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Misdiagnosis of Still's Disease

Jack Cush, MD

High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be misdiagnosed or mistreated. A current case review by Zhu et al. presents six cases initially diagnosed as systemic JIA, teaching several important lessons.

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Risk of Venous Thromboembolism in Rheumatoid Arthritis

Jack Cush, MD

RA confers a 50–100% excess risk of venous thromboembolism (VTE) compared with the general population, with adjusted hazard/odds ratios ranging from 1.3–2.2 across large cohort studies (Vojinovic, Askling, Antovic; Rheumatology, 2026).

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Joint Pain Prevalence is not Declining

Jack Cush, MD

A current report from the national NHIS survey shows that over half of US adults diagnosed with arthritis reported moderate to severe joint pain.

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JAMA: Review of Shoulder Pain

Jack Cush, MD

Shoulder pain affects 16% of adults annually and is the third most common musculoskeletal presentation in primary care. This new review reframes the diagnostic and therapeutic approach, moving away from pathoanatomic labels (rotator cuff tendinopathy, impingement, bursitis) toward the umbrella term subacromial pain, since structural findings on imaging correlate poorly with symptoms and are common in asymptomatic people.

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Efgartigimod Efficacy in Idiopathic Inflammatory Myopathy

Jack Cush, MD

Today Argenx announced the results of their Phase 3 "ALKIVIA" study; demonstrating efficacy and safety of subcutaneous efgartigimod for Idiopathic Inflammatory Myopathy (IIM, AKA inflammatory myositis).

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Can Effective Psoriasis Therapy Prevent Psoriatic Arthritis?

Jack Cush, MD

A review article assesses and integrates mechanistic, imaging, and clinical evidence to examine whether effective treatment of psoriasis may modify the future risk of psoriatic arthritis (PsA).

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"Great teachers set it up, and great students find the aha." - Seth Godin https://t.co/Fc3SPdsYCE

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Dr. John Cush RheumNow ( View Tweet)

In 2026 Abbvie granted 34 scholarships to students With Inflammatory Diseases. In the last 10 yrs, theyve granted $6 million to >350 students in the US for higher education. These awards up to $20,000 per student renewable up to 4 yrs. https://t.co/DFy5SukB6G https://t.co/9mVkrhL2lo

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Doubting RS3PE (8.14.2026) Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising. https://t.co/gmcrjb5bDu https://t.co/LiLl7XcZQS

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Multiple chronic conditions (MCCs; AKA multimorbidity) is highly prevalent in AIRDs; complicates Rx & increases adverse outcomes & all-cause mortality. MMCs 86% in RA, 81.5% in SLE, w/ a notable patterns of cardiopulmonary and mental health disorders https://t.co/AOWCsEodXR https://t.co/NyAR0TUQkE

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2026 Medscape report on Nurse practitioners shows nearly half of NPs are burned out, and for 1 in 6, that exhaustion has curdled into something heavier: both burnout and depression. Worse, 63% of NPs don't believe relief is in sight https://t.co/G8N5YgOKyA
Dr. John Cush RheumNow ( View Tweet)
SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/Savx5IOTcG
Dr. John Cush RheumNow ( View Tweet)
Rheum Survey >> What therapy do you most commonly use to treat Sjogrens disease? Answer here: https://t.co/XJEsqoSlbn

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Review of CAR-T 29 trials in systemic sclerosis (SSc): 27/29 target CD19 (other CD20, BCMA), 20/29 autologous. Only 2 RCTs; 1 w/ RTX comparator. Most included CREST. Schetts largest series had 6 dcSSc w/ skin/lung improvements. Need fewer & larger multicenter RCTs https://t.co/Me28HbaFhR
Dr. John Cush RheumNow ( View Tweet)
French study of 90 RA F pts w/ 100 pregnancies (steroids 46% & biologics 39% were used). Vs 359 controls, RA had signif. more preterm birth (PTB;OR 2.08) & small for gestational age. SGA assoc w/ nulliparity (adj OR 4.38), PTB assoc w/ maternal age (aOR 1.14) & GC ≥10 mg/d (aOR https://t.co/StCJW2rsZI
Dr. John Cush RheumNow ( View Tweet)
A Case of Sweet Syndrome https://t.co/M4ERsHnnH7 https://t.co/88bqEemJG8

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Dr. John Cush RheumNow ( View Tweet)
ZEUS Trial: IL-6 Inhibition Fails to Cut Cardiovascular Events The phase 3 ZEUS trial tested the IL-6 ligand inhibitor ZVK in over 6,000 patients with ASCVD, CKD, and elevated hsCRP. Although ZVK significantly lowered IL-6 and CRP levels, it did not improved outcomes (HR 0.99 https://t.co/jf2gAtvmpZ
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FDA & Fresenius Kabi Issues Nationwide Recall of Tyenne® (tocilizumab biosimilar) Injection 400 mg/20 mL Vials Due to Presence of Glass Particles. Applies to NDC Number 65219-594-20, Lot Number 16UI07 , Expiration date: 08/2028 . FDA warns possible ISR or VTE. https://t.co/YMRC9FO7Mu
Dr. John Cush RheumNow ( View Tweet)
US TriNetX EHR study of of seropositive RA:  31,932 without ILD; 115 RA-ILD on antifibrotic Rx & 1885 RA-ILD not Rx w/ antifibrotics. MTX was used more in RA w/o ILD (52%) vs RA-ILD (12%) on antifibrotics. RA-ILD was assoc w/ heterogeneous antifibrotic use. https://t.co/eBJBXbnQLN
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3 SLE pts w/ Bx class III/IV LN had Lg proteinuria flares (4.6–13.4 g/d) despite MMF plus belimumab & were given voclosporin (+MMF) w/ rapid, sustained proteinuria reduced (≤0.7 g/day w/in 9–12 mos) & stable/improved eGFR, & GC tapering. Creat increases Rx w/ dose adjustments https://t.co/38lcD8DPgn
Dr. John Cush RheumNow ( View Tweet)
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