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Juvenile Idiopathic Arthritis - NEJM Review

Jack Cush, MD

Sandborg et al. has published an overview of juvenile idiopathic arthritis (JIA) - its classification, biology, genetics, , clinical presentations and treatment advances in the New England Journal of Medicine (NEJM).

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A New RA Approval (8.1.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and a new treatment for RA from the FDA.

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Options for Refractory axSpA or PsA

MedPage Today

Although most patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) didn't respond adequately to the interleukin-17 (IL-17) inhibitor ixekizumab (Taltz), enough did that it should still be considered in such cases, a Danish registry study indicated.

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Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors

Jack Cush, MD

Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer.

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Subclinical Synovitis Among Psoriasis Patients

Jack Cush, MD

A systematic review shows that imaging can be used to detect subclinical synovitis among patients with psoriasis and may identify individuals at risk for future psoriatic arthritis.

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Zasocitinib (Tyk2 Inhibitor) Efficacy in Psoriatic Arthritis

Jack Cush, MD

A highly selective, tyrosine kinase 2 inhibitor zasocitinib (TAK-279), was studied in a phase 2b trial and found to be effective and safe patients with active psoriatic arthritis (PsA).

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1 in 5 Patients are Unaware of their Arthritis Diagnosis

Jack Cush, MD

Current CDC numbers suggest that arthritis (any type) affects an estimated 67.1 million (27.9% ) adults in the USA.  Interestingly, 1 in 5 do not know their arthritis subtype (21.6%, 14.4 million).

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Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients

Jack Cush, MD

More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the perioperative management of DMARDs and found inconsistencies and low quality evidence, with great reliance on conditional (expert opinion) recommendations.

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Pregnant Women on TNFi more likely to use throughout gestation, w/ less steroids. 3711 preg on TNFi in 49,925 F (w/ RA, AS, PsA, PsO, IBD) -- 64% had 3 trimester TNFi use. 89% exposed preconception & 68% cont postpartum. TNFi use incr from 55% to 73% i(20111-21) https://t.co/DVvbwx6MoW
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PsA is worse in women--why? 100 PsA pts, serum study of differentially expressed proteins - 20 times more sex-specific DEPs in PsA males than females (PsA vs controls). In women leukotriene A-4; and in men IL-36, NEK7 & PIK3CA/PIK3R1 were significant predictors. https://t.co/JzI1n6Hf5G
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Systemic immune-inflammation index (SII), as a potential biomarker -- computed as platelet count × neutrophil count/lymphocyte count. SII has been shown to be useful in RA, PsA, SpA, SLE and vasculitis, reflecting disease activity, drug responses & supplements ESR & CRP levels https://t.co/LuFaYbWiWN
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Review of risankizumab efficacy & safety included 545 psoriasis pts showing Mean PASI decreased from 14 to 0.5 at 208Wk. PASI100 achieved in 33% and 74% at 16Wk & 208Wk. Bio-naïve responded faster bio-experienced pts - only 5 pts D/C for adverse events https://t.co/VklLWpD0SF https://t.co/zZfuiFijd4

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Subclinical Synovitis Among Psoriasis Patients A systematic review shows that imaging can be used to detect subclinical synovitis among patients with psoriasis and may identify individuals at risk for future psoriatic arthritis. https://t.co/2603Aax8PP https://t.co/2XDtDg1QHh

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Dr. John Cush RheumNow ( View Tweet)
40 kids w/ Psoriasis compared to 40 juvenile PsA pts. Those w/ jPsA were more likely to be: - Obese/overweight (80 vs 17.5%) - passive smoking (37.5 vs (25%) - Signif higher ESR and CRP (P < 0.001) - Nail PsO (65 vs 22%) https://t.co/3uBHnxZYC2 https://t.co/rW48EQta2s

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Zasocitinib (Tyk2 Inhibitor) Efficacy in Psoriatic Arthritis A highly selective, tyrosine kinase 2 inhibitor zasocitinib (TAK-279), was studied in a phase 2b trial and found to be effective and safe patients with active psoriatic arthritis (PsA). https://t.co/HB0eVLLAh6 https://t.co/5Kqopaw6wL

Links:

Dr. John Cush RheumNow ( View Tweet)
BMS announced today that the FDA has accepted for review the supplemental New Drug Application (sNDA) for Sotyktu (deucravacitinib) for the treatment of adult active psoriatic arthritis. The FDA decision (PDUFA) date is March 6, 2026. https://t.co/yMxkUP5FAw https://t.co/2teEUbWFem

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Full read overview of new imaging modalities for inflammatory arthritis, including high-res.quantitative CT, ultra-high field MRI), PET, fluorescence optical imaging, optoacoustic imaging, contrast-enhanced ultrasonography - all with artificial intelligence analysis https://t.co/rbHiPWAAFP
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Biologic survival study of British Assoc. of Dermatologists Biologics Register (11/07-6/23) looked at 19,034 Rx courses (median F/U 2.3 yrs), of TNFi, IL-12/23i, IL-17i, & IL-23i. IL-23i (GUS & RIS) had best survival (~1.93yrs) for efficacy & safety (broadalumab the least) https://t.co/uhomYmiUZy
Dr. John Cush RheumNow ( View Tweet)
Biologic survival study of British Assoc. of Dermatologists Biologics Register (11/07-6/23) looked at 19,034 Rx courses (median F/U 2.3 yrs), of TNFi, IL-12/23i, IL-17i, & IL-23i. IL-23i (GUS & RIS) had best survival (~1.93yrs) for efficacy & safety (broadalumab the least) https://t.co/aAULb0e3o9
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No Increased Malignancy Risk with Ixekizumab A pooled analysis of 25 randomized clinical trials affirms the safety of ixekizumab (IXE) when used to treat patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA). The observed incidences of https://t.co/7dAoQyeq5x
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