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Eating Crow (10.10.2025)
Dr. Jack Cush reviews the news, FDA approvals, and journal articles. In this episode: HMGCR Abs, FDA approvals and Cush eats crow.
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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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How Does Your Garden Grow (9.26.2025)
Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Pool therapy, Fibrosis, NSIE's and what's best for knee OA.
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ILD Begins (8.29.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com. This week news on vaccines, safety of acetaminophen and more.
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Emapalumab Approved for MAS in Still’s
On June 27th, 2025, the FDA approved emapalumab for macrophage activation syndrome (MAS) in known or suspected Still’s disease (including both adult-onset Still’s disease (AOSD) and systemic juvenile idiopathic arthritis (sJIA)) with inadequate response or intolerance to glucocorticoids.
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Why do pts with #Still’s #AOSD
Get hospitalized?
#Sepsis
1827 unweighted & 9135 Weighted #US #hospitalizations
Worse in
men
Black
Medicaid
But is it truly #infection or Still’s flare or both?
Abst#0163
ACR25 @RheumNow @rheumacr
#ACRBest as largest N ever! https://t.co/fLMNyQQNNj
Janet Pope Janetbirdope ( View Tweet)
From Eye on Cytokine Storm- Decoding MAS by Dr Grant Schulert : “IL-18 is highly elevated in SJIa and other autoinflammatory disorders…can amplify innate signaling as well as induce IFN-gamma”. @RheumNow #ACR2025 https://t.co/6e5yfeDepX
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
Retrospective study of 42 adult Still' pts Rx after 2010 w/ IL‐1 inhib if given < 6 mos (early) or > 6mos of Sxs. Early IL-1i had more inactive dz (CID)(67% vs 38%; P = 0.17) & steroid d/c w/in 6 mos. 10 major flares observed (62% after IL‐1i suspension or spacing) https://t.co/uD1meQuYvj
Dr. John Cush RheumNow ( View Tweet)
Systematic review of Still's Dz (240 articles, 95 sJIA, 134 AOSD, 23,136 pts); sJIA Dx by ILAR in 78% & AOSD used Yamaguchi criteria 98%. While clinical and lab findings were matched betw AOSD & sJIA, there was variability in MAS , outocmes & trajectory. Standarization needed
Dr. John Cush RheumNow ( View Tweet)
German survey of 124 AOSD pts - Dz duration 7 yrs (Dx delay 2 yrs), 2/3 on biologics, 84% responding, 81% inactive by CRP. MDs report 35% of pts Sx-free. More Patients report Persistent Sxs LBP (39.5%), fatigue/weakness (39%), & joint inflammation (27%). https://t.co/2FGUPrhB8H
Dr. John Cush RheumNow ( View Tweet)
Chronic urticaria (CU) may be a presenting feature of an autoinflammatory syndrome (monogenic or multifactorial) - disorders to consider: cryopyrin-associated periodic (CAPS), Schnitzler, Still's disease, & neutrophilic urticarial dermatosis https://t.co/GKYqFzX6A0 https://t.co/QEEaw9zNjH
Dr. John Cush RheumNow ( View Tweet)
Canakinumab in VEXAS - 47 males Rx w/ anakinra (44), canakinumab (9), or both(6). Response @1 mos: ANAK 34% vs CANK 100%; 22% vs 78% @ 3 mos. Drug survival was 54 mos CANK 300/m; 7 mo CANK 150/m; 1 mo ANAK. More ISR (47% v 0) & infx w/ ANAK https://t.co/Y3iSfajTal https://t.co/qTNamGDwVI
Dr. John Cush RheumNow ( View Tweet)
Hyperferritinemia is common in Hyperinflammatory syndromes but is a hallmark of Macrophage activation syndrome and Sepsis; and is a poor prognostic sign too. MAS is excessive activation of T-lymphocytes & macrophages leading to cytokine storm & multi-organ damage. https://t.co/MUKXC0Tw3M
Dr. John Cush RheumNow ( View Tweet)
Elevated serum levels of interleukin-18 discriminate Still's disease from other autoinflammatory conditions. Sera from 53 mSAID, 220 guSAID, 49 controls show IL-18 signif increased in Still's Dz; free IL-18 levels were selectively higher in Still's disease. https://t.co/8IWXWZmWgE
Dr. John Cush RheumNow ( View Tweet)
Turkish study of Childhood-onset arthritis (n 1713; age 6.8 yrs). Most Dx: JIA 50% (most oligo), FMF 16% (recurrent oligo), vasculitis 14% (most IgA vasculitis; 94% oligo), reactive arthritis 9% (monarthritis) & acute rheumatic fever 5% (polyarticular& migratory), SLE 5% (oligo https://t.co/HkiPT0hsr7
Dr. John Cush RheumNow ( View Tweet)
Elevated serum levels of interleukin-18 discriminate Still's disease from other autoinflammatory conditions. Sera from 53 mSAID, 220 guSAID, 49 controls show IL-18 signif increased in Still's Dz; free IL-18 levels were selectively higher in Still's disease. https://t.co/oAd3JwDR5D
Dr. John Cush RheumNow ( View Tweet)
Advances in Still's disease Rx:
- using IL-1 or IL-6 inhibitors 1st line
- New FDA approval of emapalumab (IFNg) for MAS
- unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/8GhoamkV4N
Dr. John Cush RheumNow ( View Tweet)
Dermatomyositis Reviewed
Researchers from the University of Pennsylvania have published an open-access review of dermatomyositis (DM) - its manifestations, hallmark cutaneous features, etiopathogenesis and treatment options.
https://t.co/Dm85RL99UU https://t.co/SbaVBWC3Wv
Dr. John Cush RheumNow ( View Tweet)
Advances in Still's disease Rx:
- using IL-1 or IL-6 inhibitors 1st line
- New FDA approval of emapalumab (IFNg) for MAS
- unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/qefCt5b7qh
Dr. John Cush RheumNow ( View Tweet)
Emapalumab Approved for MAS in Still’s
On June 27th, 2025, the FDA approved emapalumab for macrophage activation syndrome (MAS) in known or suspected Still’s disease (including both adult-onset Still’s disease (AOSD) and systemic juvenile idiopathic arthritis (sJIA)) with https://t.co/431PQlzBsV
Dr. John Cush RheumNow ( View Tweet)
