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Equal Safety of JAK Inhibitors and TNF Inhibitors
JAMA has published a systematic review and meta-analysis of head-to-head studies showing there was no meaningful difference in safety events observed when taking either JAK inhibitor (JAKi) vs TNF antagonist (TNFi) therapies for the treatment of immune-mediated
SARD-ILD and serious infection risk: The elephant in the room
Interstitial lung disease (ILD) remains one of the largest unmet clinical needs across many systemic autoimmune rheumatic diseases (SARD). Clinicians are already keenly aware of the complexity of patients with SARD-ILD. The “elephant in the room” for all these issues: serious infection.
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September to Remember (9.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.
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SARD-ILD and serious infection risk: The elephant in the room
Interstitial lung disease (ILD) remains one of the largest unmet clinical needs across many systemic autoimmune rheumatic diseases (SARD). ILD is highly prevalent across systemic sclerosis, mixed connective tissue https://t.co/oxIteGfUTd
Dr. John Cush RheumNow ( View Tweet)
CDC 2025–26 Updates to Influenza Vaccination.
- Most are trivalent inactivated (IIV3s) or vaccines (RIV3), few live virus(LAIV3)
- FDA approved FluMist (LAIV3) for self-administration (ages 2-49)
- If <18yrs, Flu vax should thimerosal free
2023/24 Flu vax prevented 7900 deaths, https://t.co/hjLBGKWNDr
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RA-associated interstitial lung disease or bronchiectasis is assoc w/ increased risk of total and cause-specific mortality. retrospective cohort study using the Mass General Brigham Biobank 221 RA-LD cases (151 RA-ILD, 70 RA-BR). RA-LD higher mortality (34 vs 13/1000PY; HR
Dr. John Cush RheumNow ( View Tweet)
When Myositis Hits the Lungs: What Every Rheumatologist Should Know About ILD
When idiopathic inflammatory myopathies (IIM) affect the lungs, the consequences can be serious. Interstitial lung disease (ILD) is not only common in IIM, but also one of the leading causes of death, https://t.co/qRoTr3r84x
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 201 IPAF (Interstitial pneumonia w/ autoimmune feat.) pts w/ F/U 5.6 yrs. ANA+ 80%, RF+ 25%, CCP+ 14%, 88% Rx w/ IS or antifibrotics. 24% died, 7.5% transplant. Comorbidies were common; mean CCI 3.2; IPAF mortality worsened by
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Nitazenes — a class of highly potent synthetic opioids — are rapidly emerging as a major contributor to the overdose crisis; they are over 20 times more potent than fentanyl. Nitazenes are an illegal Schedule I drug that are rapidly spreading in the illicit drug market
Dr. John Cush RheumNow ( View Tweet)
There is no criteria for infection-induced Antiphospholipid syndr (APS). aPL & aCL abs have been reported w/ COVID, HCV, HIV, EBV, varicella-zoster, & CMV. infections may induce transient aPL positivity without over APS, but may precipitate APS or catastrophic APS (CAPS).
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QD Clinic: Progressive RA-ILD Management
Dr. Richard Conway, a rheumatologist in Dublin, discusses a case about managing progressive rheumatoid arthritis-interstitial lung disease, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September https://t.co/dLCXeXwl7w
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Hyperferritinemia is common in Hyperinflammatory syndromes but is a hallmark of Macrophage activation syndrome and Sepsis; and is a poor prognostic sign too. MAS is excessive activation of T-lymphocytes & macrophages leading to cytokine storm & multi-organ damage. https://t.co/MUKXC0Tw3M
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QD Clinic Video: RA and Bronchiectasis
Dr. Jeffrey Sparks, Boston, talks about rheumatoid arthritis and bronchiectasis as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025.
https://t.co/Y2u3m4rFfj https://t.co/KgrIxXlQo4
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9 yr. study of anti-Ro52 & ILD pts -- 1,026 pts 15% Ro52+: interstitial pneumonia w/ autoimmune 48%, CTD-ILD 13%, idiopathic pulm fibrosis 10%, hypersens pneumonitis 6%, idiopathic ILD 24%. Ro52+ were younger w/ more autoimmune dz, +MSA Abs, ILD progression, death, & lung https://t.co/fuFfnaYIRd
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3 yr study of FDA Adverse Event Reporting on anifrolumab shows following AEs- URIs, herpes zoster, infusion reactions, and potential new risks like dyspnea and pyrexia, not in the label. https://t.co/vP2YWGT2vR https://t.co/BruGBtXEBu
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📍Smoking, obesity and low Vit D are significant risk factors for Pre-RA.
📍Subdoligranulum arthritogenic strain is a newly described infectious agent implicated in the pathogenesis of pre-RA
@RheumNow #ACR25 @rheumarhyme https://t.co/ZzZZlfdKmk
sheila RHEUMarampa ( View Tweet)
Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD. https://t.co/Gjn2M2CNAO https://t.co/DPgDQsCWK9
Dr. John Cush RheumNow ( View Tweet)
LTBI risk in rheumatic pts is high (22%). Metanalysis 18 studies, 12,167 rheum pts shows LTBI signif. incr w/ current smoking (OR 1.50), golimumab(OR 2.90), Chloroquine (OR 1.27), age >40 (OR 1.84), prior TB OR 3.26). LTBI not increased w/ RF, ADA, ETN, BCG, Pred, smoking, DM https://t.co/0PayHJqwDn
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Retrospective French Health Data System Immune Checkpt inhibitor (ICI) study. Of 172,363 ICI-Rx adult pts, ICI myotoxicities at 6 months ranged from 0.7% -0.9%. ICI myocarditis & myositis incidence was 0.3%- 0.6%, co-occurring in ∼13–23%. ICI myotoxicity- 1-mo fatality was https://t.co/kOGKM8lC0H
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ILD Begins (8.29.2025)
Dr. Jack Cush reviews the news and journal reports from https://t.co/V10S4oVFsv. This week news on vaccines, safety of acetaminophen and more.
https://t.co/YlOK3X4hkW https://t.co/9cgcDn0xab
Dr. John Cush RheumNow ( View Tweet)
