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Dr. Jack Cush reviews the hot item takeaways from last week's RheumNow.Live 2026.
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Rheumatologic care involves multidisciplinary approaches and collaboration with specialties to treat complex, systemic diseases. While many Pods at RheumNow Live are disease specific, the Pod II focused on Advancing Practice on important and emerging areas affecting rheumatologic patients. This session focused on two major areas of need: obesity and peri-operative management.
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Dr. Jack Cush reviews the news, journal articles and regulatory news from this past week on RheumNow.com
Dr. John Cush
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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
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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
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RT @@Gibson_RheumPAC
Eczematous eruptions with IL-17 inhibition are increasingly recognized. Registry data suggest higher adjusted incidence with IL-17 inhibitors compared with other biologic classes, especially in older patients and those with atopic history. #RNL26 https://t.co/nvwl5mNg4k
Dr. John Cush
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RT @richardPAconway
Who to screen for RA-ILD is a tricky one. It is not feasible to screen everyone. This is from ACR/Chest 2023 ILD guidelines and is based on identified risk factors. #RNL26 https://t.co/NtAWYCVclJ
Dr. John Cush
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RT @richardPAconway Disease activity is a strong risk factor for RA-ILD. Particularly for moderate/high disease activity but there appears to be a linear relationship (at least above a certain threshold) #RNL26 https://t.co/ot8ttdmu5G
Dr. John Cush
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RT @richardPAconway
Lifetime risk of ILD by RA/sex/MUC5B status. We can see the synergistic effect. Also note RA>MUC5B in general. #RNL26 https://t.co/L5MOVVGIt3
Dr. John Cush
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RT @ericdeinmd
RA-ILD #RNL26
Jeff Sparks
MTX and ILD
- Rare MTX-induced pneumonitis. 7 cases in n=4786 (0.3% cases) vs <0.1 on PBO, rare diff from ILD
- No increase in incident ILD - meta-analysis of 7 studies show OR 0.49 https://t.co/k2XeAzBsYB
Dr. John Cush
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RT @ericdeinmd
#RNL26 RA-ILD Jeff Sparks
ILD pooled prevalence 0.11
Sparks: "prevalence is high but not so high that we don't screen everyone," means lots of subclinical ILD
Subtypes:
UIP 50-60%, fibrotic
NSIP 30-40%, inflammatory
Less common: LIP, DIP, RB-ILD, DAD
Dr. John Cush
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RT @richardPAconway
Dr Sparks shows risk factors for RA-ILD. Important for diagnosis (and screening?) Focus interventions on the modifiable ones! #RNL26 https://t.co/lE9Mkbq8oh
Dr. John Cush
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Advances in RA-ILD
Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26.
https://t.co/xO7hBRKeqE https://t.co/rs1MS08Svl
Dr. John Cush
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RT @ericdeinmd
Mortality risk in RA #RNL26
Myasoedova
Premature deaths in up to 1/4 of pts
Decline in mortality in RA after year 2000
Full siblings of RA also high mortality (shared genetic or environ factors affect risk?)
Risks: Seropositivity, esp ACPA, CRP, extra-artic https://t.co/ytm6odmtgR
Dr. John Cush
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FDA vs. Amgen: At Odds Over Avacopan
The FDA has requested that Amgen voluntarily withdraw avacopan (Tavneos), a treatment for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, but the company said it has no plans to pull the drug from the market. https://t.co/v5AYm6r53W
Dr. John Cush
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REcently published SMILE study looked at the potential of HCQ (vs PBO) to prevent SLE in at risk people. Had to be ANA+ and 1-2 SLICC criteria at entry. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/s4Mzoec5ga
Dr. John Cush
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Methotrexate intolerance in rheumatoid arthritis
A current large rheumatoid arthritis (RA) cohort study from Cairo assessed methotrexate (MTX) use and found over half were MTX intolerant and a third of patients were noncompliant with MTX.
https://t.co/ODiVqUXBb9 https://t.co/QwmNkrjvn6
Dr. John Cush
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Air pollution ups ANA+: Ontariio Canadi study of 3548 serum samples (2010-13) corrlated particulate matter (PM2.5) w/ serologies. Highest vs lowest quartile PM2.5 showed higher risk of ANA ≥1:640 (OR 1.46) & ≥1:1280 (OR 1.54). Pollution has systemic immune effects! https://t.co/iyC68qh49R
Dr. John Cush
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Giant Cell Arteritis Outcomes in Canada
A retrospective cohort study of patients with giant cell arteritis (GCA) demonstrates relapses are common and seen in nearly half of patients, were common after treatment is stopped and is not effectively averted by methotrexate (MTX). https://t.co/7hIpn6CJXg
Dr. John Cush
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FDA sent a complete response letter to AstraZeneca on their application (BLA) for anifrolumabs (Saphnelo) subcutaneous use in SLE. Despite a positive TULIP-SC trial & EU approval of SC-anifrolumab, FDA & sponsor still have to work things out. CRL reasons are unknown https://t.co/3dNwEyolrj
