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Moral Distress (3.27.2026)
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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Rheumatology Pitfalls (3.20.2026)
Dr. Jack Cush reviews the regulatory actions, news and journal reports from this past week on RheumNow.com.
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Predictors of Response in Lupus
A systematic review suggests that traditional measures (serologies and disease activity) are superior to biomarkers in predicting response to biologics in systemic lupus erythematosus (SLE) patients.
Pitfalls of autoimmune serologic testing
Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of serological autoimmune markers.
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NEJM: Obinutuzumab in Active Systemic Lupus Erythematosus
A phase 3 trial of obinutuzumab, an anti-CD20 monoclonal antibody, showed potent B-cell depletion and clinical efficacy active systemic lupus erythematosus without evidence of nephritis.
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Long-Term Hydroxychloroquine Retinopathy Risk
MedPage Today
About one in 18 patients taking hydroxychloroquine (HCQ) for 15 years develop retinal damage, a new meta-analysis indicated.
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A retrospective cohort study of 195 renal Bx from 135 Lupus Nephritis pts, Mod-Severe interstitial fibrosis and tubular atrophy (IFTA) strongly assoc w/non-renal response & ESRD progression (HR 8.9) (also w/ age, SLE duration, prior LN flares, higher chronicity index) https://t.co/773xsk6IHZ
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Predictors of Response in Lupus
A systematic review suggests that traditional measures (serologies and disease activity) are superior to biomarkers in predicting response to biologics in systemic lupus erythematosus (SLE) patients.
https://t.co/7YuYpoDctR https://t.co/J5VLrkDQ6G
Dr. John Cush RheumNow ( View Tweet)
A retrospective cohort study of 195 renal Bx from 135 Lupus Nephritis pts, Mod-Severe interstitial fibrosis and tubular atrophy (IFTA) strongly assoc w/non-renal response & ESRD progression (HR 8.9) (also w/ age, SLE duration, prior LN flares, higher chronicity index) https://t.co/3JGLi5R5Fs
Dr. John Cush RheumNow ( View Tweet)
REVEAL, a 5-yr real-world study of 236 SLE pts initiating anifrolumab (basekbube SLEDAI-2K 7 for mucocutaneous (67%) & MSK (49%) dz. At 6 months, 26% achieved remission, 66% reached LLDAS, and 57% achieved LLDAS5. Authors claim rapid onset of action https://t.co/16OQatOcPj https://t.co/mU9aciCNcH
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NEJM: Obinutuzumab in Active Systemic Lupus Erythematosus
A phase 3 trial of obinutuzumab, an anti-CD20 monoclonal antibody, showed potent B-cell depletion and clinical efficacy active systemic lupus erythematosus without evidence of nephritis.
https://t.co/OEuNAZlgzp https://t.co/yjUmJITAmQ
Dr. John Cush RheumNow ( View Tweet)
Prospective multinational cohort of 1180 lupus pts, followed ~2.7 yrs. 37% had renal biopsies (Class III/IV 56%). They achieved mCRR 46%, mPERR 53%, LLDAS 60%, & REMission 46% at least once. renal response highest @ 2 yrs. New organ damage 11% @ 1yr; 33% by 5yr. https://t.co/ugh60M08Xf
Dr. John Cush RheumNow ( View Tweet)
Hydralazine and the Rare Risk of Vasculitis
Since the 1980s, hydralazine has been a notable cause of drug-induced lupus, and inferred to cause vasculitis as well. A retrospective cohort study from Canada has shown that vasculitis resulting from hydralazine is possible, but https://t.co/ewqCesatbm
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Urinary biomarkers improve w/ anifrolumab in TULIP-LN (lupus nephritis) trial; 112 pts, 197 uriniary proteins assessed. Urinary CD163 and MCP-1 signif improved as early as wk 12. Anifrolumab reduced the proteomic inflammatory signature, regardless of responder status https://t.co/n6fIJVDCN1
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The Role of Calcineurin Inhibitors in Lupus Nephritis
In the U.S, lupus nephritis affects approximately 40–50% of patients with systemic lupus erythematosus (SLE), contributing significantly to the morbidity and mortality of the affected individuals (1). However, significant https://t.co/sc4cgAYzGy
Dr. John Cush RheumNow ( View Tweet)
NEJM: Obinutuzumab in Active Systemic Lupus Erythematosus
A phase 3 trial of obinutuzumab, an anti-CD20 monoclonal antibody, showed potent B-cell depletion and clinical efficacy active systemic lupus erythematosus without evidence of nephritis.
https://t.co/b5qHBotxbI https://t.co/dqzZodOokq
Dr. John Cush RheumNow ( View Tweet)
Update on FDA complete response letter to AZ regarding BLA hold for anifrolumab (Saphnelo) for SC use in SLE. CRL originally issued 10/10/25, but announced 2/3/26. FDA CRL cites critical data quality w/ key analyses in SC-TULIP study. A BLA decision expected in 1st half of 2026 https://t.co/zuwtsdL6I9
Dr. John Cush RheumNow ( View Tweet)
The Role of Calcineurin Inhibitors in Lupus Nephritis
In the U.S, lupus nephritis affects approximately 40–50% of patients with systemic lupus erythematosus (SLE), contributing significantly to the morbidity and mortality of the affected individuals (1). However, significant https://t.co/JBz0gQeJUr
Dr. John Cush RheumNow ( View Tweet)
Hydroxychloroquine Lowers SLE and RA Hospitalizations
A population-based study from British Columbia, Canada, shows that antimalarial adherence was associated with a lower risk of hospital admission in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus https://t.co/vsJDOh09ji
Dr. John Cush RheumNow ( View Tweet)
Observational study of 42 Mexican lupus nephritis pts on Immunosuppressives + Calcineurin Inhibitors (CNIs) @ 12 mos complete & partial responses seen in 26% & 36%, w/ signif reduction in proteinuria (2.89 vs 0.72 g/d, p < .001), & transient decrease in eGFR at 12 mo (109 vs 114) https://t.co/Het4GKaTmv
Dr. John Cush RheumNow ( View Tweet)
