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RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are there benefits to diet or vegan diets? What's the effect of menopause on CTD?  Ro52 makes a big entrance with all our ILD coverage this month.

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SMART study - Single vs. Split Dose Methotrexate in RA

Jack Cush, MD

Split dose weekly, oral methotrexate (MTX) was shown to be superior to single dose MTX in treating active rheumatoid arthritis (RA) patients.

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APLAR GRAY

SLE and Osteoporosis

Sheila Reyes, MD

In one of the SLE sessions at the APLAR 2025 Congress, Prof. Sandra Navarra discussed the assessment and management of osteoporosis in SLE patients, particularly glucocorticoid-induced osteoporosis (GIOP) and this article reviews the highlights and key takeaways from her talk.

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Antifibrotics - A New Class of Therapies in Rheumatology?

Shervin Assassi, MD

Rheumatologists typically manage systemic autoimmune rheumatic diseases (SARD) and associated interstitial lung disease (ILD) with immunosuppressants. However, evidence increasingly supports also the use of antifibrotic agents in this setting.

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ERS/EULAR guidelines for CTD-related interstitial lung disease

Jack Cush, MD

The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in the European Respiratory Journal and Annals of Rheumatic Diseases.

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KNee.calcinosis.inflammatin

COLCHICORT Trial

Jack Cush, MD

The COLCHICORT trial in acute calcium pyrophosphate (CPP) crystal arthritis patients showed that colchicine was inferior to prednisone treatment and that responses were also influenced by other factors.

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APLAR on blue background

APLAR 2025: What’s New in RA Management?

Aurelie Najm, MD, PhD

The unveiling of the updated 2025 recommendations for RA treatment, presented by Josef Smolen in the plenary session on the first day of the conference, sparked attention. Although not yet formally published, these updated recommendations represent a refined consensus that simplifies decision-making while reinforcing the importance of treat-to-target principles in RA.

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In #scleroderma pts with cardiac involvement, the presence of ventricular ectopy is assocd w/ ⬆️risk of mortality & SCD. ☝️these arrythmias present late so consider it in pts w/established dse who develop new-onset cardiac symptoms @RheumNow #APLAR25 @rheumarhyme @marklagacmd https://t.co/MTDfxevqwb

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sheila RHEUMarampa ( View Tweet)
Remember! ☝️ Trabecular bone screening should not be routinely used in pre-menopausal women. @RheumNow #APLAR25 #osteoporosis https://t.co/hGMExyDYUX

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sheila RHEUMarampa ( View Tweet)
3 yr study of FDA Adverse Event Reporting on anifrolumab shows following AEs- URIs, herpes zoster, infusion reactions, and potential new risks like dyspnea and pyrexia, not in the label. https://t.co/vP2YWGT2vR https://t.co/BruGBtXEBu

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Dr. John Cush RheumNow ( View Tweet)
Single center study of 47 RA-ILD pts (Dx Age 64.7 yrs; 30 mos F/U). Median 100 mos from RA Dx to RA-ILD. Nearly half (49%) recv Rx for RA-ILD; few w/ TCZ, nintedanib, pirfenidone. ~90% had RA-ILD stability/improve @ 6 & 12 mos. Progression assoc w/ tobacco use (P .025) @ 6 mos https://t.co/AK4zYgcxeK
Dr. John Cush RheumNow ( View Tweet)
AI can Dx & predict HCQ retinopathy (HR). An International, Multi-center study used retrospective data from 409 pts (171 HR+, 238 HR-) & tested on 8251 SD-OCT scans. AI Dx 100% & predicted 98.7% mean 221 D before Dx. Sensitivity 100%; specificity 98%, PPV 94%; NPV 100% https://t.co/USABVO8Ss5
Dr. John Cush RheumNow ( View Tweet)
Long-term data from the 48-wk phase 2 SLEek study of upadacitinib +/- a BTK inhibitor elsubrutinib, in SLE pts, showed both arms effective (little added from BTK), @ 1yr, 127 pts maintained efficacy, GC dose and flare rates https://t.co/FbTHCGZ4pQ https://t.co/cATXVHsiXV

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Dr. John Cush RheumNow ( View Tweet)

Peter Taylor describing the range of potential benefits of Interception strategies in Pre-RA: A) From Ideal: full interception B) To Good outcome: stratified intervention based on high risk population for delay/interception C) To ?Beneficial: attenuate severity of established RA https://t.co/6mqA9tV7ME

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Aurelie Najm AurelieRheumo ( View Tweet)
Abatacept and Methotrexate may Lower Risk of Interstitial Lung Disease in RA A post hoc, pooled analysis of of rheumatoid arthritis (RA) clinical trials shows those received abatacept had a lower rate of Interstitial lung disease (ILD). https://t.co/3AISriCUeC https://t.co/nN03e4ZBDU

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Dr. John Cush RheumNow ( View Tweet)
Ellen Gravallese update on RA pathogenesis Her take on RA interception studies “While drug repurposing has not proven capable of preventing transition from Pre RA to RA, we need to better understand disease mechanisms to offer other interventions” @RheumNow #APLAR25 @APLAR_org https://t.co/d39ihVvWyA

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Aurelie Najm AurelieRheumo ( View Tweet)
Methotrexate significantly lowers Systolic BP Australian researchers have shown that methotrexate (MTX) has another secondary, beneficial effect by significantly lowering systolic blood pressure, and contributes to its well docuented cardioprotive effecs. https://t.co/HDnDWahuul
Dr. John Cush RheumNow ( View Tweet)
SSc-ILD ABs & LESSONS: 30% of won't progress. Triple negatives (ATA, ACA, ARA) wont progress. Males & diffuse dz > predictive than Abs. Great read on if Abs are biomarkers to predict Rx effect. https://t.co/YcZt4aAvL0 https://t.co/wOknKRfRHf

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Dr. John Cush RheumNow ( View Tweet)
Higher Medical Costs with Corticosteroid Use Rheumatoid arthritis (RA) health insurance claims database study from Japan shows that RA patients initially treated with glucocorticoids (GCs) and disease-modifying antirheumatic drugs (DMARDs) experienced greater medical costs and https://t.co/ETWX9yH11w
Dr. John Cush RheumNow ( View Tweet)
A case–time-control study of French National Health Insurance database w/ 34 241pts Rx w/ IL-17(R)A inhibitor (2016-2021) (for PsO, PsA, AS, JIA) found no significant association betw IL-17(R)A inhibitors & MACEs over 6 months compared to TNFi Rx pts. https://t.co/fJuPFYKnSr https://t.co/Vscnsq0DTA

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Dr. John Cush RheumNow ( View Tweet)
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