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Review of HLA-B27

Jack Cush, MD

HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint trafficking point to new plausible, targetable pathways.

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Added IVIG is Effective in Myositis

Jack Cush, MD

A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly diagn

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Early RA Referral Clinics Work!

Jack Cush, MD

An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals.

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Weight Loss Improves Psoriatic Disease Substantially!

Jack Cush, MD

Even before the introduction of incretin therapy and bariatric surgery, many randomized and interventional studies (2019–2026) have consistently showed that weight loss produces clinically meaningful, dose-dependent improvement in both psoriasis and psoriatic arthritis.

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A Day of Infamy (9.11.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz!

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JAMA: Review of Adult Rheumatoid Arthritis

Jack Cush, MD

Smolen, Kerschbaumer, Aletaha, and Robinson have published a comprehensive review article of rheumatoid arthritis (RA) in JAMA, noting significant changes to our understanding and treatment guidelines.

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Obesity in Axial Spondyloarthritis: what are we missing beyond the scale?

Antoni Chan, MD, PhD

Obesity in axial spondyloarthritis (axSpA) is not a minor comorbidity. Beyond the scale, there are several factors that need to be considered with obesity in axSpA.

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AI Diagnosing Rheumatic Disease?

MedPage Today

Prof. Valmed, a large language model (LLM) cleared by European regulators for medical diagnosis, outperformed human physicians for diagnosing rheumatologic conditions in terms of speed but not accuracy, a randomized trial showed.

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Indian study of 85 #RA pts in LDA or better (DAS28-ESR ≤ 3.2). W/ 6 mos F/U, 39 (46%) had 1+ RA flare (DAS28 > 3.2); time to flare 12 wks (8–18) unrelate to Dz activity. Predictors: seropositivity (HR 2-2.3) https://t.co/ifqeoPtxpx https://t.co/ltx64X55fd

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Weight Loss Improves Psoriatic Disease Substantially! Even before the introduction of incretin therapy and bariatric surgery, many randomized and interventional studies (2019–2026) have consistently showed that weight loss produces clinically meaningful, dose-dependent https://t.co/BWeW7fzSC8
Dr. John Cush RheumNow ( View Tweet)
Chinese 52 wk study of XKH004, a novel, SC, humanized anti-17A/F in 323 active AS pts Rx q4 wks vs PBO. @ Wk 16, XKH004 was superior for ASAS40 (45.4% vs 19.4%; P<0.001), improved to 66% by wk 52. https://t.co/f7w41m4QZy https://t.co/5MPm388kau

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Dr. John Cush RheumNow ( View Tweet)
In 2022, Overweight & obesity affect 65.8% of Swiss PsA pts (vs gen pop.= 43%) and has increased since 2007. Obesity was assoc w/ elevated CRP (56% vs 37%), Inc Pt global assess (3.2 vs 2.8), & MD global (2.5 vs 2.1) & lower EQ-5D-3L(0.7 vs 0.8). https://t.co/xPoy4dgvlD https://t.co/aeB5N6LgCd

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Dr. John Cush RheumNow ( View Tweet)
JAMA: Review of Adult Rheumatoid Arthritis This JAMA narrative review is a follow-up to their 2018 publication, informed by 123 articles (46 RCTs, 28 cohort studies, 11 systematic reviews/meta-analyses, 15 guidelines) covering epidemiology, pathogenesis, diagnosis, and https://t.co/6Fiu9iLF5I
Dr. John Cush RheumNow ( View Tweet)
TriNetX retrospective EHR study showed VTE in #RA not incr by taking JAKi. Pts undergoing THA/TKA Rx w/ JAKi (n 284) vs TNFi (n 288). VTE- 17 JAKi (6%) vs 11 TNFi (3.8%)- nonsignif incr (RR 1.57) https://t.co/OM5ipieQtr https://t.co/ng8b9EkWmT

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Dr. John Cush RheumNow ( View Tweet)
QD Clinic: Weight Loss Changed the Course of RA Dr. Bella Mehta, New York, presents this case which highlights that obesity may be a target for disease modification in rheumatoid arthritis, as part of RheumNow's "The Obesity Imperative" campaign, presented in September 2026. https://t.co/KNNS0cHmA4
Dr. John Cush RheumNow ( View Tweet)
RCT 451 chronic LBP in general practice shows 8-wk telehealth mindfulness reduced pain intensity and interference at 6 months compared with usual care, BUT changes did not meet the prespecified mean 1-point MCID between groups. Is it worth doing? https://t.co/H4oYTeq1is https://t.co/cozq7gGnYO

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Dr. John Cush RheumNow ( View Tweet)
Cohort analysis shows autoimmune rheum Dz (AIRD) pts who recv COVID vax w/ boosters & updates were 41%, 71%, and 69% less likely to have COVID-related hospitalization (vs no Vax). If only initial vaccine series (without booster/updated vaccine), risk reduction was 5.6%. (n= https://t.co/NdEKKWdOAy
Dr. John Cush RheumNow ( View Tweet)
Swedish study of 1097 #RA pts looked at modifiable healthy lifestyle habits (HLHs: EtOH use, smoking, physical activity). At Baseline, 56% had three HLHs , unchanged (58%) at Yr 3. Nonsmoking incr 77-83%, healthy alcohol from 85%-97%. but healthy PA decr 84-71%. Lifestyle modif. https://t.co/cDyQwiN6Ae
Dr. John Cush RheumNow ( View Tweet)
12 mos Danish study of 157 822 first-time semaglutide for obesity management (SOM) intiators. 77 483 discontinued treatment w/in 12 mos. (13% at 3 mo, 27% 6 mos, 39% @ 9 mos. D/C more likely in younger, men, low-income, on GI or psych meds, & pts with comorbididities. Few https://t.co/oJLnrxXFz0
Dr. John Cush RheumNow ( View Tweet)
Swedish Pt Registry of 4317 AAV pts showed GPA & MPA had signif incr risk of CV dz (HR 2.04) & thromboembolism (HR 2.45); males incr MI risk (HR 2.25) & females incr ischemic stroke risk (HR 1.64). Sibs had no excess CVD-TE risk. The highest CVD-TE risk occurred within 3 mos. of https://t.co/FdbIXoCZf0
Dr. John Cush RheumNow ( View Tweet)
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