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Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis
A prospective French study of rheumatoid arthritis (RA) or spondyloarthritis (SpA) patients showed that most maintained stable disease activity during pregnancy, but over one-third flared and required major changes in treatment.
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PAFLAR Guidelines for Polyarticular Juvenile Idiopathic Arthritis
The Pediatric African League against Rheumatism (PAFLAR) initiative has published its guidelines for the diagnosis and treatment of polyarticular juvenile idiopathic arthritis (pJIA).
Axial Involvement in Psoriatic Arthritis
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.
World Changers (3.14.2025)
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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Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs
A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (compared with TNFis).
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Are Combination Biologics Safe?
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).
Spatial transcriptomic profiling on pre- and post-Rx synovial tissue Bxs from RA - Tx naive pts on DMARDs or adalimumab. Rx refractory patients had high expression of COMP, and fibroblast TGFβ signaling driving synovial tissue fibrosis https://t.co/1xFVvoddCD https://t.co/kYvhyX8VuS
Dr. John Cush RheumNow ( View Tweet)
Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs
A retrospective US administrative claims cohort study of Rheumatoid arthritis (RA) patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a… https://t.co/8jqJwkEbZF https://t.co/cQ9aheU5mc
Dr. John Cush RheumNow ( View Tweet)
Stelara Biosimilar Steqeyma Launches at 85% Discount https://t.co/2ZR7LMq1JT https://t.co/coHj1jh8JB
Dr. John Cush RheumNow ( View Tweet)
Are Combination Biologics Safe?
Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution.
https://t.co/zcmo9mTRoS https://t.co/Q1lB0LvymF
Dr. John Cush RheumNow ( View Tweet)
Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/aU8j4d6pei https://t.co/Ft99jwzPB3
Dr. John Cush RheumNow ( View Tweet)
Available the first time: https://t.co/4UQlqwujiR 2025 On Demand!
On Demand gives you access to all lectures, Q & A panels, and STEP talks, and all speaker slides and handouts — all packed with insights you won’t find anywhere else.
Non-CME, practical, and finally here.… https://t.co/qZb8OKjPpw https://t.co/Exr8u6QkNc
Links:
Dr. John Cush RheumNow ( View Tweet)
Are Combination Biologics Safe?
Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution.
https://t.co/IEIi6kQI4b https://t.co/KVSbqeMbyA
Dr. John Cush RheumNow ( View Tweet)
Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/3Y2cOzt3TQ https://t.co/6f8yiwMqAa
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of cancer risk w/ abatacept vs placebo or TNFi in #RA. (18 RCTs, 10 LTE, 15 535 PYs ABA exposure) show no signif increase in malignancy for ABA vs PBO (IRR 0.58) or TNFi (IRR 0.72). Observational data ABA > other b/tsDMARDs (IRR 1.21; 1.15–1.28), but not csDMARDs… https://t.co/2aBfwyKv0e https://t.co/zUmaHZN3mR
Dr. John Cush RheumNow ( View Tweet)
DANBIO registry study - 21 982 Rx Starts, 96 475 PYs & 1423 cancers identified. Overall cancer risk w/in tocilizumab/sarilumab, abatacept or rituximab were not signif increased (HRs ranged from 0.7 to 1.1) compared with TNFi & with bDMARD-naïve real world RA pts… https://t.co/fPLFlWoQsw https://t.co/4KlGnjfNKm
Dr. John Cush RheumNow ( View Tweet)
Selective mutation of Traf1/cIAP2 (V196) interaction attenuates inflammatory responses that may contribute to rheumatoid arthritis activity. THis may lead to a new class of therapies for RA https://t.co/kYqAqGsSEA https://t.co/JWUN6iTvxa
Dr. John Cush RheumNow ( View Tweet)
Cochrane review of TNF inhib. in #JIA shows TNFi efficacy, but uncertainty about LT safety, pain, function, & Dz control - esp compared to MTX. 9 studies, 678 JIApts, age 8-15 yrs (80% F), Dz duration 0.8-6.7 yrs. Withdrawls 1% v 3%; Serious AE 6% v 7% (PBO vs TNFi).… https://t.co/i35m5uzG1m https://t.co/VzJN9PmmMh
Dr. John Cush RheumNow ( View Tweet)
TNF Inhibitor Drug-Induced Lupus
A study from the FDA's adverse event reporting system (FAERS or Medwatch) database identified cases of drug induced systemic lupus erythematosus (SLE) in patients receiving tumor necrosis factor-α (TNF-α) inhibitors - a paradoxical reaction to… https://t.co/LYq0qxDtp3 https://t.co/vRYrBAIMEA
Dr. John Cush RheumNow ( View Tweet)
Cochrane review of TNF inhib. in #JIA shows TNFi efficacy, but uncertainty about LT safety, pain, function, & Dz control - esp compared to MTX. 9 studies, 678 JIApts, age 8-15 yrs (80% F), Dz duration 0.8-6.7 yrs. Withdrawls 1% v 3%; Serious AE 6% v 7% (PBO vs TNFi).… https://t.co/twmYfFg702 https://t.co/hG3j4sMPr9
Dr. John Cush RheumNow ( View Tweet)
