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An Epidural Letdown (4.4.2025)

Jack Cush, MD

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

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Diagnostic delays and Undertreatment of Psoriatic Arthritis

EurekAlert!

New research from the University of Bath in the UK reveals delayed diagnosis and undertreatment of psoriatic arthritis often results in irreversible damage to joints.

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Treating chronic inflammatory diseases with JAK inhibitors

Science Daily

Janus kinase inhibitors (JAKis) are an important treatment option for people with chronic inflammatory diseases such as rheumatoid arthritis, psoriasis, Crohn's disease or ulcerative colitis.

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Autoimmune Disease Impact Report

Jack Cush, MD

Integrated Benefit Institute, a nonprofit independent research organization, has published its 2025 Autoimmune Disease Impact Report, which examines the health and productivity impacts of five prevalent and costly autoimmune conditions: rheumatoid arthritis, multiple sclerosis, inflammat

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Targeting Obesity in Rheumatic Disease Patients

Jack Cush, MD

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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ERA, APPs, & Alpha GAL (3.21.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  Listen in for 2 new case questions - Ask Cush Anything.

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Axial Involvement in Psoriatic Arthritis

Jack Cush, MD

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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Diagnostic delays and Undertreatment of Psoriatic Arthritis New research from the University of Bath in the UK reveals delayed diagnosis and undertreatment of psoriatic arthritis often results in irreversible damage to joints. https://t.co/AyaxUXJs8n https://t.co/9x9GhnTR1Y

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Dr. John Cush RheumNow ( View Tweet)
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/0Ra8eUeBOi https://t.co/0dwOSxjVxs

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Dr. John Cush RheumNow ( View Tweet)
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/7sY1sX9B3O https://t.co/EislRI5WAy

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Dr. John Cush RheumNow ( View Tweet)
Review article shows that in psoriasis pts, adding #MTX to TNFi increases efficacy, but there is limited data on adding MTX to either IL-17 or IL-23. But in Psoriatic Arthritis (PsA), adding MTX provides no added efficacy compared to biologic monotherapy https://t.co/FiSFIjpsXo https://t.co/ComFg253u9

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Dr. John Cush RheumNow ( View Tweet)
Targeting Obesity in Rheumatic Disease Patients Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese. https://t.co/OYtsbfJQ2e https://t.co/xEZI3mkY0q

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Dr. John Cush RheumNow ( View Tweet)
Rheums! Have a rheumatology question or case for Dr.Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/VkPL7thzo8 https://t.co/h85iF6tIVk

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Dr. John Cush RheumNow ( View Tweet)
PAFLAR Guidelines for Polyarticular Juvenile Idiopathic Arthritis The Pediatric African League against Rheumatism (PAFLAR) initiative has published its guidelines for the diagnosis and treatment of polyarticular juvenile idiopathic arthritis (pJIA). https://t.co/4MbU8ZDLZf https://t.co/o3Oym9ff0f

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Dr. John Cush RheumNow ( View Tweet)
Axial Involvement in Psoriatic Arthritis Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively. https://t.co/MmRMlEp7zR https://t.co/ZAbfpIWwRM

Links:

Dr. John Cush RheumNow ( View Tweet)
Study of 26 Enthesitis-related arthritis (ERA) pts (mean Dx age 12 yrs; 77% male; 58% B27+). These were later assessed as adults (20yrs age, <35yrs). Most were in remission/LDAS, but ~20% had synovitis or enthesitis, 73% SI Dz, 15% hip & 8% spinal damage https://t.co/FFEhyA5I6A https://t.co/hE65GNcFpY

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Dr. John Cush RheumNow ( View Tweet)
Japanese study of hip replacements (THA) - #RA pts undergoing THA at higher risk for dislocation and reoperation. Retrosp database study of THA - matching 3,951 RA vs 11,853 OA. w/ RA incr risk of dislocation (OR 2.8) & reoperation (OR: 2.25). No diff infx, Fx, VTE, death… https://t.co/Mz8niRlFaa https://t.co/mgcXTnw5Al
Dr. John Cush RheumNow ( View Tweet)
Is better earlier imaging needed for axial #PsA? to better visualize spinal ligamentous soft tissue Spinal entheseal soft tissue and contiguous ligamentous tissues are poorly visualized on MRI in early inflammatory back pain pts. https://t.co/4w4CamMT4I https://t.co/RQigMjMe9n

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Dr. John Cush RheumNow ( View Tweet)
Can you distinguish which PsA? Persistent inflammatory (PIPsA) vs non-inflammatory PsA (NIPsA)? NIPsA has normal ESR/CRP, w/ obesity, biomechanical pain, OA, fibromyalgia, secondary post-inflam damage or central pain mechanisms. https://t.co/WwhdIkpJFJ https://t.co/6b5KHQRfKo

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Dr. John Cush RheumNow ( View Tweet)
Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/aU8j4d6pei https://t.co/Ft99jwzPB3
Dr. John Cush RheumNow ( View Tweet)
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