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Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA

Jack Cush, MD

After the first tumour necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid arthritis (RA) responded by switching to upadacitinib, compared to cycling to a second TNFi, adalimumab.

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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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Updated CRA/SPARCC Recommendations for Axial Spondyloarthritis

Jack Cush, MD

In 2024, the Canadian Rheumatology Association (CMA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) published a comprehensive set of 56 treatment recommendations for the management of axial spondyloarthritis. This first update is focused on the reassessment of IL-17i recommendations.

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Biologics

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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Spotty Medicare Coverage for Newer Rheumatoid Arthritis Meds

MedPage Today

Medicare coverage of targeted disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) -- both under Medicare Advantage and in separate Part D plans -- is likely to leave many patients wanting, researchers found.

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2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management

Jack Cush, MD

The European Alliance of Associations for Rheumatology (EULAR) has updated their rheumatoid arthritis (RA) management recommendations, notably with fewer recommendations (total of 9, down from 11 in 2022 version), by merging and removing previous recommendations.

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TRACE study of 90 axSpA pts Rx w/ either TNFi or secukinumab (150 or 300 mg)- at wk 56, 59% achieved clinical-remission & 43% achieved w56-MRI-remission (SPARCC) w/ benefits by wk 4. Predictors of clinical remission: ASDAS & BMI (@wk16); none @wk56 https://t.co/CEsAeRMvUE https://t.co/SfSAm3u4IM

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Dr. John Cush RheumNow ( View Tweet)
Malignancies Not Increased with Biologic Therapies The risk of malignancy in RA patients receiving biologic agents was evaluated by metanalysis of RCTs and found no significant increased risk of malignancy compared with other DMARDs or with placebo. https://t.co/ZEO4jP5RwA https://t.co/C1YeTSh7ZN

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Dr. John Cush RheumNow ( View Tweet)
TRACE study in 90 active axSpA, biologic-naïve, Rx w/ secukinumab 150 mg; @wk16 ASDAS remission in 30 (35%)& 55 incr SEC to 300 mg. By wk 24, 22% of 300 mg achieved ASDAS remission; but without signif change in MRI inflamm (SPARCC). Most MRI changes in 1st 4wks https://t.co/pMMtrxxDLh
Dr. John Cush RheumNow ( View Tweet)
Couldn’t attend https://t.co/4UQlqwujiR 2026? You can now watch the entire meeting On Demand. This high-impact program features leading experts discussing: • RA outcomes and pathogenesis • Obesity, inflammation, and rheumatic disease • Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3

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Dr. John Cush RheumNow ( View Tweet)
Updated CRA/SPARCC Recommendations for Axial Spondyloarthritis The original CRA/SPARCC recommendations endorsed IL-17i and TNFi as equivalent second-line options for adults with active axSpA who fail an adequate NSAID trial. JAK inhibitors were reserved for patients with prior https://t.co/e1iLSksgYj
Dr. John Cush RheumNow ( View Tweet)
Ixekizumab With Tirzepatide Efficacy in Obese Psoriatic Arthritis The TOGETHER-PsA trial has demonstrated the efficacy and safety of ixekizumab (IXE) administered with tirzepatide (TZP) in adult active psoriatic arthritis (PsA) patients who were overweight or obese. https://t.co/KFwfi9FaAh
Dr. John Cush RheumNow ( View Tweet)
AFFINITY Study - Combination Biologic Therapy in PsA A pilot trial assessed the efficacy and safety of the guselkumab+golimumab (COMBO) combination versus GUS monotherapy in active PsA (failing a prior tumor necrosis factor inhibitor (TNFi-IR) and showed superiority in ACR 50 https://t.co/f2CB8FnZMB
Dr. John Cush RheumNow ( View Tweet)
Real-world safety of tofacitinib vs biologics in 48,167 #PsA pts Rx w/ TOFA (3,166); TNFi (27K); IL-17Ai (20K); risankizumab (4,381); ustekinumab (4,499). Crude IRs/100 PY were 1.78-2.53 for serious infxn, 0.27–0.61 MI/stroke, 0.17–0.42 VTE, & 0.74–1.06 cancer. TOFA had signif https://t.co/dErlkyY9WC
Dr. John Cush RheumNow ( View Tweet)
Real-world safety of tofacitinib vs biologics in 48,167 #PsA pts Rx w/ TOFA (3,166); TNFi (27K); IL-17Ai (20K); risankizumab (4,381); ustekinumab (4,499). Crude IRs/100 PY were 1.78-2.53 for serious infxn, 0.27–0.61 MI/stroke, 0.17–0.42 VTE, & 0.74–1.06 cancer. TOFA had signif https://t.co/Z5wZTGc5gB
Dr. John Cush RheumNow ( View Tweet)
Retrospective TriNetX Network cohort study of adult PsA (N 123,031) pts, propensity- matched to non-PsA controls. PsA had signif higher CV morbidity: MACE (HR 1.74); mortality (HR 1.95); CHF (HR 1.96), MI (HR 1.71), & CVA (HR 1.49). bDMARDs reduced MACE (HR 0.95) & mortality (HR https://t.co/bHrq9KpwBM
Dr. John Cush RheumNow ( View Tweet)
Long-Term Bimekizumab Safety Data Adverse effects from bimekizumab through 2 years or more of treatment for psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) were about as expected from shorter-term data, results from long-term extension studies indicated. https://t.co/AaJxewNQmQ
Dr. John Cush RheumNow ( View Tweet)
UCB announced topline results of the BE-BOLD head-to-head study where bimekizumab (IL-17i) was superior to risankizumab (IL-23i) study; 553 active PsA in achieving an ACR50 response at 16 weeks. Enrolled PsA pts were either bilogic naïve or who had previous exposure to 1 TNFi

Dr. John Cush RheumNow ( View Tweet)

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