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Managing Perioperative DMARDs with Arthroplasty

Jack Cush, MD

Postoperative complications with arthroplasty may be related to chronic inflammation and immunosuppressive therapy. Yet a recent retrospective study total ankle arthroplasty in end-stage RA patients shows that early postoperative wound complications are unaffected by the continued use of their preoperative medications including DMARDs.

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Vitamin D and Lupus Outcomes (11.21.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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APEX Study: Inhibition of structural damage progression with Guselkumab in Psoriatic Arthritis

Jack Cush, MD

Guselkumab, a human IL-23 inhibitor, was evaluated in patients with active psoriatic arthritis (PsA) and shown to have both clinical and radiographic benefits at weeks 24 and 48.

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Pulse Steroids and Mycophenolate in Juvenile Dermatomyositis

Jack Cush, MD

JAMA Dermatology has published a pilot study demonstrating the safety and efficacy of intermittent intravenous methylprednisolone pulse (IVMP) therapy plus mycophenolate in 28 patients with juvenile dermatomyositis (JDM).

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Rheumatology Supply and Demand (2009 - 2024)

Jack Cush, MD

A retrospective review of US rheumatology manpower and training between 2009 and 2024 shows that US rheumatology training has become competitive with an increasing surplus of applicants compared to available training positions, which have also increased over time.

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25-Hydroxyvitamin D levels and Lupus Outcomes

MedPage Today

Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said.

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Treating During Pregnancy (11.14.2025)

Jack Cush, MD

Dr. Jack Cush reviews the journal articles, news and guidelines from this past week on RheumNow.com

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Zantac is Back! Ranitidine has been off the market for 5yrs, withdrawn over concerns about N-nitrosodimethylamine (NDMA) impurity affecting shelf-life. The FDA has approved reformulated ranitidine tablets - the drug has the same prior efficacy and safety label. https://t.co/j655eiCvgf
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Vitamin D and Lupus Outcomes (11.21.2025) Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow. https://t.co/M2e4kMi5H7 https://t.co/wEcAjWJSk7

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Colchicine prevents total joint arthroplasty (TJA). Study of 31,478 colchicine initiators, followed 4.5 yrs. W/ an overall 12% lower risk of TJA (HR 0.88 95% CI 0.81 to 0.96), and a 23% lower risk of TJA in those with knee/hip OA (HR 0.77) https://t.co/1JsZd8K0sI

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No risk of MACE seen w/ initiation of IL-17(R)A inhib. French study of 34 241 ipts Rx IL-17(R)Ai and 381 MACEs. MACE risk was not elevated (OR, 1.25 [95% CI, 0.75-2.08] vs TNF-α inhibitors. https://t.co/WcjgRhr8mj https://t.co/Gp54eLlXSI

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Pulse Steroids and Mycophenolate in Juvenile Dermatomyositis JAMA Dermatology has published a pilot study demonstrating the safety and efficacy of intermittent intravenous methylprednisolone pulse (IVMP) therapy plus mycophenolate in 28 patients with JDM. https://t.co/i2HBycbWY9
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Cochrane review & metanalysis of Colchicine & CV outcomes. 12 studies, 22,983 prt (11,524 on colchicine). Good evidence colchicine signif. reduces the risk of MI (RR 0.74), stroke (RR 0.67), but does not incr serious adverse events (RR 0.98), but causes GI AEs (RR 1.68) https://t.co/wqOtGLdxep
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ICYMI: Head-to-Head Clinical Trials https://t.co/LpvqQRP06b https://t.co/YkXYvUuJWx

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Review of neonatal Fc receptor (FcRn) blockers, being developed by J&J, argenx & UCB, showing utility in autoimmune dz as they reduce autoantibodies. FcRn inhibitor market may be worth USD 3.3 billion by 2035. Approved for myasthenia gravis & being developed in Sjögren’s, SLE, https://t.co/mBUla87dK5
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Serum IL-1Ra levels are elevated in Lg vessel vasculitis - 21 active, Rx naive LVV pts (13 GCA, 8 TAK), IL-1Ra higher in TAK (465 pg/mL) & GCA (385 pg/mL) vs NLs (170). IL-6 also incr. in LVV, but IL-1β & IFN-γ incr in GCA & ^ IL-17in TAK. IL-1Ra correlate w/ CRP in GCA & https://t.co/TFDpK5DqcJ
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Australian Vaccine study (2019 - 2021) - w/in 12 mos of b/tsDMARD initiation 73% (11,225/15,460) recv influenza vaccination. High-dose Flu vax used in 28% in 60–69 yo, but > 80% older than 70yo. Only 9.7% recv pneumococcal & 2.4% zoster Zostavax or Shingrix) vax w/in 6 months of https://t.co/xoGTWMUi1L
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Metanalysis of 56 articles & 72,677 RA pts w/ a Dz duration of 9.7 yrs looked at biologic persistence. In csDMARD-IR, over 5 yrs TCZ (66%) & golimumab (62%) best. In bDMARD-IR, ABA (45%) & ETN (41%) best. Lower Rx survival predicted by steroids, hi Dz activity, & female https://t.co/tepL0A9Fwb
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Treating During Pregnancy (11.14.2025) | RheumNow https://t.co/sTv7O6YcnA https://t.co/KT0qGFJu0O

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Tocilizumab Beats Methotrexate in GCA Dr. Mike Putman reports on abstract 0891 (MEthotrexate versus TOcilizumab for treatment of Giant cell Arteritis (METOGiA trial): a multicenter, randomized, controlled trial), presented at the #ACR25. https://t.co/IeCWZGupqR https://t.co/SCF1guorMs

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