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Sleep and Obesity: A Bidirectional Relationship

Jack Cush, MD

In July 2026, JAMA concisely reviewed the bidirectional relationship between sleep health and obesity. Obesity affects roughly 40% of US adults and sleep problems affect nearly one-third. This review outlines the biological mechanisms and clinical interventions relevant to weight management.

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NME: New Molecular Entities (8.28.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com. Take this week's RheumIQ and test your knowledge!

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Wealth and Where you Live Influences Outcomes

EurekAlert!

Patients from wealthier European countries tend to start treatment with biologics earlier but also stop or switch treatment earlier. They also experience lower disease activity at treatment start than patients in middle- and low-income countries.

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A Tribute to Daniel L. Kastner, MD, PhD (1951–2026)

Jack Cush, MD

The rheumatology, genetics and NIH communities mourn for Dr. Daniel L. Kastner, who died on July 28, 2026, in Bethesda, Maryland, at age 74. The following are declarations, tributes, and memories dedicated to this mensch of a man, titan of science, memorable mentor and humble physician.

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Methotrexate Safety Tips (7.31.2026)

Jack Cush, MD

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

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The Wider Implications of Dactylitis

Jack Cush, MD

Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis. This review article discusses the wider implications of dactylitis in rheumatology and medicine underscores the diagnostic and prognostic significance of this manifestation.

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Psoriatic Arthritis: EULAR 2026 Recap

Jack Cush, MD

Years of IL-17 vs. IL-23 debate in PsA finally got tested head-to-head: bimekizumab outperformed risankizumab on joint outcomes in the BE BOLD trial, while a GLP-1 combination study suggests weight and metabolic status are active drivers of PsA — not just comorbidities. This recap also digs into early signals that biologic choice may influence whether psoriasis progresses to PsA, and why some well-controlled patients are still in pain.

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ACP Position Paper on Dietary Supplements

Jack Cush, MD

More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives.

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QD Clinic: The Weight Behind Delay in Diagnosis Dr. Antoni Chan, London, discusses a case of a patient with ankylosing spondylitis whose weight delayed the diagnosis and treatment of AS. This QD Clinic is presented as part of RheumNow's "The Obesity Imperative" campaign, https://t.co/fDozAaX64j
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Rheums! Do you have a Rheumatology question or case for Dr. Cush? Record it here, and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/LZ59KW8HdA https://t.co/DwHdvpTYax

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Aortic inflammation (Aortopathies) occurs in autoimmune rheumatic diseases (ARD) including Takayasus, #GCA, SLE, RA, AS, SSc, relapsing polychondritis, Cogan’s syndr, Behçet’s, & IgG4-related disease). Dx imaging options: CTA, MRI, & PET/CT. Underlying path may be granulomatous, https://t.co/paUlV4kdwJ
Dr. John Cush RheumNow ( View Tweet)
Aortic inflammation (Aortopathies) occurs in autoimmune rheumatic diseases (ARD) including Takayasus, #GCA, SLE, RA, AS, SSc, relapsing polychondritis, Cogan’s syndr, Behçet’s, & IgG4-related disease). Dx imaging options: CTA, MRI, & PET/CT. Underlying path may be granulomatous, https://t.co/lKBhEnTcKB
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Ivarmacitinib (AKA SHR-0302) is a JAK1 inhib approved in China. Phase II/III RCT (NCT04481139) in active #AS Rx w/ ivarmacitinib 4 mg (n 187) or placebo (n 186) showing IVRMA @wk 12 IVRMA had signif better ASAS20 response(49% vs 29%) & ASAS40 (32% vs 18%). Also superior: total https://t.co/ilVtrQgHxR
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Joint Pain Prevalence is not Declining A current report from the national NHIS survey shows that over half of US adults diagnosed with arthritis reported moderate to severe joint pain. https://t.co/zq7pGaZO72 https://t.co/kvco72v5IZ

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Prolonged exposure to targeted Rx in #SpA not assoc w/ increased cancer risk. French claims study 56,591 SpA pts- 1,224 CA (1,029 solid, 116 Heme). TNFi, IL17i, IL12/23i, IL23i, JAKi Exposure >6 vs ≤6 mos assoc w/ lower CA (HR 0.86; 0.75-0.99); signif for Heme (HR 0.65), not https://t.co/rHAa0CkAjT
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2026 BSR Pain Guideline: What Rheumatologists Need to Know The British Society for Rheumatology has issued its first guideline dedicated solely to pain in inflammatory arthritis (IA)—covering RA, PsA, axial SpA and JIA. https://t.co/3Jtneox8Rh https://t.co/06ccLhjhMh

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Dr. John Cush RheumNow ( View Tweet)
The Wider Implications of Dactylitis Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis. https://t.co/HRaIvMHMSV https://t.co/XOcHbFVMsS

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Dr. John Cush RheumNow ( View Tweet)
Coding: ICD-10 Code M45.7 describes ankylosing spondylitis of the lumbosacral region, a billable ICD-10-CM diagnosis code valid for FY2026. M45.7 became effective October 1, 2025 and belongs to the M45 parent category covering ankylosing spondylitis by anatomical site. https://t.co/jBmoD0CVps
Dr. John Cush RheumNow ( View Tweet)
From 2015-2024, 148 inflam arthritis pts (43 SpA, 35 PsA, 50 RA) w/ a prior cancer were followed 58.1 mos. 24 (19%) had CA recurrence/progression. Post-CA exposure to b/ts-DMARDs did not incr. recurrence risk after adjusting for age & comorbidity burden. https://t.co/MHKIqwyjNN https://t.co/uhOdq1cCPW

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Metanalysis of 51 studies shows vaccination is suboptimal in Rheum. Influenza Vax rates: RA 50%, SLE 42%, AS 43% & Psa 53%. Pneumococcal vaccinations even lower: 37%, 30%, 39% and 41%. More by with age & comorbidites and by rheumatologists (vs PCPs) https://t.co/3DborC9BLW https://t.co/MPDeJUH0HI

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