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SARD-ILD: Significant diagnostic and treatment delays
Should we be screening all our patients with systemic autoimmune rheumatic disease (SARD) for interstitial lung disease? I have been asking myself that question after the recent publication of American Thoracic Society Interstitial Lung Disease screening guidelines. The ATS guidelines, which were published in May, recommend universal CT chest screening for all asymptomatic patients with RA, systemic sclerosis, idiopathic inflammatory myopathies, mixed connective tissue disease, and Sjögren’s disease.
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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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SUA levels & adverse health outcomes? Australian ASPREE trial of 11,878 older participants had baseline SUA measurements. SUA levels had NO ASSOC. w/ all-cause mortality, disability-free survival, CV Dz, MACE, cancer mortality, cognitive decline, or dementia. In females, low SUA https://t.co/VY6NJsetW9
Dr. John Cush RheumNow ( View Tweet)
Non-Pharmacologic ILD Care
Jon T. Giles, MD, MPH, discusses non-Pharmacologic approaches to ILD treatment and patient care. Sponsored By: Boehringer Ingelheim
https://t.co/Mxg9P50m7C
#ILD #Rheumatology https://t.co/5wD1K7J1Gq
Dr. John Cush RheumNow ( View Tweet)
Study of 43 PsA pts starting bDMARD shows Calprotectin was elevated in PsA, decreased w/ biologics, but had no signif correlation w/ US synovitis. Baseline calprotectin, S100A12, IL-6, IL-17A, IL-23, CXCL10 were high. Calprotectin, S100A12, IL-6 decreased w/ Rx (p < 0.05).
Dr. John Cush RheumNow ( View Tweet)
QD Clinic: Beyond the Numbers in Newly Diagnosed ILD
Dr. Eric Dein, Summit, NJ, presents a case of a new patient with interstitial lung disease, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025.
https://t.co/HLnX5WbbTw https://t.co/SZeI4bqSAm
Dr. John Cush RheumNow ( View Tweet)
How to assess ILD in your patients?
Have a high index of suspicion in your patients with connective tissue disease (especially systemic sclerosis, inflammatory myositis), and rheumatoid arthritis. All patients with CTD may develop ILD but it is more common (% of patients with https://t.co/UXdvPJCqDi
Dr. John Cush RheumNow ( View Tweet)
August 29, 2025, FDA has terminated the Arthritis Advisory Committee, citing infrequent meetings & that the effort and expense of maintaining the committee “is no longer justified.”
The committee last met on 5/6/21 to review avacopan - that was subsequently approved. REALLY? https://t.co/w3Z6TszeWZ
Dr. John Cush RheumNow ( View Tweet)
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)
Hitting the Target: T2T Therapy in SLE
Treat-to-target strategies are not a new concept in rheumatology. It has shown to improve patient outcomes and quality of life in rheumatoid arthritis and psoriatic arthritis and is now being increasingly adopted not only in SLE research https://t.co/PfnG0AeJsH
Dr. John Cush RheumNow ( View Tweet)
RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.Are there benefits to diet or vegan diets? What's the effect of menopause on CTD? Ro52 makes a big entrance with all our ILD coverage this month. https://t.co/T68Cprogm3
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).
Dr. John Cush RheumNow ( View Tweet)
Definitions for Interstitial Lung Disease: A Consensusfrom the Fleischner Society https://t.co/gEqmkdJLDh https://t.co/8nnWKbKjk9
Dr. John Cush RheumNow ( View Tweet)
Call to Update the Classification Criteria in Idiopathic Inflammatory Myopathies (IMM), Why?
- EULAR/ACR myositis criteria dont cover specific myositis subtypes
- Polymyositis is rare
- antisynthetase & necrotizing myopathy & Jo1 Dz not well represented
- Need to include MSA, https://t.co/LUfF0VCeJ7
Dr. John Cush RheumNow ( View Tweet)
My article 👇 summarizing
the 2025 update of EULAR recommendations by @eular_org, presented by Josef Smolen at @APLAR_org
https://t.co/QFWZmqm6IR
@RheumNow #APLAR25 https://t.co/ctQdu8gQEO
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
GCs have potent anti-inflammatory effects but it’s long term complications can be catastrophic.
In SLE pts, it shows a 3-fold increased risk of organ damage for each addtl 1mg of Pred/day.
📌Aim for short duration of use with lowest effective dose
@RheumNow #APLAR25 https://t.co/UugrcX073Z
Links:
sheila RHEUMarampa ( View Tweet)
A self learning program to train non Rheumatologists to interpret pelvic X-rays and identify sacro-iliitis?
It works, but it seems the participants were already well trained as pre test scores were already reaching 60+%
Surprised to see radiologists constituting 1/4 of the test https://t.co/mRcFRSuAws
Aurelie Najm AurelieRheumo ( View Tweet)
PsO/PsA patients have an ⬆️ CV risk brought about by traditional and CV risk factors.
Do you perform regular CV risk screening in your patients?
@RheumNow #APLAR25 https://t.co/BGNKrKeLsI
sheila RHEUMarampa ( View Tweet)
IL-17is demonstrate efficacy in SpA tx
Comparable with TNFis & JAKis in terms of achieving ASAS40 response rates
IL-17is are generally well-tolerated w/⬇️TB risk (very important tx consideration esp in Asia)
But watch out for candidal infx, IBD exacerbation
@RheumNow #APLAR25 https://t.co/rSUJlZOhKV
Links:
sheila RHEUMarampa ( View Tweet)
