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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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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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Sjögren's Graduates (8.22.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports, FDA approvals, drug safety, and more from this week.

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2025 BSR Recommendations for ANCA-associated Vasculitis

Jack Cush, MD

The British Society for Rheumatology (BSR) and British Health Professionals in Rheumatology (BHPR) have published a guideline for the management of adults with ANCA-associated vasculitis (AAV); specifically three conditions: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA).

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DMARDs,biologics,RA

Rheums Speak - RA Treatment Survey

Jack Cush, MD

RheumNow's August 2025 “Live Vote” surveys examine Rheumatologist impressions, knowledge and practices over the last 20 years when treating rheumatoid arthritis.

The first survey on RA Treatment (7/28/2025) sheds light on evolving prescribing habits, use of biologics, and key frustrations in RA care.

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DNA,genotyping,gene,sequencing

Molecular profiling of RA synovium predicts biologic responses

Jack Cush, MD

Machine learning analysis of pre-treatment synovial tissue biopsy from rheumatoid arthritis (RA) patients starting either etanercept (ETN), tocilizumab (TCZ) and rituximab (RTX) revealed

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#0853 Olink proteomics in anti-Ro+ pregnancies identifies macrophage-derived IL-6 & CCL3 as serum predictors of foetal AV block These pro-inflammatory proteins predicted fAVB independent of maternal diagnosis or Ab titres, pointing to new pathogenic pathways. @RheumNow #ACR25

Mrinalini Dey DrMiniDey ( View Tweet)

#1627 SLR informing the 2025 @eular_org recommendations for PMR & LVV 🔍 141 studies (30 RCTs) reviewed: new & further evidence for IL-6, JAK & B-cell-targeted therapies. Data will underpin updated management guidance. @RheumNow #ACR25

Mrinalini Dey DrMiniDey ( View Tweet)

Upadacitinib in GCA doesn't just affect IL-6, it alters IFNg, known to be important in vascular change in GCA. If UPA in GCA has some cardiovascular concerns extrapolated from RA, it also has some plausible cardiovascular benefits too that TCZ may not #ACR25 ABST0751 @RheumNow https://t.co/rMetLPP9z6

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David Liew drdavidliew ( View Tweet)
From Eye on Cytokine Storm- Decoding MAS by Dr Grant Schulert : “IL-18 is highly elevated in SJIa and other autoinflammatory disorders…can amplify innate signaling as well as induce IFN-gamma”. @RheumNow #ACR2025 https://t.co/6e5yfeDepX

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Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
Muscle mass & JAKi? 15 active RA pts (+ sarcopenia risk) Rx w/ tofacitinib - signif. improved @1 mo. @6 mos muscle mass signif improved (+242 cm3, +4%, p=0·017) {less w/ NSAIDs); w/ signif creatinine incr (0.06 mg/dl) & decr in serum IL-6, IL-1 & TNF. No change in CK, myoglobin, https://t.co/taY7DisMOS
Dr. John Cush RheumNow ( View Tweet)
Review of IL-1 family cytokines in inflammation and immunity - including, IL-1, IL-18, IL-33, IL-36, IL-37, IL-38, IL-1Ra, etc. Full read -- Good Reference!! https://t.co/01o05qYPjU https://t.co/HLcfPM2cPw

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Dr. John Cush RheumNow ( View Tweet)
Canakinumab in VEXAS - 47 males Rx w/ anakinra (44), canakinumab (9), or both(6). Response @1 mos: ANAK 34% vs CANK 100%; 22% vs 78% @ 3 mos. Drug survival was 54 mos CANK 300/m; 7 mo CANK 150/m; 1 mo ANAK. More ISR (47% v 0) & infx w/ ANAK https://t.co/Y3iSfajTal https://t.co/qTNamGDwVI

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Dr. John Cush RheumNow ( View Tweet)
Join us Sept 23 @ 7PM ET for the next Rheum to Breathe Journal Club! We’ll dive into two pivotal ILD studies: 📄 FIBRONEER (Nerandomilast in PPF) – NEJM 2025 📄 RECITAL (Rituximab vs Cyclophosphamide in CTD-ILD) – Lancet Panelists: Dr. Toby Maher, Dr. Shervin Assassi Moderator: https://t.co/BebFhDJ1mM
Dr. John Cush RheumNow ( View Tweet)
Study of 43 PsA pts starting bDMARD shows Calprotectin was elevated in PsA, decreased w/ biologics, but had no signif correlation w/ US synovitis. Baseline calprotectin, S100A12, IL-6, IL-17A, IL-23, CXCL10 were high. Calprotectin, S100A12, IL-6 decreased w/ Rx (p < 0.05).

Dr. John Cush RheumNow ( View Tweet)

Advances in Still's disease Rx: - using IL-1 or IL-6 inhibitors 1st line - New FDA approval of emapalumab (IFNg) for MAS - unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/8GhoamkV4N

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Dr. John Cush RheumNow ( View Tweet)
Systematic review of Rx options for #PMR (24 pubs, 10 RCTs, & 13 prognostic studies) concludes IL6-R inhibitors effective GC sparing agents; RTX & Tofa are promising. Quality trials needed to refine Rx & establish prognostic markers for decision-making. Fast-track clinics https://t.co/c3rI6u1aI6
Dr. John Cush RheumNow ( View Tweet)
Advances in Still's disease Rx: - using IL-1 or IL-6 inhibitors 1st line - New FDA approval of emapalumab (IFNg) for MAS - unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/qefCt5b7qh

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 35 studies, 887 participants, shows 3 consecutive nights of sleep deprivation (~4.3hr/hs) assoc w/ signif. increase in IL-6 (p < 0.01) and C-reactive protein (p = 0.03) in blood. This was not seen w/ a single night of total or partial sleep deprivation https://t.co/M60wPUbsch
Dr. John Cush RheumNow ( View Tweet)
Full read review of DMARD effects on CV Risks. Strongest CV protective effects for MTX & TNF inhibitors. Potentially beneficial are sulfasalazine, hydroxychloroquine, & leflunomide. More info needed on IL-6, IL-17/23 inhibitors. Concerns over NSAIDs & JAKi https://t.co/INEdCt0pxa
Dr. John Cush RheumNow ( View Tweet)
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