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2026 Resolutions (1.9.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, announcements and journal articles from this past week on RheumNow.com. More on Variable bendability, a better way to treat RA, and a novel advance for GLP1a in PsA; and 2026 Resolutions!

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GLP-1 Agonist plus IL-17 Inhibition in Obese Psoriatic Arthritis

Jack Cush, MD

Lilly announced the topline results from its phase 3b "TOGETHER PsA" trial, showing that the combination use of ixekizumab (Taltz) and tirzepatide (Zepbound) was superior to IXE alone, yielding both significant weight loss and ACR50 disease control in adults with active psoriatic arthritis (PsA).

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Lupus,flare,malar,DermNetNZ

Subcutaneous Anifrolumab Effective in Lupus

ACR

A new study published in Arthritis & Rheumatology demonstrates that subcutaneous administration of anifrolumab provides efficacy comparable to intravenous administration, offering a promising alternative for at-home care of patients living with moderate-to-severe systemic lupus erythematosus.

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Knee,injection

Glucocorticoid Injections in Knee Osteoarthritis

Jack Cush, MD

A randomized clinical trial of 60 patients found that glucocorticoid injections into the infrapatellar fat pad (IPFP) did not significantly reduce pain scores in patients with inflammatory knee osteoarthritis (compared to placebo).

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Best of 2025: 2025 BSR Guideline for Treatment of Axial Spondyloarthritis

Jack Cush, MD

Editor's note: This article was originally published April 22, 2025, and is being shared again as part of RheumNow's 'Best of 2025' series as we close out the year. Enjoy!

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Japan retrospective study of 38 RA pts who developed MTX assoc lymphoproliferative disorder (LPD) - 22 w/ spontaneous regression (SR) vs 16 non-SR (w/ 5 deaths). non-SR Pt had higher LDH levels at Dx & lower lymphocyte recovery 1 mo. post MTX withdrawal & higher mortality risk https://t.co/TRizVwP2BQ
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Shortened Leukocyte telomere length (PBL-TL) is assoc w/ systemic sclerosis–ILD. Study of PBL-TL in 244 SSc vs 314 controls, found signif shorter PBL-TL in SSC. Short PBL-TL was assoc w/ ILD & Pulm HTN, more lung related hospitalizations, but not w/ Raynauds, skin or vascular dz

Dr. John Cush RheumNow ( View Tweet)

Plenty of evidence that toxic environmental exposures increase #RA risk. Full read, intelligent report from Stanhope et al showing how (healthy environmental) green space exposures are protective & capable of preventing RA!! Lifestyle is gigantically important in your https://t.co/LUWmHhUT7F
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Assess Reproductive Health in SLE Clinic Visits Systemic Lupus Erythematosus (SLE) mainly affects women of childbearing age, increasing their risk of infertility, miscarriages, and pregnancy complications due to disease factors and medications. Rheumatologists should actively https://t.co/hqWSpqJ6HN

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J&J announced positive topline results from Phase 2b JASMINE study showing the efficacy of of nipocalimab, FcRn blocker that reduces AutoAbs & B cell activity. Study met its 24 wk primary endpoint (SRI-4 response) vs placebo. There were no new safety signals https://t.co/87FZIogmkW
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Nordic Registry Study on NSAID use of ~750K, w/ 34-40% under 60 yrs. 48-58% started NSAIDs before Dx of OA. NSAID use incr w/ age from 18 to 55 yrs, then declined. OA pts have a substantial risk of GI complications in all age groups, including those under 60 yrs. Need to consider https://t.co/PLoUVI4Hys
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58 newly Dx #PMR pts (on <8 wks steroids/GC) randomised 1:1 MTX 25 mg/wk or placebo, w/ 24-week GC-tapering protocol. @wk 52 GC-free remission achieved in 80% of MTX vs 46% of placebo pts (risk difference 34%, 1-sided 95% CI: 14%, 1-sided P = .0042) https://t.co/75SLx5LtqZ https://t.co/HtDAJe5VI2

Links:

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Systematic review of Difficult-to-treat RA (D2T-RA): 23 articles, 27,987 RA pts from 13 countries - pooled prevalence of D2T-RA was 11.7% (10.9% overall; 13.2% in b/tsDMARDs-treated RA). 47% D2T-RA had persistent inflammatory refractory RA (PIRRA). Prevalence decreased w/ https://t.co/0Gatzbfxid
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APP Pearls “Steroids: Set a stop date upfront, educate on side effects, and teach "every milligram matters." Prevents dependence and eases tapering” - Barbara A. Slusher, MSW, PA-C, DFAAPA, DipACLM

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UK study of 1846 RA pts starting a b/tsDMARDs, ~30% on steroids & majority (2/3) continued use over the first year of new novel treatment. This suggests these aer either severe RA pts or that we are not vigilant in limiting/weaning/stopping steroids in RA patients - which is it? https://t.co/7NWeAWTjSy
Dr. John Cush RheumNow ( View Tweet)
Japan retrospective study of 38 RA pts who developed MTX assoc lymphoproliferative disorder (LPD) - 22 w/ spontaneous regression (SR) vs 16 non-SR (w/ 5 deaths). non-SR Pt had higher LDH levels at Dx & lower lymphocyte recovery 1 mo. post MTX withdrawal & higher mortality risk https://t.co/SsBQRxFvD1
Dr. John Cush RheumNow ( View Tweet)
JAMA teaching case: 57 yoF w/ RA Rx w/ HCQ, NSAID, TNFi (ETN -->ADA) develops a new rash - pruritic vesicles/papular on neck, mouth, ears, chest, hands w/ some becoming ulcerated plaques, ESR >100. WHAT TO DO? A) steroids; B) stop ADA; C) Benadryl or D) Read more? Pt had https://t.co/DQpeUOC5I3
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APP Pearls “It’s important to explain the difference between an overreactive immune system vs. a weakened immune system” - Miguel Rodriguez, ANP

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Best of 2025: Glucocorticoids in SLE: how to start, how to follow, how to stop 70+ years after their debut, glucocorticoids remain a fast, powerful tool for SLE—but long-term toxicity comes at a high cost. Guidelines now favor GC “bridging therapy”: use briefly, taper fast. The https://t.co/RS0JQquv6j
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2025 update of EULAR recommendations on lupus nephritis At the 2025 EULAR congress in Barcelona, Prof Dimitrios Boumpas presented updated EULAR recommendations on managing lupus nephritis (LN). The key change is that the historic standard of care (mycophenolate with https://t.co/78J1L80Zxe
Dr. John Cush RheumNow ( View Tweet)
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