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How Does Your Garden Grow (9.26.2025)

Jack Cush, MD

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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Polypharmacy Impairs Rheumatoid Arthritis Outcomes

Jack Cush, MD

A French early rheumatoid arthritis (RA) study has shown that polypharmacy (PP) was associated with significant lower treatment responses and more serious adverse events (SAEs). 

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Rheumatoid arthritis begins long before symptoms

EurekAlert!

Scientists have discovered that rheumatoid arthritis (RA) doesn’t start when the pain begins. It silently starts years earlier.The new research reveals that people at risk for RA experience dramatic immune system changes long before they feel symptoms.   

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High-Resolution CT in CTD-Interstitial Lung Disease

Jack Cush, MD

A systematic review and meta-analysis examined the role of high-resolution computed tomography (HRCT) in diagnosing and characterizing interstitial lung disease (ILD) associated with connective tissue diseases (CTDs).

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Big Fat FDA Pink Slip (9.19.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com. Today we cover GLP-1 agonists, acupuncture, what JAKs won’t do & an FDA Pink Slip. 

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GLP-1 Drugs Reduce Rheumatoid Arthritis Symptoms

MedPage Today

Patients with rheumatoid arthritis (RA) who used GLP-1 receptor agonists had less disease activity and improved cardiovascular biomarkers, a small retrospective study indicated.

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Data from 2019 National Health Survey on 87,678 ppl -- 21.6% had chronic back pain. Chronic LBP assoc w/ multimorbidity in 62% (esp. CV dz, arthritis, & depression) https://t.co/LFdWr0s6tg https://t.co/Enj162VYJl

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Our final webinar in this month's Rheum to Breathe: ILD campaign brings together ILD experts to discuss best practices in diagnosis, screening, and monitoring, covering: tools, labs, and imaging; timing and frequency of screening; ILD screening in RA; and, referral strategies. https://t.co/Culzv9bSD4
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Screening for RA-ILD: metanalysis of 9 studies, 1380 RA pts - RA-ILD prevalence ranged from 6.7-42.7%; 18.9% via HRCT. None examined risk factors. Male sex & smoking were ~12% higher in RA-ILD & RA disease onset age was 7 years higher in RA-ILD pts. DAS didnt https://t.co/qA2oitwQg5
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Prospective French study of 101 RA-ILD (mean 66yrs) assessed for shorter WBC telomere length (LTL); short LTL seen in 43% & assoc w/ lower FVC (82% vs 93%pred) & TLCO (49% vs 63%) & greater FVC/DLCO decline & lung progression after 12 mos (47% vs 22%; p<0.001) https://t.co/ObVeon0riy
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Monthly survey - 351 ArthritisPower #RA Registry pts reported 523 nonserious infxns (31% ; most URI), few resulted in ED or hospitalization. But NSIA led to missed work (37%) or RA Rx interruptions (26%) and more fatigue. NSIE may contribute to more disease flares https://t.co/Al5B5oxvFg
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Panel of IPF assoc 8 biomarkers (eotaxin, Flt-3L, IL-8, MDC, MCP-1, MMP-2/7/9) tested in 2 RA-ILD cohorts (n 164). IPF multibiomarker scores higher in RA-ILF vs RA alone. Highest quartile had ~2 fold incr risk of prevalent & incident ILD https://t.co/vYg9iB4EtH https://t.co/5ZZx6gg7A4

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GLP-1 Drugs Reduce Rheumatoid Arthritis Symptoms Patients with rheumatoid arthritis (RA) who used GLP-1 receptor agonists had less disease activity and improved cardiovascular biomarkers, a small retrospective study indicated. https://t.co/x2soZxuZCO https://t.co/84lnQOzsvP

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Dr. John Cush RheumNow ( View Tweet)
Equal Safety of JAK Inhibitors and TNF Inhibitors JAMA has published a systematic review and meta-analysis of head-to-head studies showing there was no meaningful difference in safety events observed when taking either JAK inhibitor (JAKi) vs TNF antagonist (TNFi) therapies for https://t.co/DTux5QdETS
Dr. John Cush RheumNow ( View Tweet)
STOP-RA: Hydroxychloroquine Fails in ACPA+ Arthralgia Deane et al has published the results of the STOP-RA trial, demonstrating that 12 months of hydroxychloroquine (HCQ) did not prevent the development of clinical RA at 36 months. https://t.co/wsnc9uZi1P https://t.co/MwZJAQs7Rt

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Dr. John Cush RheumNow ( View Tweet)
SMART study - Single vs. Split Dose Methotrexate in RA Split dose weekly, oral methotrexate (MTX) was shown to be superior to single dose MTX in treating active rheumatoid arthritis (RA) patients. https://t.co/K0C63GgHvn https://t.co/FTJ11fpKnB

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Dr. John Cush RheumNow ( View Tweet)
RA-associated interstitial lung disease or bronchiectasis is assoc w/ increased risk of total and cause-specific mortality. retrospective cohort study using the Mass General Brigham Biobank 221 RA-LD cases (151 RA-ILD, 70 RA-BR). RA-LD higher mortality (34 vs 13/1000PY; HR

Dr. John Cush RheumNow ( View Tweet)

STOP-RA: Hydroxychloroquine Fails in ACPA+ Arthralgia Deane et al has published the results of the STOP-RA trial, demonstrating that 12 months of hydroxychloroquine (HCQ) did not prevent the development of clinical RA at 36 months. https://t.co/HLLhwgcVrS https://t.co/MKpeXhVdoe

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Dr. John Cush RheumNow ( View Tweet)
How to assess ILD in your patients? Have a high index of suspicion in your patients with connective tissue disease (especially systemic sclerosis, inflammatory myositis), and rheumatoid arthritis. All patients with CTD may develop ILD but it is more common (% of patients with https://t.co/UXdvPJCqDi
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Hitting the Target: T2T Therapy in SLE Treat-to-target strategies are not a new concept in rheumatology. It has shown to improve patient outcomes and quality of life in rheumatoid arthritis and psoriatic arthritis and is now being increasingly adopted not only in SLE research https://t.co/PfnG0AeJsH
Dr. John Cush RheumNow ( View Tweet)
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