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Rheumatology Pay Up (9.25.2026)

Jack Cush, MD

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

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Obesity and Psoriatic Disease

Mason Arbabi, MD and Juliana S. Simonetti, MD

Obesity is a clinically important comorbidity in psoriasis and psoriatic arthritis. Excess adiposity contributes to systemic inflammation and cardiometabolic risk and may adversely affect disease severity and response to some systemic therapies. Intentional weight loss should be considered an adjunct to appropriate dermatologic and rheumatologic treatment.

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Scleroderma-Specific Autoantibodies in Early Systemic Sclerosis

Jack Cush, MD

Prognostication is tenous in early scleroderma, especially in those with diffuse cutaneous systemic sclerosis (dcSSc). dcSSc has associated with substantial morbidity and disease-specific mortality.

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Steroid Delusions in Giant Cell Arteritis

Jack Cush, MD

A real world analysis of drug use in giant cell arteritis (GCA) patients shows that despite intending to taper patients off glucocorticoids (GC) by 24 months, 75% remained on GCs for ≥ 48 months.

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Endocrine Society - State of Obesity Science and Management

Jack Cush, MD

The Endocrine Society has published a scientific statement reframing obesity as a heterogeneous, chronically dysregulated fat-mass disorder, the biology of which is being tested effectively by GLP-1/GIP receptor agonists. Is this precision-medicine? We await long-term safety data, while assessing the outcomes in rheumatic and musculoskeletal disorders.

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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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ACR Updates Osteoarthritis Guidance

ACR

The American College of Rheumatology (ACR) has released updated clinical guidance for the treatment and management of osteoarthritis (OA) of the knee, hip, and hand. The evidence-based recommendations update the 2019 ACR/Arthritis Foundation guideline and are designed to support individualized, shared decision-making between patients and clinicians.

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2024 death rates from unintentional falls among adults≥65 yrs were 74.8/100K for men (66.6 women) Rates were higher for men > women. Fall death rates incr w/ age: highest ≥85 years. https://t.co/b4RwFHbZKj https://t.co/8m9mGUewYu

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Rheum Survey: Beyond weight loss, How will GLP-1 drugs benefit rheumatic pts?

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Earlier Dx of axSpA is assoc w/ lower long-term spinal structural damage. Swiss study compared xray outcomes betw 138 early (<2yrs) & 238 established axSpA pts w/ 11.5 yrs F/U. Differences became evident 10-15 yrs after Dx. https://t.co/E9oR37CEiD https://t.co/7FiaqJIRRC

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Southern Israel study (2009-24) shows fibromyalgia prevalence Incr from 1.04% to 3.88%, esp 30-59 yrs; more males, w/ more Psych comorbidities; fewer hospitalizations & specialist visits but increased imaging. More use of pregabalin, duloxetine, & gabapentin. https://t.co/kgmvdZF9HQ
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Systematic review of 290 psoriasis pregnancies 211 live births (73%) finds biologic exposure (UST 241, 42 TNFi) during PREG assoc w/ favorable maternal/fetal outcomes. Only 24 cont either CZP or ADA throughout PREG. Rates of miscarriage, LBW, congenital anomalies, comparable w/ https://t.co/H5GLrvxwPv
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Metabolomic/proteomics w/ cardiac MRI & longitudinal outcomes in 488079 UK Biobank pts shows chronic systemic inflammation assoc w/ reduced LV volumes, incr CV risk (cytokines, GFs, IL-1, TNF as potential mediators) https://t.co/3woGOttKHz https://t.co/eJLkPyJe6U

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Study of 119 Rheum pts on GLP-1 Rx (65% T2DM, 35% obesity; mean BMI 35). @ 12 mos wt loss −7.7 kg & 56% improved ≥1 BMI category. Signif decr in A1c, FBS, lipids, LDL, TG, ESR & CRP. GLP-1RAs useful cardiometabolic benefits https://t.co/fdNtvGu8Vb~ https://t.co/EdAqXfsjW0

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Observational study of 63,215 neuropsychiatric (NP) pts showed semaglutide signif lowered NP events over 2yrs (vs metformin, SGLT2 inhibitors, DPP-4 inhib);unrelaed to wt loss. Less substance, mood anxiety, CNS atrophies, neuromuscular, eating/sleep & personality/impulse-control https://t.co/tbuvLRK3QE
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Chinese 52 wk study of XKH004, a novel, SC, humanized anti-17A/F in 323 active AS pts Rx q4 wks vs PBO. @ Wk 16, XKH004 was superior for ASAS40 (45.4% vs 19.4%; P<0.001), improved to 66% by wk 52. https://t.co/f7w41m4QZy https://t.co/LELo52zUb7

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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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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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Obesity Journal Club: Tuesday Nite Rheumatology The Obesity Journal Club explores the TOGETHER PsA and STEP 9 trials and what emerging evidence tells us about the relationship between obesity, weight loss, and rheumatic disease. Panelists discussed the results of these trials, https://t.co/3C1RLyRj0b
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