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Should Lupus Nephritis Receive PJP Prophylaxis?

Jack Cush, MD

A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and risk factors. 

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Vamorolone: a New Steroid on the Horizon?

Jack Cush, MD

Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases.

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Steroids, Prophylaxis and Pneumocystis Pneumonia

Jack Cush, MD

A case-control study has shown that glucocorticoids and tapering glucocorticoids are risk factors for the development of Pneumocystis jirovecii pneumonia (PJP).

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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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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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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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Crohn’s Microbiome may Predispose to Axial Spondyloarthritis

EurekAlert!

People with Crohn’s disease and related joint inflammation linked to immune system dysfunction have distinct gut bacteria or microbiota, with the bacterium Mediterraneibacter gnavus being a potential biomarker, according to new study by Weill Cornell Medicine researchers.

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Opioid Deaths are Down (2.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  Opioid deaths are down, IL-33 levels are up and Weight loss is in the news again this week!

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Participation is Up! (1.31.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. We also have two call-in cases on "Ask Cush Anything".

Be sure to join in the fun at RNL 2025 next weekend - Gong Show Karaoke; what will you sing?

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Hepatitis B (Keep)

AGA Guideline: Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals

Jack Cush, MD

The American Gastroenterology Association has published its revised clinical practice guidelines for the prevention and treatment of hepatitis B virus (HBV) reactivation in at-risk patients, particularly those with immune-mediated disease, receiving immunomodulatory therapy and steroids.

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185 children with SLE (cSLE) were analyze for long-term outcomes. 38 (20.54%) had serositis. Pts w/ serositis were younger, had more Dz activity, acomorbidities, & mortality. Having both serositis and ESRD increased risk of poor 20 Yr survival. https://t.co/fw8wcuS48E https://t.co/LgS3Sxy7gd

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Dr. John Cush RheumNow ( View Tweet)
185 children with SLE (cSLE) were analyze for long-term outcomes. 38 (20.54%) had serositis. Pts w/ serositis were younger, had more Dz activity, acomorbidities, & mortality. Having both serositis and ESRD increased risk of poor 20 Yr survival. https://t.co/tnYgg6MNXp https://t.co/zJor1oTFfD

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Dr. John Cush RheumNow ( View Tweet)
Steroids, Prophylaxis and Pneumocystis Pneumonia A case-control study has shown that glucocorticoids and tapering glucocorticoids are risk factors for the development of Pneumocystis jirovecii pneumonia (PJP). The authors provide guidance on the optimal timing for prophylaxis https://t.co/0nKVEKOEex
Dr. John Cush RheumNow ( View Tweet)
Systematic review 21 studies showed potential of RTX with IVIg in autoimmune Dz - 10 studies on pemphigus (85 pts) - all Positive outcomes except 1 paraneoplastic pemphigus. Infections (eg, P. jirovecii pneumonia) seen in 3. 11 studies (24 pts) Rx'd neuropathies, CND lupus& https://t.co/o0RRUBIqmS
Dr. John Cush RheumNow ( View Tweet)
Alpha-gal syndrome (AGS) is a (Lone Star) tick-borne allergy to the galactose-α-1,3-galactose carbohydrate, found in mammalian meat/products; Sxs (hives, itching, swelling, and GI issues) present 2-8 hrs after meat & be life-threatening. Time to Dx has dropped considerably, w/… https://t.co/p1M9Qaf1jz https://t.co/jTJzq7YtVJ
Dr. John Cush RheumNow ( View Tweet)
Do infections lead to Kawasaki Dz (KD)? Swedish registry study of 1774 KD vs 17 731 controls. +Hx of Infx incr risk of KD (OR 2.3; 2.0 to 2.5) - mostly Resp, skin, GU & GI Infx. Infxns usually clustered before KD Dx (OR 5.1 15–28d; OR 1.3 6-12 mos prior KD. More infx = more KD… https://t.co/V9zbcmJdKv https://t.co/Evl3rtCxUO
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Risk for Serious Infection with Low-Dose Glucocorticoids in RA https://t.co/5frAX3W7Hz https://t.co/PHeqCacxKa

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Dr. John Cush RheumNow ( View Tweet)
Full read review of association betw #RA & Chikungunya fever (viral infxn transmitted by Aedes mosquitoes). Theres no true link betw RA & CHIKV; but incidence of RA after CHIKV is 13.7% (based on 16 reports, 2879 pts, 449 RA postCHIKV) https://t.co/8fxIS846Nd https://t.co/YD1aLIVrrI

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Dr. John Cush RheumNow ( View Tweet)
TheDaoIndex @KDAO2011 A practical clinic-based approach to assessing CVD, CA screening, lung disease, infections for rheums by Dr Bryant England who offers us menus.. start by asking about symptoms. #RNL2025 https://t.co/AcQDJS870I https://t.co/UCyDOF2GRZ

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Dr. John Cush RheumNow ( View Tweet)
Infectious Sacroiliitis A large Chinese cohort study of patients with infectious sacroiliitis (SI) suggests that CT-guided biopsy of the sacroiliac joint is necessary to properly identify the infectious pathogen leading to SI. https://t.co/GYI8iz0rOS https://t.co/3wQR47Wd4g

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