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3 Months of Romosozumab in Postmenopausal Osteoporosis

Jack Cush, MD

A report in The Lancet Diabetes & Endocrinology suggested that 3 months of romosozumab (ROMO) followed by denosumab is as effective at increasing hip bone mineral density (BMD) as the standard 12-month course.

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Early vs Delayed Belimumab in Lupus

Jack Cush, MD

An economic evaluation of early vs delayed use of the Blys inhibitor, belimumab (BEL), in systemic lupus erythematosus (SLE) has shown both cost effectiveness and clinical utility of early BEL initiation in active lupus patients.

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Referral Rules to Live By (2.20.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Highlights include referral rules, combination biiologics in psoriasis and don't use JAK inhibitors in pregnancy.

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Ortho v Rheum

Referrals - Orthopedics or Rheumatology?

Jack Cush, MD

“Orthopedics or rheumatology, who should I see?" A question, often asked with urgency, posed by those who genuinely don’t know who to see for a musculoskeletal (MSK) complaint.  Inquiring patients, family, or other physicians may be one forum for such a request. Another occurs in the hospital and clinic when referrals for MSK issues can go in either direction.  How would you guide such requests?  And what would your answers be based on?

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A Modern Approach to Osteoporosis Management

Adela Castro, MD

Currently, fewer than half of patients diagnosed with osteoporosis receive appropriate pharmacologic therapy. This treatment gap reflects several challenges in osteoporosis management, including limited disease awareness, barriers to medication access, clinician discomfort with therapy selection, and uncertainty regarding the optimal timing of treatment initiation.

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Together PSO Trial - Combination Ixekizumab and Tirzepatide

Jack Cush, MD

Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over IXE alone.

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Can I Use JAK Inhibitors During Pregnancy?

Jack Cush, MD

In 2020, the ACR Recommendations on Reproductive Health notably avoided firm guidance on the use of JAK inhibitors (JAKi) during pregnancy stating, "There is no available evidence regarding use or safety of the new small- molecule agents, tofacitinib, baricitinib, and apremilast, during pregnancy."

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Terkeltaub RNL26 Gout lecture

Disease Modification, Disparities and the Next Therapeutic Frontier in Gout

Audrey Gibson, PA-C

Gout management has entered what Dr. Robert Terkeltaub MD from UC San Diego described as its “disease-modifying era,” during his talk at RheumNow Live 2026. In a recent comprehensive review of the past, present, and future of gout therapy, the central message was clear: “We can really apply disease modification to gout based on prospective, randomized controlled trials.”

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Peripheral manifestations are inconsistently assessed in axSpA trials. b/tsDMARDs have small-to-mod effects on peripheral Sxs & may be underestimated. Assessments in axSpA RCTs were low for periph arthritis 54%, enthesitis in 64% and dactylitis in only 10% of studies. https://t.co/cCNvU1oZMh
Dr. John Cush RheumNow ( View Tweet)
Prevention in Lupus and Therapeutic Evolution in Sjögren’s explores the proactive approach in autoimmune diseases, moving from theory to empirical evaluation. Recent discussions on incomplete lupus and the SMILE trial, along with advancements in Sjögren’s treatments, underscore https://t.co/KY9nHnpkxk
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC Given rising resistance, effective first-line regimens and adequate duration (14 days) are critical. PPI-based quadruple regimens remain highly effective when patients can adhere. #RNL26 https://t.co/bxqMbPFegt
Dr. John Cush RheumNow ( View Tweet)
New studies posted this week in Arthritis & Rheumatology: Adalimumab ± MTX as first-line therapy for childhood-onset chronic uveitis https://t.co/L4QiZZBBG7 Bisphosphonates & PPI/H2RA coprescriptions in polymyalgia rheumatica https://t.co/62Pqt5Ab58 Phase 3b SOLSTICE trial: https://t.co/MsK4XC3eNh

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American College of Rheumatology ACRheum ( View Tweet)
Population survey of 21 000 US adults, 62.3% reported recent use of any OTC or prescription meds. Past-7-day prevalence of any OTC medication was equal to RX med use (46%) and increased use with age among both male and female individuals. https://t.co/xeWBQ0DnlB https://t.co/c8lqXOmAaT

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Dr. John Cush RheumNow ( View Tweet)
FDA has Changed labels for 6 Menopausal Hormone Therapies (HRT) removing black box warnings for CV dz, breast CA, & dementia. 1st six HRTs includes estrogen-& progestogen-only Rx:Prometrium, Divigel, Cenestin, Enjuvia, & combo Rx Bijuva, & topical Estring. https://t.co/ZpcKkzYPKn https://t.co/f9XbmlKZNo

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Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC Given rising resistance, effective first-line regimens and adequate duration (14 days) are critical. PPI-based quadruple regimens remain highly effective when patients can adhere. #RNL26 https://t.co/rQps2rls8G
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC Who should be tested? Test only if you plan to treat. Indications include: • Active or prior ulcers • MALT lymphoma • Gastric cancer • Chronic atrophic gastritis Avoid indiscriminate testing. #RNL26 atoid arthritis https://t.co/2KJluSAPNx
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD #RNL26 @RheumNow Uzma Haque GLP1 on pts with  SLE and diabetes Retrospective study - major improvements in MACE HR 0.66 VTE HR 0.49 Renal progession HR 0.77 Mortality HR 0.26 A major tool for rheumatic care! https://t.co/qR3HKfsugZ
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC Baseline serum urate >8–9 mg/dL strongly predicts worse flares, hospitalizations, and joint damage over years. Urate level should inform urgency and intensity of therapy. #RNL26 https://t.co/4RBVXZxCCX
Dr. John Cush RheumNow ( View Tweet)
RT @Gibson_RheumPAC Drug-induced SCLE remains an important mimic in biologic-treated patients. Compared with idiopathic SCLE, drug-induced disease is often more widespread and may resolve with antibody normalization after withdrawal.#RNL26 https://t.co/ICOzg3Tz4L
Dr. John Cush RheumNow ( View Tweet)
RT @Gibson_RheumPAC Important rheumatology signal: dupilumab-associated inflammatory arthritis. Usually seronegative, imaging-supported, and sometimes persistent despite normal labs. Co-management and careful work-up are essential.#RNL26 https://t.co/r73cSZC59s
Dr. John Cush RheumNow ( View Tweet)
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