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The pain that inflammation does not explain in SpA and PsA
Clinicians often come across the scenario of a patient with well-controlled spondyloarthritis where the ASDAS in the low disease activity range, CRP normalised, joints clinically quiet. However, the patient returns to the clinic still reporting significant pain. Their rheumatologist adjusts the biological, waits, returns. The pain persists.
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Quiz Talk (5.22.2026)
Dr. Jack Cush talks of birthdays, Quizzes and journal articles this week on the podcast.
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Fatigue in SLE
An NIH lupus cohort study looked at fatigue in SLE and found associations with organ damage, obesity, but does not correlate with disease activity in systemic lupus erythematosus (SLE) patients.
🔮 Can polygenic risk scores predict PsA timing in psoriasis?
Another GWAS study (n=703) says YES!
70-SNP model achieves AUC 0.843 for predicting PsA onset <10 vs >10 years
#POS0088 #EULAR2026 @RheumNow https://t.co/wI4Jy8Yu2A
Nelly ZIADE 🍀 Nellziade ( View Tweet)
@RheumNow HOT #Obesity session (7)
📢A call for action
Current RMD treatments ignore obesity:
They all target immune response but miss the metabolic-inflammatory loop
Breaking that cycle may be the missing piece
Obesity must be part of every rheumatology plan
#EULAR2026 @rheumnow
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Treatment for #lupus #brain #fog?!
#small #RCT of Memantine a N-methyl-D-aspartate receptor (NDAR) antagonist used in #Alzheimers
SLE-more permeability in #brain #SLE -antiDNA cross reacting w NDAR
#memantine N=19 v #PBO N=25 showed more improvemt
#EULAR2026 @RheumNow POS701 https://t.co/qvHOy9oDS7
Janet Pope Janetbirdope ( View Tweet)
ClearMEMory: Ph2 RCT evaluating memantine for tx of cognitive impairment in SLE using RBANS as outcome measure
MEM grp had sig. higher change in RBANS TIScore upto wk 12 vs. PBO, esp. immediate memory index score
Potential adjunct tx for NPSLE?
AbsPOS0701 @RheumNow #EULAR2026 https://t.co/UffdVPRu6s
sheila RHEUMarampa ( View Tweet)
D2T RA shows a linked brain–psychology–immune signature
Cohort D2T RA vs non-D2T RA vs HC
91% D2T RA
Higher catastrophizing
Higher pain sensitivity
More emotion-focused coping strategies
“Chronic pain-like” profile
Associated with higher CNS related gene expression NRG1 https://t.co/nkQco73vqI
Aurelie Najm AurelieRheumo ( View Tweet)
Sad to see this but important to be aware. Increasing risk of suicide using colchicine in Familial Mediterranean Fever. #POS0768 #EULAR2026 @rheumnow.
Average age 28! 87%female, only 7 % with psychiatric referral!
Retrospective 15 pts. https://t.co/241SE6O395
Links:
Bella Mehta bella_mehta ( View Tweet)
Day 2 of #EULAR2026 Studies to look forward today in #axSpA: new classification criteria performance, sex differences in disease progression, early disease treatment data, primary care education to reduce delays to diagnosis @RheumNow
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
🥗 Does diet improve PsA?
DIPSA RCT: Mediterranean/DASH/Standard all improved DAPSA in 92pts
Weight loss drove outcomes
OP070 #EULAR2026 @RheumNow https://t.co/k5y7bvDbDQ
Nelly ZIADE 🍀 Nellziade ( View Tweet)
This retrospective cohort of NPSLE pts
showed clinical assocs with MRI findings: Pts w/ focal symptoms - abn MRI
Pts w/ diffuse symptoms - normal MRI except brain atrophy
Interesting to know how this can aid in future mgt strategies for NPSLE
OP093 @RheumNow #EULAR2026 https://t.co/omvdWk6EZK
sheila RHEUMarampa ( View Tweet)
Curcumin in arthritis may have NSAID like clinical efficacy. But how? Metanalysis lays out the multiple potential effects for it to inhibit inflammatory signaling pathways (NF-κB, TNF-α, IL-1β, IL-6, COX-2, and PGE2) https://t.co/gSYVwpl41P https://t.co/0xZdyiF4QN
Dr. John Cush RheumNow ( View Tweet)
Goofy study of the month! (pub in JAMA!) RCT 170 adults w/ chronic LBP + MRI disc herniation found that amoxicillin-clavulanate, 500 mg/125 mg bid x 3 mos did not improve pain at 3 or 12 mos (vs PBO). Whatha... https://t.co/njrw6itAP8 https://t.co/CW2ssNPxf1
Dr. John Cush RheumNow ( View Tweet)
APR: Fibromyalgia
Dr. Jack Cush reviews Fibromyalgia as part of the Advanced Practice Rheum video series.
https://t.co/jq6dSXy6SU https://t.co/bDGRhhY2D9
Links:
Dr. John Cush RheumNow ( View Tweet)
Depression screening (PHQ-8) equally accurate in pts w/ & w/o chronic pain. Depression screening is not biased by overlapping symptoms in depression and chronic pain. https://t.co/UWf97NDPAK https://t.co/7dvt35RT9E
Links:
Dr. John Cush RheumNow ( View Tweet)
Meet the RheumNow #EULAR2026 Reporting Team
Delivering real-time insights from the forefront of rheumatology:
🩺 Dr. Antoni Chan (@synovialjoints)
🩺 Dr. Mrinalini Dey (@DrMiniDey)
🩺 Dr. Jiha Lee (@JihaRheum)
🩺 Dr. Aurelie Najm (@AurelieRheumo)
🩺 Dr. Janet Pope https://t.co/zpIeGWpL6P
Dr. John Cush RheumNow ( View Tweet)
Advanced Practice Rheum: Fibromyalgia
https://t.co/Wx09nPMA5n https://t.co/UAysDMGuFC
Links:
Dr. John Cush RheumNow ( View Tweet)
JAMA Insights on Chikungunya (affects 35 million worldwide) - mosquito-borne alphavirus seen in tropics, also travelers. Dz char by fever, disabling polyarthritis; less rash, HA, myalgia, N/V, conjunctivitis; rarely myocarditis. https://t.co/Fa3cHygc4W https://t.co/jmh2WjOcI5
Links:
Dr. John Cush RheumNow ( View Tweet)
Chronic Low Back Pain Disappointments in a Randomized Trial
Annals of Internal Medicine reports that patients with chronic low back pain (cLBP) may benefit from physical therapy (PT); but when that fails, other secondary measures (cognitive behavioral therapy (CBT) or https://t.co/17JObbXz5U
Dr. John Cush RheumNow ( View Tweet)
