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Doubting RS3PE (8.14.2026)
Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.
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ZEUS Trial: IL-6 Inhibition Fails to Cut Cardiovascular Events
The phase 3 ZEUS trial (published in JAMA Dec. 2025) tested the IL-6 ligand inhibitor ziltivekimab in over 6,000 patients with atherosclerotic cardiovascular disease, chronic kidney disease, and elevated hsCRP—a population enriched for an inflammatory driver of risk.
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What's New in Lyme Disease
JAMA has published an overview of new considerations on Lyme disease, focusing on Diagnostics, Vaccines, and Prevention.
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Rethinking Treatment of EGPA
Eosinophilic granulomatosis with polyangiitis (EGPA) has long been managed by extrapolating results from microscopic polyangiitis and granulomatosis with polyangiitis clinical trials. But new insights into EGPA's has lead to advances in therapy and new treatment paradigms.
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A Tribute to Daniel L. Kastner, MD, PhD (1951–2026)
The rheumatology, genetics and NIH communities mourn for Dr. Daniel L. Kastner, who died on July 28, 2026, in Bethesda, Maryland, at age 74. The following are declarations, tributes, and memories dedicated to this mensch of a man, titan of science, memorable mentor and humble physician.
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Methotrexate Safety Tips (7.31.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Four Decades of Gout Management
During this month-long campaign on Gout, we have documented many significant changes in our approach to gout, as well as many unmet needs and deficiencies that merit our continued, primary attention. We are all familiar with the famous 1905 quote, “Those who cannot remember the past are
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Treatment goals in gout: aim for remission!
Rheumatologists are used to the concept of disease remission as this is a treatment goal we use for many chronic rheumatic diseases in our clinical practice.
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Uricase-Targeted Therapies in Gout
In most mammals, uricase catalyzes the oxidation of uric acid to allantoin, a highly soluble compound easily excreted by the kidneys. But humans lack functional uricase, leaving xanthine oxidase inhibitors (allopurinol/febuxostat) as first-line urate-lowering therapy (ULT). Uricase-based biologics are reserved for uncontrolled/refractory gout patients with gouty flares, active synovitis, and/or non-resolving tophi despite optimized oral ULT.
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When Gout Flares, So Does the Cardiovascular System
We have spent decades teaching that a gout flare is a joint problem: a hot, swollen, painful joint that we treat with anti-inflammatory drugs and move on from (i.e., the treat to avoid symptoms strategy). The campaign title says it well — gout is more than flares.
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