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Dr. Jack Cush reviews the news and major articles from this week, including FDA safety warnings, reports from AAD, PsA trials.
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The Journal of Neurology has posted a review and update of Primary CNS vasculitis (PCNSV), also termed primary angiitis of the CNS (PACNS). PCNSV is rare, potentially fatal, and highly treatable, making timely recognition and accurate diagnosis critical.
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Yesterday the FDA issued a Drug Safety Communication alerting patients and health care professionals about postmarketing identification of serious (drug induced) liver injury, including fatal cases, associated with the use of avacopan (Tavneos) in patients with ANCA- associated vasculitis.
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The TOGETHER-PsA trial has demonstrated the efficacy and safety of ixekizumab (IXE) administered with tirzepatide (TZP) in adult active psoriatic arthritis (PsA) patients who were overweight or obese.
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The NEJM reports that brepocitinib, an oral TYK2–JAK1 inhibitor, was studied in a phase 3 trial of refractory dermatomyositis (DM) patients and shown to have significant benefits at the higher dose.
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A pilot trial assessed the efficacy and safety of the guselkumab+golimumab (COMBO) combination versus guselkumab (GUS) monotherapy in active PsA (failing a prior tumor necrosis factor inhibitor (TNFi-IR) and showed superiority in ACR 50 responses but not minimal di
Dr. John Cush
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FDA has issued a drug safety warning for avacopan (Tavneos), dentifying 76 cases of drug-induced liver injury, including 7 cases of rare vanishing bile duct syndrome (VBDS). There were 8 deaths https://t.co/2GkYNg1Apn https://t.co/fW2qafKCew
Dr. John Cush
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Myocarditis causes 17,000 deaths/Yr worldwide. Causes include A) iatrogenic/autoimmune: checkpoint inhibitors & gene therapy; B) High income countries: parvo B19, herpesvirus 6; C) low income: dengue, HIV, malaria and Trypanosoma cruzi (Chagas disease) https://t.co/0FjPyXygpz https://t.co/04J23AiqtK
Dr. John Cush
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Target trial emulation: biologics or JAK vs RTX in RA-ILD -- abatacept (n=694), JAKi (156), IL-6i (389), or TNFi (734), PS-matched =# RTX; no significant differences (HR 0.74-1.09 NS) in outcomes of resp hosp, lung transplant & death. But ABA (HR 0.84) & JAKi (HR 0.62) had less https://t.co/c9IVwQYwMN
Dr. John Cush
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What's it like to have RA? LISA: "It only took me three short years to go from rock climbing to a power wheel chair and that stage of the disease was frightening and painful and you feel hopeless and as if your life plan is being stolen from you. Once I was able to start https://t.co/d49htc8k4m
Dr. John Cush
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Retrospective study of 1st SLE pregnancies from LUNA Registry. Fetal loss was associated w/ aPL (OR 2.46) & pulse steroids (2.46), but not w/ SSA Abs (1.32). 247 pregs, 194 live births, 53 fetal loss. Ro+ vs Ro- no difference in live births or preterm births https://t.co/bsMMvVyffw
Dr. John Cush
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5 Retrospective cohorts of PM/DM pts showed IIM (myositis) had signif higher risks of IIM patients HTN w/ pregnancy (OR 2.73), & C-section (OR 2.03). Also more preterm birth (3.7), SGA/IUGR (1.9) https://t.co/w6qymR0I2w https://t.co/ovtwdleRfE
Dr. John Cush
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Brepocitinib in Dermatomyositis
The NEJM reports that brepocitinib, an oral TYK2–JAK1 inhibitor, was studied in a phase 3 trial of refractory dermatomyositis (DM) patients and shown to have significant benefits at the higher dose.
https://t.co/YNxrVTIubb https://t.co/uFY3kMOvui
Dr. John Cush
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FDA has issued a drug safety warning for avacopan (Tavneos), dentifying 76 cases of drug-induced liver injury, including 7 cases of rare vanishing bile duct syndrome (VBDS). There were 8 deaths https://t.co/WkBhs1rNpf https://t.co/ZXdHsAJUOQ
Dr. John Cush
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Moral Distress (3.27.2026)
Dr. Jack Cush reviews the journal reports and news from RheumNow. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
https://t.co/LdNcsUcHc2 https://t.co/tRYeDhQ3hC
Dr. John Cush
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Myocarditis causes 17,000 deaths/Yr worldwide. Causes include A) iatrogenic/autoimmune: checkpoint inhibitors & gene therapy; B) High income countries: parvo B19, herpesvirus 6; C) low income: dengue, HIV, malaria and Trypanosoma cruzi (Chagas disease) https://t.co/en4OnhWPda https://t.co/urwkjlVeg6
Dr. John Cush
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Target trial emulation: biologics or JAK vs RTX in RA-ILD -- abatacept (n=694), JAKi (156), IL-6i (389), or TNFi (734), PS-matched =# RTX; no significant differences (HR 0.74-1.09 NS) in outcomes of resp hosp, lung transplant & death. But ABA (HR 0.84) & JAKi (HR 0.62) had less https://t.co/2ZVyf8neVH
Dr. John Cush
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Long-Term Bimekizumab Safety Data
Adverse effects from bimekizumab through 2 years or more of treatment for psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) were about as expected from shorter-term data, results from long-term extension studies indicated. https://t.co/hp2jVSGk8G
Dr. John Cush
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Real-world safety of tofacitinib vs biologics in 48,167 #PsA pts Rx w/ TOFA (3,166); TNFi (27K); IL-17Ai (20K); risankizumab (4,381); ustekinumab (4,499). Crude IRs/100 PY were 1.78-2.53 for serious infxn, 0.27–0.61 MI/stroke, 0.17–0.42 VTE, & 0.74–1.06 cancer. TOFA had signif https://t.co/dErlkyY9WC
Dr. John Cush
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A retrospective cohort study of 195 renal Bx from 135 Lupus Nephritis pts, Mod-Severe interstitial fibrosis and tubular atrophy (IFTA) strongly assoc w/non-renal response & ESRD progression (HR 8.9) (also w/ age, SLE duration, prior LN flares, higher chronicity index) https://t.co/773xsk6IHZ
