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POETYK PsA-1: Deucravacitinib in Biologic-Naïve PsA

Jack Cush, MD

POETYK PsA-1 trial tested the disease modifying efficacy of deucravacitinib, a tyrosine kinase 2 (TYK2) inhibitor, in psoriatic arthritis (PsA) patients and was shown to be superior vs to placebo for clinical responses, patient-reported outcomes, and structural damage inhibition in PsA.

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Mentshlichkeit* (8.7.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and recent journal reports on RheumNow.com.

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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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COLIPSO prospective study of psoriasis or psoriatic arthritis adults starting ts/bDMARDs; MRI done serially. 35 pts f/u for ~29 wks - MASLD. Only Rx w/ IL-17 inhibitors improved liver fat and inflammation in psoriatic disease as well as clinical outcomes. https://t.co/MFjvh5OJg2 https://t.co/k0C7RSvaaR

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Dr. John Cush RheumNow ( View Tweet)
British Dermatology Biologics registry (BADBIR) 18976 #PSO pts had incidence serious infxns (SIE) 28 SEI/1000 Pt-Yrs; higher if they had prior infxn (79/1000 PYs). SIE signif lower w/ RIZankizumab (HR 0.74-.80) vs BROAD, ETN, other standards Rxs. SIE deaths rare (1.81/1000 PYs) https://t.co/GTr3DLCVXs
Dr. John Cush RheumNow ( View Tweet)
British Dermatology Biologics registry (BADBIR) 18976 #PSO pts had incidence serious infxns (SIE) 28 SEI/1000 Pt-Yrs; higher if they had prior infxn (79/1000 PYs). SIE signif lower w/ RIZankizumab (HR 0.74-.80) vs BROAD, ETN, other standards Rxs. SIE deaths rare (1.81/1000 PYs) https://t.co/5HqJ3zpO0g
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)
3 Rx are FDA approved for hidradenitis supprativa (secukinumab, adalimumab, bimekizumab). New JAK1i Povorcitinib in STOP-HS1 and STOP-HS2 ph 3 PCTs (608/619 pts). Povo showed HiSCR50 ~42% vs PBO 29% @wk12. AE: acne, pharyngitis https://t.co/n3FJUOjNuo https://t.co/9YAmPqW44z

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Dr. John Cush RheumNow ( View Tweet)
Psoriasis = Myocardial Dysfunction (unrelated to Cardiometabolic Risk Factors) 1010 PsO pts vs controls w/o skin dz, assessed clinically & by ECHO. PSO pts (even w/ controlled dz) had signif more myocardial dysfunction (17% vs 6%). Higher BMI & DM independently assoc w/ https://t.co/MjcRmgyCWX
Dr. John Cush RheumNow ( View Tweet)
UTSW observational study of labs (n 14,199) changes w/ MTX use in 2,439 pts (13% RA, 11% PsO/PsA, 15% inflam arthritis) - found no difference in labs q3 vs q6 mos. No signif correlation betw monitoring intervals & changes in ALT, AST,WBC, HCT, MCV, PLT, FIB-4. Small https://t.co/gKwA7juexG
Dr. John Cush RheumNow ( View Tweet)
Fibrosis-4 (FIB-4) Index for Liver Fibrosis is calculated from age, AST, ALT, Plts. Study of 174 RA, PsA, PsO pts on MTX find 11% w/ fibrosis (by elastography). FIB-4 AUC for fibrosis =0.68 (weak). Fibrosis was signif assoc w/ FIB-4 >1.62, DM, obesity, advanced steatosis https://t.co/GYrhs2U1s3
Dr. John Cush RheumNow ( View Tweet)
Psoriatic Arthritis: EULAR 2026 Recap https://t.co/tBMu4CEn0o https://t.co/iztShOHxOf

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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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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
RT @aurelierheumo What is new in PsA? Dennis McGonagle's take at #EULAR2026 -a strong year for discovery in mechanisms of transition from PSO to PsA -publication of the first single cell atlas Enthesis -Better understanding of VTE mechanisms in JAKi in PsA -clinical aspects

Dr. John Cush RheumNow ( View Tweet)

RT @yuz6yusof #EULAR2026 OP0337 In double blind LTE WILLOW study, cutaneous efficacy (change in CLASI, CLASI 70/50) was maintained in Enpatoran, TLR 7/8-i by WK48. Those switched from PBO to ENP at WK24 also showed equal efficacy to ENP-ENP group. Promising treatment for #CLE

Dr. John Cush RheumNow ( View Tweet)

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