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Lifestyle and Incretin Therapy Advice for Rheumatologists

Jack Cush, MD

As GLP-1/GIP receptor agonists become standard co-management tools for obese patients with RA, PsA, axSpA, and gout, this JAMA Insights perspective by Kushner, et al. reframes lifestyle counseling as an adjunct to pharmacotherapy - a reversal of the traditional model. This has with direct implications for how we counsel obese patients we start or co-manage on these agents.

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Early RA Referral Clinics Work (9.18.2026)

Jack Cush, MD

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

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Early RA Referral Clinics Work!

Jack Cush, MD

An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals.

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A Day of Infamy (9.11.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz!

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JAMA: Review of Adult Rheumatoid Arthritis

Jack Cush, MD

Smolen, Kerschbaumer, Aletaha, and Robinson have published a comprehensive review article of rheumatoid arthritis (RA) in JAMA, noting significant changes to our understanding and treatment guidelines.

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Phenotypic cluster analysis of 134 CPPD pts from COLCHICORT & CHRONIC-CPPD European cohorts ID 4 Grps: 1) C1 monoarticular recurrent flares, older, W, ^CRP; 2) C2 monoarticular w persistent arthritis; 3) C3 polyarthritis lower CRP; 4) C4 polyarticular (spine/shoulder( & recurrent https://t.co/ghMCmDLCki
Dr. John Cush RheumNow ( View Tweet)
True or False: The TriNetX retrospective study found that JAK inhibitors significantly increased VTE risk in rheumatoid arthritis patients undergoing hip or knee replacement compared to TNF inhibitors. Check your knowledge in the latest RheumIQ quiz at https://t.co/LHFv1P6XZe.

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Dr. John Cush RheumNow ( View Tweet)

True or False: According to a metanalysis of 87 studies, higher BMI and smoking were linked to reduced methotrexate efficacy in rheumatoid arthritis. Check your knowledge in the latest RheumIQ quiz at https://t.co/LHFv1P6XZe.

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Dr. John Cush RheumNow ( View Tweet)

Discussing Weight Loss: 3 Minute Script Dr. Jack Cush's 3 Minute Script as discussed in his Introducing Weight Loss video. https://t.co/JRWAPc5if5 https://t.co/jI65VzTIfs

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Dr. John Cush RheumNow ( View Tweet)
Obesity and Rheumatic Disease Presented as part of RheumNow's "The Obesity Imperative" campaign. https://t.co/d2fl4EJX8Q https://t.co/AZGfKRvZrx

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 87 studies shows predictors of #MTX response: early Dz, low dz activity, early MTX initiation, and absence of erosive disease. Smoking and higher BMI were linked to reduced efficacy. https://t.co/OfB09aHNOS https://t.co/4UiOgfW940

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Dr. John Cush RheumNow ( View Tweet)
Early RA Referral Clinics Work! An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals. https://t.co/6vGd0S0V1W https://t.co/2ATEMRhtMM

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Dr. John Cush RheumNow ( View Tweet)
Indian study of 85 #RA pts in LDA or better (DAS28-ESR ≤ 3.2). W/ 6 mos F/U, 39 (46%) had 1+ RA flare (DAS28 > 3.2); time to flare 12 wks (8–18) unrelate to Dz activity. Predictors: seropositivity (HR 2-2.3) https://t.co/ifqeoPtxpx https://t.co/ltx64X55fd

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Dr. John Cush RheumNow ( View Tweet)
Single center study of FALLs in 124 ambulatory RA females ≥50 yrs.(age 68 yrs, DAS28 2.6, sarcopenia 16%, prior fall 25%). 27.4% had falls; predicted by prior fall hx (OR 2.76, hypnotics/anxiolytics (3.92), not steroids or sarcopenia (NS trend) https://t.co/J62RPF9rQs https://t.co/OKxdPl5Oev

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Dr. John Cush RheumNow ( View Tweet)
JAMA: Review of Adult Rheumatoid Arthritis This JAMA narrative review is a follow-up to their 2018 publication, informed by 123 articles (46 RCTs, 28 cohort studies, 11 systematic reviews/meta-analyses, 15 guidelines) covering epidemiology, pathogenesis, diagnosis, and https://t.co/6Fiu9iLF5I
Dr. John Cush RheumNow ( View Tweet)
TriNetX retrospective EHR study showed VTE in #RA not incr by taking JAKi. Pts undergoing THA/TKA Rx w/ JAKi (n 284) vs TNFi (n 288). VTE- 17 JAKi (6%) vs 11 TNFi (3.8%)- nonsignif incr (RR 1.57) https://t.co/OM5ipieQtr https://t.co/ng8b9EkWmT

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Dr. John Cush RheumNow ( View Tweet)
QD Clinic: Weight Loss Changed the Course of RA Dr. Bella Mehta, New York, presents this case which highlights that obesity may be a target for disease modification in rheumatoid arthritis, as part of RheumNow's "The Obesity Imperative" campaign, presented in September 2026. https://t.co/KNNS0cHmA4
Dr. John Cush RheumNow ( View Tweet)
The 1980s quietly rewired rheumatology. Methotrexate became the anchor DMARD. APS emerged as a distinct clinical syndrome. SLE classification was standardized. Cytokine biology began pointing toward the biologic era. A decade that moved rheumatology from symptom control toward https://t.co/9NUXorQDTG

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Aravind Palraj Rheumat_Aravind ( View Tweet)
High BMI decreases the odds for MDA in PsA, esp w/ TNFi Rx (but not Inflx, IL-17i, IL-12/23i, IL-23i, JAKi). Longitudinal PsA cohort 1291 pts (mean BMI 29); Higher BMI independently assoc w/ signif. lower odds for MDA (OR 0.97), also female, age, smoking, FM & Xray damage. https://t.co/zAJ8Pmk1HY
Dr. John Cush RheumNow ( View Tweet)
Cohort analysis shows autoimmune rheum Dz (AIRD) pts who recv COVID vax w/ boosters & updates were 41%, 71%, and 69% less likely to have COVID-related hospitalization (vs no Vax). If only initial vaccine series (without booster/updated vaccine), risk reduction was 5.6%. (n= https://t.co/NdEKKWdOAy
Dr. John Cush RheumNow ( View Tweet)
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