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The Increasing Cost of First-Line Biologics for Plaque Psoriasis

Jack Cush, MD

A national commercial claims analysis of first-line use of biologics in biologic−naive plaque psoriasis patients found a near doubling of net treatment costs from 2007 to 2021 ($21 236 to $47 125).

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EMR Messaging Woes (4.11.2025)

Jack Cush, MD

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

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An Epidural Letdown (4.4.2025)

Jack Cush, MD

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

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ERA, APPs, & Alpha GAL (3.21.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  Listen in for 2 new case questions - Ask Cush Anything.

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Axial Involvement in Psoriatic Arthritis

Jack Cush, MD

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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World Changers (3.14.2025)

Jack Cush, MD

Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.

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syringe, pill, DMARD, Treatment, therapy

Are Combination Biologics Safe?

Jack Cush, MD

Although package inserts commonly warn against combining the use of biologic or targeted therapies, there is growing interest in such combination therapy for patients with problematic immune-mediated inflammatory diseases (IMID).

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Valentine RNL 2025 Review (2.14.2025)

Jack Cush, MD

Dr. Jack Cush reviews highlights from RheumNow Live 2025 held in Dallas, TX on Feb. 8-9, 2025.

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Drug Naming Games (2.7.2025)

Jack Cush, MD

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

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Best of 2024: ASLeap: Higher Dose Secukinumab in Ankylosing Spondylitis

Jack Cush, MD

Ankylosing spondylitis (AS) patients not responding to usual dosing with secukinumab (150 mg) after 16 weeks were dose escalated to secukinumab (SEC) 300 mg, but failed to show improvement by week 52.

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Phase 2, DBRPCT of nanobody anti-IL-17, izokibep in 172 Psoriatic arthritis pts, showed higher ACR50 rates for izokibep 80mg vs PBO at wk 16 (52% vs 13%; p=0.0006) w/ 40mg=48%. Other arthritis, psoriasis, enthesitis, dactylitis, QOL outcomes also improved.https://t.co/CQn9EVjr9g https://t.co/vVnTo2FPV6

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Dr. John Cush RheumNow ( View Tweet)
The IL-17A inhibitor, secukinumab, is in late-stage development forthe treatment of giant cell arteritis and polymyalgia rheumatica. https://t.co/JzzqS7bSjd https://t.co/9Qm0YsJmOL

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Dr. John Cush RheumNow ( View Tweet)
In our latest episode, @deodhara takes us behind the scenes of his research on IV secukinumab in #AxSpA. Discover key findings from the INVIGORATE-1 study, how it’s shaping treatment options, & what’s next in AxSpA research. LISTEN NOW → https://t.co/2IBixQSdpO @ACR_Journals https://t.co/HzcJw0pzWI

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American College of Rheumatology ACRheum ( View Tweet)
Review article shows that in psoriasis pts, adding #MTX to TNFi increases efficacy, but there is limited data on adding MTX to either IL-17 or IL-23. But in Psoriatic Arthritis (PsA), adding MTX provides no added efficacy compared to biologic monotherapy https://t.co/FiSFIjpsXo https://t.co/ComFg253u9

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Dr. John Cush RheumNow ( View Tweet)
Ontario study of 11 641 older psoriasis pts & hospitalized serious infx in those on b/tsDMARDs. IL-12, IL-23, and IL-17 inhibitors were assoc w/ 35% lower rates of SIE, while MTX, other older systemic meds, TNFi were not incr/decr. But JAK inhibitors had signif 3 fold incr in… https://t.co/ffFdHjme65 https://t.co/DkTsadUNx2
Dr. John Cush RheumNow ( View Tweet)
#Benralizumab vs #Mepolizumab both work for #EGPA Which to use? 🤷‍♀️ perhaps some advantage of more steroid sparing w Benralizumab? ? JAKi ?long acting #IL5i #RNL2025 ⁦@RheumNow⁩ https://t.co/UkthHpNRIq

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Janet Pope Janetbirdope ( View Tweet)
New for HS - Bimekizumab is 3rd FDA approved therapy based on BE HEARD 1&2 - Other approved ADA (2015, PIONEER 1&2), SEC (2023, SUNRISE/SUNSHINE) Clinical trials: IL23 failed, ILalpha failed Brodulamab (IL17a) clinically meaningful response TNF trials @RheumNow #ACR2025 https://t.co/BfzwNQ1wUB

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Eric Dein ericdeinmd ( View Tweet)
Is IL-23i better than IL-17i at lowering PsA risk? Retrospective, real-world EHR data study from TriNetX shows that among 4580 adult psoriasis pts (2,273 on IL23i vs 2,307 on IL17i), IL23i had signif lower PsA incidence (HR 0.60; 0.44–0.82, P 0.001), esp if 41-65 yrs (HR 0.42) &… https://t.co/ZuCAiOTIke https://t.co/8PkDCugYy0
Dr. John Cush RheumNow ( View Tweet)
North American Real-world EHR data of PsA & axSpA pts (n 2200 Ea.) found no higher rates of CVD (acute MI, CVA or revascularization) or solid cancers (breast, colorectal, lung, prostate) when comparing JAKi to either TNFi or IL-17i use (over 3 years). https://t.co/macjpWxdnY https://t.co/9gXiomU3YD

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Dr. John Cush RheumNow ( View Tweet)
Antiviral prophylaxis is essential for HBsAg+ patients receiving cytokine inhibitors, given the high risk of reactivation. Metanalysis of 10 studies shows reactivation in 21% of HBsAg+ patients without prophylaxis vs 4.4% in HBsAg−/HBcAb+ patients. https://t.co/eHzIeA8uJK https://t.co/CmZw8C8ibn

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Dr. John Cush RheumNow ( View Tweet)
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