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

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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Obesity and Low Back Pain

EurekAlert!

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. 

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Best of 2025: Targeting Obesity in Rheumatic Disease Patients

Jack Cush, MD

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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Best of 2025: Vitamin D for Prevention of Disease

Jack Cush, MD

JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults.

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Reefer Madness (12.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com.  B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.

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APPs in the News (12.5.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.

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Turkey Tryptophan (11.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

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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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Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
Best of 2025: Targeting Obesity in Rheumatic Disease Patients Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese. https://t.co/aPGuYFCWLo
Dr. John Cush RheumNow ( View Tweet)
Best of 2025: Vitamin D for Prevention of Disease JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults. https://t.co/PFHO7x5nxH https://t.co/fvwzLgYGJe

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Dr. John Cush RheumNow ( View Tweet)
Lilly announced phase 3 RCT TRIUMPH-4, where Retatrutide, a new GIP, GLP-1 & glucagon recpt agonist, was given to obese (BMI >35), knee osteoarthritis pts *without diabetes*. Wt loss at 68 wks was 28.7% with reduced WOMAC pain scores of -4.5 points (75.8%) https://t.co/73yIyvwRtL
Dr. John Cush RheumNow ( View Tweet)
MEDISPO study of 38 mild-mod psoriasis pts, 16-wk Mediterranean diet vs low-fat diet. Mediterranean diet did much better w/ PASI change −3.4 vs 0, more pts achieving a PASI 75 reduction (47.4% vs none) https://t.co/ZJU58VanGr https://t.co/x6juAT672B

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Dr. John Cush RheumNow ( View Tweet)
Retrospective EHR study of 38,327 COVID-19 infx pts & 1,143 whodeveloped post Covid Syndrome (PCC). PCC risk was signif higher in women & obese. Pre-COVID, psoriasis (OR 1.41) & RA (OR 1.64) had incr risk of PCC. Post COVID, more Sjögren’s (OR 4.05) among PCC. https://t.co/0Z48Hy43XY
Dr. John Cush RheumNow ( View Tweet)
Medical Cannabis for Pain Management Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients. https://t.co/kxTDqbzpgg https://t.co/fBumEAgISU

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Dr. John Cush RheumNow ( View Tweet)
Dr, Tuhina Neogi writes its time for a new understanding of OA; its not just wear n tear. Based on preclinical and clinical evidence, OA is a systemic, whole-body disease and that this should change future research and treatment of #OA. https://t.co/HQWI14WSXg https://t.co/5bIWgqaETU

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Dr. John Cush RheumNow ( View Tweet)
WHO recommendations on GLP-1 agonists: 1) conditional recommendation - GLP-1 drugs can be used for for long-term obesity treatment by adults, except pregnant women; 2) GLP-1a use should be paired with a healthy diet and physical activity. Access to these drugs is a problem. https://t.co/jMa7rbJPby
Dr. John Cush RheumNow ( View Tweet)
Obesity-inflammation axis in PsO & PsA: obesity is assoc w/ less remission& poorer drug responses; possibly from adipokines, biomechanical stress, gut dysbiosis, etc. Notably, weight loss can improve both psoriatic disease course and response to therapy. https://t.co/cZbeu0zfmR https://t.co/EoCTNKk265

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Dr. John Cush RheumNow ( View Tweet)
PROSPERO meta-analysis shows an effect of diet on #RA risk. 8 independent studies (n=270,121) showed a reduced risk of incident RA with Anti-inflammatory (OR 0.56; 0.31–0.99), Mediterranean (OR 0.88; 0.78–0.99), and HEI (OR 0.60; 0.25–1.47), but not DASH diets https://t.co/qf4kTVyJ0m
Dr. John Cush RheumNow ( View Tweet)
PROSPERO meta-analysis shows an effect of diet on #RA risk. 8 independent studies (n=270,121) showed a reduced risk of incident RA with Anti-inflammatory (OR 0.56; 0.31–0.99), Mediterranean (OR 0.88; 0.78–0.99), and HEI (OR 0.60; 0.25–1.47), but not DASH diets https://t.co/Qr9lXWRAED
Dr. John Cush RheumNow ( View Tweet)
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