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Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA
After the first tumour necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid arthritis (RA) responded by switching to upadacitinib, compared to cycling to a second TNFi, adalimumab.
Follow the Money (4.23.2026)
Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week.
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Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Danish registry study of truncal (2,260) vs superselective (3,810) vagotomy (1977-95) vs general popul. (10:1). Truncal incr. RA risk (aHR 2.62), but selective did not (aHR 1.05. Neither had effect on OA risk https://t.co/dqejtN9TwY https://t.co/R0OJZTxd5T
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Smoking is most established environmental risk factor for RA- Dz risk, severity, & RA-ILD. Role of other airborne pollutants is mixed: particulate matter & nitrogen dioxide show inconsistent associations w/ RA https://t.co/Fkemc5hAUB
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Arthralgia w/ HIGH ACPA level >3x ULN) has a 30–50% probability of being diagnosed with RA within 3–5 years https://t.co/iJTyMQM480
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https://t.co/4UQlqwujiR 2026 brought together leading rheumatology experts for two days of practical, clinically focused education.
Now you can watch the full program On Demand.
Highlights include:
• RA mortality trends and the mucosal hypothesis
• IL-23 vs IL-17 inhibitor https://t.co/YMfxa7PDXF
Links:
Dr. John Cush RheumNow ( View Tweet)
Does monotherapy work? network meta-analysis of 31 RCTs, 13 csDMARDs, Leflunomide, SSZ & gold were better than placebo & equal to MTX regarding annual xray progression scores. Evidence in favor BUT failed to study monoRx vs Combo Rx https://t.co/cMSZ4QHi5G https://t.co/o9ikhJu3UM
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TriNetX study of 7,929 RA pts Rx w/ bDMARDs (n 2668) w/in 6 mos of elective hand surgery - perioperative bDMARD continuation (34%) was not associated with significant increases in risks of wound healing failures (1.4% vs 1.4%) or SSI (2% vs 1.5%) https://t.co/NY6l2jRswb https://t.co/IxoYtLNGvf
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Mortality in Rheumatoid Arthritis: A Story of Decline, Delay, or Plateau? Dr. Elena Myasoedova
In this https://t.co/4UQlqwujiR 2026 podcast, Dr. Elena Myasoedova examines mortality trends in RA, exploring whether we are seeing continued decline, delayed impact, or a concerning https://t.co/yUob3Tv0tR
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Dr. John Cush RheumNow ( View Tweet)
Chinese target emulation trial of MDA-5+, dermatomyositis w/ ILD. 106 Rx w/ UPA & 328 w/ TOFA. 6-month lung transplantation-free survival 72% vs 67% (UPA v TOFA). UPA non-inferior to TOFA in MDA5+DM-ILD https://t.co/BBAfbM06AM https://t.co/QP8YdX7CcH
Dr. John Cush RheumNow ( View Tweet)
Does monotherapy work? network meta-analysis of 31 RCTs, 13 csDMARDs, Leflunomide, SSZ & gold were better than placebo & equal to MTX regarding annual xray progression scores. Evidence in favor BUT failed to study monoRx vs Combo Rx https://t.co/eHdRPAcnkd https://t.co/1odwJjyL6A
Dr. John Cush RheumNow ( View Tweet)
In this https://t.co/4UQlqwujiR 2026 podcast, Dr. Kristin Demoruelle explores the mucosal origins of RA and implications.
🎧 Listen here: https://t.co/ehPLdB4byb
#Rheumatology #Autoimmunity #RNL2026 https://t.co/nLEPM3REi4
Dr. John Cush RheumNow ( View Tweet)
Leeds study of 63 pts w/ palindromic rheumatism (PR) progressed to Persistent IA (PIA) @ median 13.4 mos, hands predominating across flares. PIA developed in joints involved in PR flares in 71% of pts. @RA Dx, PR onset pts had signif higher swollen joints(4.1 vs 3.2) https://t.co/g2vjfVjDlK
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Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/rS69epQiif
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Potential new mechanism of MTX Effx - MTX polyglutamates accumulates in monocytes by D5, modulates transcriptional signature “non-classical monocyte”-assoc genes by Wk4, & predicts MTX responses https://t.co/0HtvWOczba https://t.co/oIs4V34hw3
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Malignancies Not Increased with Biologic Therapies
The risk of malignancy in RA patients receiving biologic agents was evaluated by metanalysis of RCTs and found no significant increased risk of malignancy compared with other DMARDs or with placebo.
https://t.co/ZEO4jP5RwA https://t.co/C1YeTSh7ZN
Dr. John Cush RheumNow ( View Tweet)
Rheumatoid Arthritis Faculty Panel Q&A
This expert panel from https://t.co/4UQlqwujiR 2026 brings together leading faculty to address real-world challenges in RA care, offering practical insights you can apply immediately in practice.
🎧 Listen here: https://t.co/LOiUuia852 https://t.co/REvpPJv0O8
Dr. John Cush RheumNow ( View Tweet)
Couldn’t attend https://t.co/4UQlqwujiR 2026?
You can now watch the entire meeting On Demand.
This high-impact program features leading experts discussing:
• RA outcomes and pathogenesis
• Obesity, inflammation, and rheumatic disease
• Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3
Links:
Dr. John Cush RheumNow ( View Tweet)
