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Optimizing DMARD Therapy in Rheumatoid Arthritis

Jack Cush, MD

A phase IV trial from Spain demonstrates that optimization of therapy by lessening biological DMARDs in rheumatoid arthritis (RA) may be feasible, with a low risk of flare.

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RA Hands Difficult deformity

Not all difficult-to-treat RA will have rapid radiographic progression

Jack Cush, MD

A study of radiographic outcomes in difficult-to-treat rheumatoid arthritis (D2T RA) and poly-refractory RA (pr-RA) show a subset in whom damage is rapid and in need of more aggressive therapy.

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Sequencing DNA to find new lupus treatments

EurekAlert!

Medical University of South Carolina geneticist Betty Tsao, Ph.D., will lead a five-year project to identify rare mutations associated with childhood-onset systemic lupus erythematosus (SLE), or lupus, with more than $3.5 million in funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Tsao holds the Richard M. Silver Endowed Chair for Inflammation Research in the Division of Rheumatology and Immunology at MUSC.

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Associations in Rheumatology (10.3.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and important associations in rheumatology from the past week on RheumNow.com.

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Activity Trackers Can Predict RA Flares

MedPage Today

People with rheumatoid arthritis (RA) who experienced disease flares often showed changes in heart rate and physical activity captured by popular wearable devices 4 weeks before they became clinically apparent, a small study indicated.

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Hip Osteoarthritis Treated with Exercise plus Weight Loss Diet

Jack Cush, MD

An exercise and diet intervention study showed that while exercise improved hip pain, adding a weight loss diet to exercise did not change hip pain but improve most secondary outcomes.

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Guselkumab FDA Approved for Pediatric Psoriasis and Psoriatic Arthritis

Jack Cush, MD

FDA announced yesterday that guselkumab (Tremfya) is approved for use in pediatric patients moderate to severe plaque psoriasis (PsO) or active psoriatic arthritis (PsA) in children six years and older (weighing at least 40 kg).  

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How Does Your Garden Grow (9.26.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Pool therapy, Fibrosis, NSIE's and what's best for knee OA. 

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Polypharmacy Impairs Rheumatoid Arthritis Outcomes

Jack Cush, MD

A French early rheumatoid arthritis (RA) study has shown that polypharmacy (PP) was associated with significant lower treatment responses and more serious adverse events (SAEs). 

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ILD in Juvenile Dermatomyositis: Moving Toward Better Outcomes JDM is typically recognized for its striking skin rashes, vasculopathy, and muscle inflammation. Less visible, but equally significant, is lung involvement. ILD is increasingly acknowledged as a critical driver of https://t.co/vNGWAB88Mc
Dr. John Cush RheumNow ( View Tweet)

🆕 ILD (Part III): clinical practice focus 🔬 Diagnostic challenges 🧑⚕️ Case-based learning 📈 Evidence & outcomes 🌍 Global perspectives ⬇️ Download & learn more: https://t.co/WhpVzAfPDD Created by @MithuRheum | For our Rheum to Breathe: ILD Campaign https://t.co/4CL9mX9D6Y

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Post hoc analysis of Gout (CARES) trial (rx w/ ULT) showed remission @ 1yr increased from 37% to 63% at yr 6. In 6 yrs, 59% achieved remission 1+ times. Remission was signif assoc w/ age, race, Hi Dz severity, comorbidities, and febuxostat treatment https://t.co/uTOkch8VW6 https://t.co/Ykc7JV6m7r

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There is no consensus on flare definition in PSA. Review of 12 #PsA studies shows flare prevalence ranged 7% to 10%, w/ incidence was 22–23%. Over 12 mos, current patient-reported flare = 10%, physician-reported flare = 7% https://t.co/2LKlnaMSyv https://t.co/0TYXiZGsSc

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UK remission rates for early RA have been stablebut there are variations. DAS study of 13 752 RA, 35% in remission - but 28% (London) to 40% (East England). Delays in referral since COVID-19. Less remission w/ youth, female, Black, hi DAS28, delayed DMARDs. longer Sxs duration https://t.co/57QlnEqBci
Dr. John Cush RheumNow ( View Tweet)
Lung Involvement in Pre-RA When I see patients with rheumatoid arthritis (RA)-associated interstitial lung disease (ILD), I’m often asked: “Are the lungs and joints really connected?” The answer is yes, and the connection extends further back than some may realize. https://t.co/7Yl0flhJ3p
Dr. John Cush RheumNow ( View Tweet)
Polypharmacy Impairs Rheumatoid Arthritis Outcomes A French early rheumatoid arthritis (RA) study has shown that polypharmacy (PP) was associated with significantly lower treatment responses and more serious adverse events (SAEs). https://t.co/QAJYzHEaFv https://t.co/vUeBsLCYNE

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Dr. John Cush RheumNow ( View Tweet)
Inception SLE study of 674 pts (without LN), mean age 34 yrs - 154 (23%) developed new proteinuria (LN) after median of 3.6 yr. Cumulative antimalarial exposure did NOT lower risk of LN (HR 0.98; 0.94-1.02); same for those w/ serologically active SLE (HR 0.97) https://t.co/8OU3yJAvhN
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OL study of 60 pts w/ new idiopathic retroperitoneal fibrosis (GFR >30) Rx w/ low dose MTX+pred VS Pred only. @ 9 mos remission: 90% MTX+Pred vs 81% Pred (noninferior). Time-to-remission, RPF thickness & relapses were same; but pred use was lower w/ MTX+pred (p < 0.001) https://t.co/13cjnl4Ke4
Dr. John Cush RheumNow ( View Tweet)
Monthly survey - 351 ArthritisPower #RA Registry pts reported 523 nonserious infxns (31% ; most URI), few resulted in ED or hospitalization. But NSIA led to missed work (37%) or RA Rx interruptions (26%) and more fatigue. NSIE may contribute to more disease flares https://t.co/Al5B5oxvFg
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Panel of IPF assoc 8 biomarkers (eotaxin, Flt-3L, IL-8, MDC, MCP-1, MMP-2/7/9) tested in 2 RA-ILD cohorts (n 164). IPF multibiomarker scores higher in RA-ILF vs RA alone. Highest quartile had ~2 fold incr risk of prevalent & incident ILD https://t.co/vYg9iB4EtH https://t.co/5ZZx6gg7A4

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