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GLP-1 Agonist plus IL-17 Inhibition in Obese Psoriatic Arthritis

d Jack Cush, MD

Lilly announced the topline results from its phase 3b "TOGETHER PsA" trial, showing that the combination use of ixekizumab (Taltz) and tirzepatide (Zepbound) was superior to IXE alone, yielding both significant weight loss and ACR50 disease control in adults with active psoriatic arthritis (PsA).

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Lupus,flare,malar,DermNetNZ

Subcutaneous Anifrolumab Effective in Lupus

d ACR

A new study published in Arthritis & Rheumatology demonstrates that subcutaneous administration of anifrolumab provides efficacy comparable to intravenous administration, offering a promising alternative for at-home care of patients living with moderate-to-severe systemic lupus erythematosus.

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memorium.2

2025 Rheumatologists, In Memorium

d Jack Cush, MD

In 2025, Rheumatology lost many of our greatest clinicians, compatriots, and mentors. This is an honor roll for those who cared, taught, advised and supported many patients, and many of us.

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Knee,injection

Glucocorticoid Injections in Knee Osteoarthritis

d Jack Cush, MD

A randomized clinical trial of 60 patients found that glucocorticoid injections into the infrapatellar fat pad (IPFP) did not significantly reduce pain scores in patients with inflammatory knee osteoarthritis (compared to placebo).

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Assess Reproductive Health in SLE Clinic Visits Systemic Lupus Erythematosus (SLE) mainly affects women of childbearing age, increasing their risk of infertility, miscarriages, and pregnancy complications due to disease factors and medications. Rheumatologists should actively https://t.co/hqWSpqJ6HN

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J&J announced positive topline results from Phase 2b JASMINE study showing the efficacy of of nipocalimab, FcRn blocker that reduces AutoAbs & B cell activity. Study met its 24 wk primary endpoint (SRI-4 response) vs placebo. There were no new safety signals https://t.co/87FZIogmkW
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Nordic Registry Study on NSAID use of ~750K, w/ 34-40% under 60 yrs. 48-58% started NSAIDs before Dx of OA. NSAID use incr w/ age from 18 to 55 yrs, then declined. OA pts have a substantial risk of GI complications in all age groups, including those under 60 yrs. Need to consider https://t.co/PLoUVI4Hys
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CASTLE Phase 1/2a CAR-T cell trial of 24 Tx refractory SLE, SSC, IIM pts w/ MB-CART19.1 (autologous CD19 CAR-T). Good safety (no CRS Gr 2 or higher or ICANS) @wk 24 & 22/24 achieved efficacy (9/10 SLE remission; 9/9 SSc no progression, 4/5 IIM major/mod response). All GC free on https://t.co/1BJidCuCeb
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Kick off 2026 with #RheumNowLive—two days of cutting-edge rheumatology, rapid-fire STEP talks, interactive Q&A, and real-world insights with Drs. Jack Cush, Arthur Kavanaugh, and a powerhouse faculty. Register: https://t.co/QeIm7OE6yM https://t.co/ToFO4xEFbx

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Data from NHIS surveys show in the USA 24.8 million adults with arthritis reported having an activity limitation AND that the arthritis attributable work limitations in US adults 18-64 yrs affects 38.8%. https://t.co/Ul2GjrFqfp https://t.co/Ul2GjrFqfp https://t.co/qzJQwBYDWT

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VA registry study; among 2771 RA pts (~65y), 64 (2.3%) had CPPD by ICD9/10 codes. RA+CPPD pts signif older [68 v. 64y], w/ more comorbidity/OA (94 v 80%), spine Dz, DM, but less ACPA (63 v 78%). SNRA+CPPD achieved less LDA, more use of pred & b/tsDMARDs (OR >2), death, TJR. Is https://t.co/hUPJzDseVc
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AC&R metanalysis of Generalized Joint Hypermobility (GJH) in adults - 46 studies (n=23,000 pts). GJH required 6 or more Beighton criteria, w/ prevalence of 2%, but 5% in young adults (18-25 yrs). Propose Dx thresholds should vary w/ age = ≥6/9 (18-25y), ≥5/9 (26-65y) & ≥4/9 https://t.co/fgDGKwUozh
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Obesity and Low Back Pain A large patient population study finds weight gain, increases risk for low back pain - the risk increased 7% for every BMI unit or 10 pounds over ideal weight. https://t.co/EZQwhLpNjg https://t.co/tIlEQmedp7

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58 newly Dx #PMR pts (on <8 wks steroids/GC) randomised 1:1 MTX 25 mg/wk or placebo, w/ 24-week GC-tapering protocol. @wk 52 GC-free remission achieved in 80% of MTX vs 46% of placebo pts (risk difference 34%, 1-sided 95% CI: 14%, 1-sided P = .0042) https://t.co/75SLx5LtqZ https://t.co/HtDAJe5VI2

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Adult co-twin study of 1261 pairs, 1/2 Rx w/ metformin. Although metformin Rx Twin had higher BMI, they had significantly less incident peripheral OA (adjusted HR 0.60; 0.44–0.82). @ 10 yrs, 6.7% of treated twins, vs 9.7% of non-treated twins had incident OA, with difference of https://t.co/7KpiGssFSo
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Systematic review of Difficult-to-treat RA (D2T-RA): 23 articles, 27,987 RA pts from 13 countries - pooled prevalence of D2T-RA was 11.7% (10.9% overall; 13.2% in b/tsDMARDs-treated RA). 47% D2T-RA had persistent inflammatory refractory RA (PIRRA). Prevalence decreased w/ https://t.co/0Gatzbfxid
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Anti-mitochondrial M2 Ab (AMA-M2) in 987 IIM pts-- 55 (6%) were AMA-M2 positive. AMA-M2+ had signif. higher rates of polymyositis (56% vs 23.5%), GGT, alk phos levels, & 3 fold more cardiac involvement (60 vs 13%) (arrhythmias, CHF, pulm HTN (31-56%), but no effect on survival https://t.co/WYWeDpiYOh
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DPC - direct primary care offices run by nurse practitioners - states that allow independent NP practices have NPs opening DPC offices, that operate under a membership model, with pts paying for access to the office services, tests, and imaging. Over 2,300 DPC offices currently

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APP Pearls “Steroids: Set a stop date upfront, educate on side effects, and teach "every milligram matters." Prevents dependence and eases tapering” - Barbara A. Slusher, MSW, PA-C, DFAAPA, DipACLM

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Congratulations to Dr. Proton Raman - a world class rheumatologist and research scientist!!! https://t.co/ofzGLsofi0

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