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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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DMARDs,biologics,RA

Rheums Speak - RA Treatment Survey

Jack Cush, MD

RheumNow's August 2025 “Live Vote” surveys examine Rheumatologist impressions, knowledge and practices over the last 20 years when treating rheumatoid arthritis.

The first survey on RA Treatment (7/28/2025) sheds light on evolving prescribing habits, use of biologics, and key frustrations in RA care.

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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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FDA Approves Vagal Nerve Stimulator for RA

Jack Cush, MD

SetPoint Medical announced that the FDA has approved the company’s SetPoint System, a first-in-class neuroimmune modulation innovation for treatment of moderate-to-severe rheumatoid arthritis (RA) for those who are not adequately managed by—or cannot tolerate—existing advanced RA therapies, such as biological and targeted synthetic DMARDs.

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Factors Affecting Biologic Use in Rheumatoid Arthritis

Jack Cush, MD

A San Francisco Rheumatoid Arthritis Panel cohort survey between 1999–2011, showed numerous sociodemographic, disease, and health characteristics that influenced the initiation of treatment with biologic agents for rheumatoid arthritis (RA).

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Japans IORRA study of 10,613 RA pts (2007-21) - 915 deaths from cancer (28%), lung Dz (22%), CV Dz (16%). Protective Rx were MTX and bDMARDs, while even low-dose glucocorticoids showed increased mortality risk. https://t.co/lV5WmC5l1X https://t.co/QncyqXSRE9

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Retrospective review of 9 #RA pts w/ elevated liver enzymes who were Rx w/ TNF inhibitor (4 adalimumab, 5 etanercept; 78% female, median BMI 37). Over 3 yrs F/U, LFTs declined, fibrosis scores (FIB-4) signif decreased; albumin & bilirubin remained stable https://t.co/Hcwa3qaupv https://t.co/OwGY5jxxyZ

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Potentially novel RA vaccine of recombinant HLA-DRB1 04:01 bound to type II collagen (COL2) peptide COL2259-273 that was chemically modified at glycine position 265 & shows to suppress collagen induced arthritis in human DRB1 04:01-expressing mice https://t.co/TtBt49DQDa https://t.co/qMXzmvNc1b

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Review of macrophage phenotypes (M1, M2, etc) in rheumatic diseases. In RA synovial Tiss macrophages - are MerTK+CD206+ w/ remission and MerTK−CD206− w/ active inflammation. Tissue fibrosis in PSS driven by Profibrotic CD206+ and CD163+ cell subsets https://t.co/vIG7SYsaWq https://t.co/OKnzOFIlKr

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A New RA Approval (8.1.2025) Dr. Jack Cush reviews the news, journal reports and a new treatment for RA from the FDA https://t.co/hHNvdOKp2z https://t.co/lUAZM7bY7X

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CCL17 is a downstream mediator of GM-CSF. Drug repurposing review of FDA approved Rx shows 5 Rx w/ anti-CCL17 effects - fluoxetine, ractopamine, ponesimod, terbutaline & etravirine, w/ inhibition of STAT5, IRF4 & CCL17 & shows antiinflamm effects in RA animal model https://t.co/2aTyZMWPJn
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FDA Approves Vagal Nerve Stimulator for RA SetPoint Medical announced the FDA approved the SetPoint System, a neuroimmune modulation treatment for moderate-to-severe rheumatoid arthritis (RA), for patients not well-managed or cannot tolerate—existing RA therapies like https://t.co/McheSz30dl
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MTX or TNFi use in elderly #RA pts w/in a year of Dx of melanoma was not associated with increased mortality. This included melanoma in situ (48%), localized (47%) and regional (5%) melanoma. Steroid use however was assoc w/ reduced survival. https://t.co/QOXfEf51S1 https://t.co/GZ5dedEMfM

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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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Mild cognitive impairment (MCI), (a reversible precursor to dementia) is increased in elderly RA (n=378) and is signif. assoc w/ course of disease(OR 1.07), DAS28 (OR 1.31), high CRP (OR 1.01) & osteoporosis (OR 1.88) as independent risk factors. https://t.co/45DY03sD23 https://t.co/kdX9TnykVK

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RA & GOUT? S. Korean study of 34,356 new RA pts vs 103,068 controls. RA had 2.7 X higher risk of gout vs non-RA. Seropos & Seroneg equal incr risk (aHR 2.8 & 2.6), slightly higher in SPRA(aHR 1.07). RA on b/tsDMARDs had lower risk (aHR, 1.93) vs Untreated (aHR, 2.78). https://t.co/P0oqq5bVnq
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Factors Affecting Biologic Use in Rheumatoid Arthritis A San Francisco Rheumatoid Arthritis Panel cohort survey between 1999–2011, showed numerous sociodemographic, disease, and health characteristics that influenced the initiation of treatment with biologic agents for https://t.co/azDYk6saHN
Dr. John Cush RheumNow ( View Tweet)
RHEUM Survey: Starting a new biologic agent in RA, when do you expect to see a good response? CLICK HERE>> https://t.co/NBXu4cNLVj a.6 weeks b.3 months c.4 months d.6 months e.With adverse events

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Cancer screening in RA - retrospective, matched cohort study of 1,614 RA vs 1,597 controls (mean 63 yrs); @ 5 yrs, RA had less cervical cancer screens (52% vs 58%) (aHR:0.83); but no decrease in screens for breast (aHR:0.98), prostate (aHR:0.99), or colorectal (aHR:1.04) CA https://t.co/NnxRnZcZwq
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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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