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MSK Manifestations in Pediatric IBD
Arthritis and musculoskeletal (MSK) symptoms may accompany pediatric-onset inflammatory bowel diseases (pIBD) as an extra-articular intestinal manifestation, but may vary in presentation and clinical course.
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Associations in Rheumatology (10.3.2025)
Dr. Jack Cush reviews the news, journal reports and important associations in rheumatology from the past week on RheumNow.com.
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Big Fat FDA Pink Slip (9.19.2025)
Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com. Today we cover GLP-1 agonists, acupuncture, what JAKs won’t do & an FDA Pink Slip.
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September to Remember (9.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.
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Sjögren's Graduates (8.22.2025)
Dr. Jack Cush reviews the news, journal reports, FDA approvals, drug safety, and more from this week.
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The Patient Journey with Rheumatic Disease
Oton and colleagues have reviewed the "patient journey" - from symptoms to specialty referral in those diagnosed with rheumatic and musculoskeletal diseases (RMDs).
Repurposing & Pipeline (8.8.2025)
Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.
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Juvenile Idiopathic Arthritis - NEJM Review
Sandborg et al. has published an overview of juvenile idiopathic arthritis (JIA) - its classification, biology, genetics, , clinical presentations and treatment advances in the New England Journal of Medicine (NEJM).
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Axial involvement in PsA (axPsA)? study of 581 PsA pts (mean 45 yrs) found 31% w/ SpA-SI joint (SIJ) abnormalities on MRI (MRI-axPsA). MRI-axPsA pts had BM edema(69%), erosions (68%), fat lesions (58%). ~45% w/ Xrays, 29% met Xray mNY criteria for AS (38% +MRI). +MRI assoc w/ https://t.co/MRbs8G3MWq
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Study of 246 axSpA (nraxSpA 82, r-axSpA 164) w/ Sxduration 26 yrs. axSpA had more comorbid Dz (^CCI) esp for uveitis (28 vs 1%), IBD (10 v 1%), PsO (10 v 3%)], CVD (7 v 3%), FM (12 v 3%). BUT NO DIFF between r-axSp & nraxSpA for comorbidities https://t.co/0ERLt083yq https://t.co/65x02ZFKTb
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Dr. John Cush RheumNow ( View Tweet)
HLA-B27: still the most important genetic factor in axSpA susceptibility, but has lower frequency African American, South American & Middle Eastern pop. B27 discerns clinical subsets of SpA and PsA, particularly acute anterior uveitis or axSpA with psoriasis, https://t.co/S4s0NvuwNY
Dr. John Cush RheumNow ( View Tweet)
Commercial claims analysis of 8855 adults w/ axSpA and/or PsA, 1771 who had joint replacements. JAK inhibitor use did not significantly reduce joint replacement (OR 0.67; 0.41–1.08), BUT TNFi, Non-TNFi biologics & DMARD users had signif fewer surgeries (OR ~0.65) vs NSAID users https://t.co/vnBnFcPxGw
Dr. John Cush RheumNow ( 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)
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
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sheila RHEUMarampa ( View Tweet)
An important message from Prof. @XBaraliakos on D2M-axSpA:
Re-evaluate your diagnosis & check for comorbids before labelling pts as tx-refractory or difficult-to-manage.
consider other causes: FM, other causes of pain
@RheumNow #APLAR25 @rheumarhyme @marklagacmd https://t.co/Lo0yShOK0P
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sheila RHEUMarampa ( View Tweet)
Stay sharp in RA, PsA & SpA care. Get the latest breakthroughs + expert insights at RWCS 2026. Don’t miss 'Year in Review: Rheumatology Advances.' Register now: https://t.co/majEsY4tXK https://t.co/fgGniR1OGk
RWCS RWCSmtg ( View Tweet)
China study of 670 SpA pts rx w/ sulfasalazine betw 2016 to 2023 (469 pure AS; 201 w/ peripheral Sxs). SSZ Signif. reduced peripheral Sxs development (HR 0.49) and improved disease activity in both pure axial and axial-with-peripheral Sxs. https://t.co/5HdQCos9yM https://t.co/tTMScQDHBq
Dr. John Cush RheumNow ( View Tweet)
Cohort study of 1,553 Biologic or JAKi Rx IBD (Crohns; UC) pts (SpA excluded) found 106 (6.8%) w/ MSK Sxs & 30 (1.9%) later Dx w/ SpA (20: axial, 10: peripheral) after median F/U 5.2 yrs. SpA risk factors: partial Mayo UC (HR 1.57) & HLA-B27 positivity (HR 3.70) https://t.co/WgLLUjlLMk
Dr. John Cush RheumNow ( View Tweet)
Difficult to manage SpA (D2M-axSpA) defined as failure ≥ 2 b/tsDMARDs (diff MOAs). Study of 129 axSpA pts, 8.5% were D2M, & 3% were treatment refractory (more inflammation- TR). D2M had signif higher BASFI (4.2 vs. 2.9), BASDAI (5.1 vs. 3.5), ASDAS (3.7 vs. 2.8). Predictors: https://t.co/4qdHEFxr3J
Dr. John Cush RheumNow ( View Tweet)
Mid East/N African Survey on #SpA referrals.
- 190 Rheum responded (68% consultants, 53% tertiary,95% urban)
- 89% reported delay in axSpA presenting (most: Ortho, FP, internists)
- 2/3 Dx challenges
- > 60^ Pt non-adherence (side effects or Sx improvement) https://t.co/6jBdOqp2gM
Dr. John Cush RheumNow ( View Tweet)
