examines trends in rheumatoid arthritis (RA)-related mortality among U.S. postmenopausal women (aged 55 and older). They found RA mortality rates have declined, yet disparities in who is most affected persist, especially for white women, and those over 85 yrs of age.
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Emergencies, Independence & Hemorrhage (1.23.2026)
Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com
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Full read review & update on Rhabdomyolysis. 26K cases/Yr in USA. Muscle damage leading to weakness, myalgias, swelling, myoglobinuria, electrolyte probs, AKI. Causes: 1) exogenous toxins (46%); 2) trauma; 3) myopathies/metabolic muscle dz (10%), infxn. AKI in 46%, & death in https://t.co/E2LcLeMls0
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC
Given rising resistance, effective first-line regimens and adequate duration (14 days) are critical. PPI-based quadruple regimens remain highly effective when patients can adhere.
#RNL26 https://t.co/bxqMbPFegt
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD
#RNL26
Prosthetic joint infection vs flare?
- PJI risk 50-80% higher in RA (OR 1.47-1.8)
- Immunosuppressants, intra-artic injections, RA activity, BMI incr risk
- Delay in diagnosis https://t.co/XTozafDQyf
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD
#RNL26
Inflammatory arthritis pts getting TKA:
- increased risk of RBC transfusion (OR 1.39), infection (1.64) and readmission (1.46)
- THA: also risk of mechanical complications (like dislocation) OR 1.3 https://t.co/ovW2C2EuXF
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)
RT @richardPAconway
We have improved RA mortality in many areas but respiratory (mainly ILD) and infectious issues remain stubbornly elevated. #RNL26 https://t.co/ViucOIOOzY https://t.co/3kIqPMeKKX
Links:
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAconway Disease activity is a strong risk factor for RA-ILD. Particularly for moderate/high disease activity but there appears to be a linear relationship (at least above a certain threshold) #RNL26 https://t.co/ot8ttdmu5G
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinmd
RA-ILD #RNL26
Jeff Sparks
MTX and ILD
- Rare MTX-induced pneumonitis. 7 cases in n=4786 (0.3% cases) vs <0.1 on PBO, rare diff from ILD
- No increase in incident ILD - meta-analysis of 7 studies show OR 0.49 https://t.co/k2XeAzBsYB
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAconway
UIP is predominant radiologic pattern in RA-ILD. Contrast with our other diseases. But by no means exclusive - up to 50% of RA-ILD have a more inflammatory pattern. Important treatment implications! #RNL26 https://t.co/HmW1mz429i
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinmd
Mucosal Hypothesis RA #RNL26
Demoruelle
Mucosal origins of RA?
Key sites of immune-environment interaction initiate local inflamm, becomes systemic
Link of lung inflamm/immune dysregulation - ass w/ smoking, ILD
NETs in lung drive RA path?
Gut/oral microbes drive
Dr. John Cush RheumNow ( View Tweet)
Japanese nationwide survey of 1943 RMD pts taking Azathioprine (AZA) 34% had adverse events: hepatobiliary (149%), GI (10%), blood/lymphatic (9%), infections (5%), & skin (2.4%). AEs lead to 71% D/C AZA. Serious AEs (Gr ≥3) higher w/ older (OR 2.5), & SLE (OR 2.3) https://t.co/lVNYVQATfx
Dr. John Cush RheumNow ( View Tweet)
IXCHIQ - a live-attenuated chikungunya virus vaccine: 10-30% have mild-moderate adverse effects, w/ headache, fatigue, & myalgia. <3% have severe AEs. Rare reports of encephalitis in elderly post Ixchiq, due to type I IFN-neutralizing autoantibodies (same w/ yellow-fever Vax) https://t.co/3VlZCd4sGc
Dr. John Cush RheumNow ( View Tweet)
🧬 PAPA Syndrome: When Sterile Inflammation Mimics Infection
(Pyogenic Arthritis, Pyoderma gangrenosum, Acne)
•A rare monogenic autoinflammatory disease
•Caused by gain-of-function mutations in PSTPIP1
🧠 Pathophysiology
•Mutant PSTPIP1 → increased interaction with pyrin https://t.co/tJ4INdgfky
Ravi Kumar RheumattDoc ( View Tweet)
Turkish study of 128 Psoriatics (62 PSO, 66 PsA) found more periodontitis in PsA vs PSO (47% vs 31%; P=.058). Signif. higher levels of Dz activity seen for PSO (CPDAI: OR 1.38; P = .001) & enthesitis (MASES: OR 1.39; P < .001) if periodontitis present in PsA patients. https://t.co/d8OfarFWeG
Dr. John Cush RheumNow ( View Tweet)
French Retrospective study (2011-22) of 36129 adult psoriasis pts on biologics who recv antibiotics (9366/26% @ baseline, 61% during FU). Abx treatment assoc w/ 12% greater risk biologic D/C (HR 1.12); more for multiple Abx courses (HR 1.29; 95% CI, 1.24-1.35) https://t.co/2Jv5xCibyd
Dr. John Cush RheumNow ( View Tweet)
Diffuse Alveolar Hemorrhage in Rheumatic Disease
A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/K1fLo5iHpd
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Mu3OyA4EOD
Dr. John Cush RheumNow ( View Tweet)
A 2 yr. old female pt reported w/ a a novel P435S gain-of-function variant in TLR7 (thought pathogenic in SLE) - pt dx w/ juvenile SLE, recurrent infection, and neuroinflammatory features. A review of 12 other TLR7 GOF variants revealed similar SLE associations. https://t.co/NU553QwCtj
Dr. John Cush RheumNow ( View Tweet)
