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Infectious Rheumatology (5.15.2026)
Dr. Jack Cush discusses his favorite journal articles from the past week on RheumNow.com.
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Review of Toll-like Receptor Research
EurekAlert!
A new review on Toll-like receptors (TLRs) systematically summarizes forty years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding of
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Breaking the Rules: Dual-Advanced Combinations in Rheumatology
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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Branebrutinib (Bruton's tyrosine kinase inhibitor) was studied in phase 2 RCT of 85 RA pts for 12 weeks and was safe but failed to achieve an ACR50 response (19% BTK vs 33% PBO; p=0·16). https://t.co/gTjLJm9iIW https://t.co/GN9p1P8ZNJ
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RA adds to mortality risk in nontuberculous mycobact. infx (NTM). Retro study 1420 NTM pts, 66 (4.6) had RA. RA was independent predictor of resp-death (HR 4.30) - partly explained by ILD & systemic inflammation https://t.co/S9bndHsXCE https://t.co/mC74Qve1LZ
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ArthritisPower Registry (now PatientSpot) survey study of 351 RA pts (age 60, F 84%); reported 439 nonserious infx. 27% total infx, 14%w/ MD visist & Abx. Infx incr w/ GC ≥10 mg/d (OR 1.94), but Biologics & JAKi not assoc. w/ greater NSIE risk vs cs DMARDs https://t.co/bHqFnoY0Ud
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Influential Rheumatoid Factors (5.8.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.
https://t.co/BaugLQEIai https://t.co/WdWXAfB5lk
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CorEvitas RA registry study of 9601 RA pts starting b/tsDMARDs (52K yrs F/U) - 10.4% had eGFR<60 9CRI). Achieving CDAI remission was lower w/ CRI - 28% vs 19%(adj HR 0·76 [0·66–0·88]) https://t.co/E42N3PQHwG https://t.co/WNIGGCpCfZ
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Full read review of Preclinical Rheumatoid Arthritis:
- Mucosal Origin Hypothesis
- Gut Microbiota
- Smoking & environment
- Periodontitis
- Immunosenescence
- T cell abnormalities
- Drug prevention https://t.co/SdcDtYGObO https://t.co/2UYGs5eTsu
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Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/8VnmVsuU2h
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24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/hwkpeav4MQ
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Medicare analysis of RA pts w/ metastatic nonsmall cell lung CA (mNSCLC) looked at 663 ICI-treated pts - 46% Rx w/ glucocorticoids (median Pred 6.6 mg/d). GC use was not associated with survival outcomes https://t.co/mwQeAgyKTC https://t.co/SR2XRD5Rhx
Dr. John Cush RheumNow ( View Tweet)
Breaking the Rules: Dual-Advanced Combinations in Rheumatology
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.
https://t.co/4lyYTTwJUU https://t.co/sYpYbCjlzm
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Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis
In this prospective observational study 811 CIA patients analyze outcomes in patients with and without MetS, including cardiovascular death/hospitalization and all-cause death/hospitalization. https://t.co/WT3wTpeGPi
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More Comorbidity in Difficult-to-Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
https://t.co/guMm6mqJGr https://t.co/xiykw5tBlJ
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Full read review of Preclinical Rheumatoid Arthritis:
- Mucosal Origin Hypothesis
- Gut Microbiota
- Smoking & environment
- Periodontitis
- Immunosenescence
- T cell abnormalities
- Drug prevention https://t.co/UgqNBnKLMT https://t.co/2YZEiRCKNi
Dr. John Cush RheumNow ( View Tweet)
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/TmoodnuJTe
Dr. John Cush RheumNow ( View Tweet)
24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/pAEqYJIKaw
Dr. John Cush RheumNow ( View Tweet)
Taiwan, real-world study 267 RA new DMARD starts w/ tofacitinib (145) or TNFi (122). Post adjustments; no significant difference in Efficacy, AEs, Serious AE (20 v 21%), MACE (0 v 0.8%), CA (2% vs 0.8%), deaths (1.4% vs 3.3), SIE (13% vs 8.2%) or H zoster (12% v 3%) https://t.co/XLsdfKyeGx
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French prospective study of pregnancy in 94 RA & 124 SpA pts. RA more likely to flare 1st 6 mos postpartum (62 v 43%), while SpA remained stable in preg & postpartum. bDMARD continuation during pregnancy was more frequent in SpA; 55-60%restarted bDMARD postpartum. https://t.co/usKHS4wYbN
Dr. John Cush RheumNow ( View Tweet)
