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Treating Obesity is Disease-Modifying (9.4.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  New drugs approved, new drugs halted and some drugs out of control. Ready to test your knowlege? Take this week's quiz!

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BMI Affects JAK Inhibitor Responses in Rheumatoid Arthritis

Jack Cush, MD

A meta-analysis of Janus kinase (JAKi) inhibitors clinical trials in rheumatoid arthritis (RA) has shown higher BMI was associated with poorer responses and a reduced treatment benefit with JAK inhibitors in RA patients.

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Music and Pain Relief

Jack Cush, MD

If laughter is the best medicine, then music has to be second best. A new scoping review in Pain Reports by Bradt et al., examines the effect of music-based interventions (MBIs) on pain management. While its efficacy is well established, how or why music relieves pain has never been fully explained.

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EBR Journal Club: Dapirolizumab Pegol in SLE (PHOENYCS GO)

Michael Putman, MD, MSCI

The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal to an important RCT in rheumatology. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How great are the benefits and harms? And what didn’t they show me? This edition: PHOENYCS GO (dapirolizumab pegol in SLE).

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“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis

Jack Cush, MD

The proposed approach to difficult-to-treat rheumatoid arthritis is based on the EULAR definition (having failed 2 or more b/tsDMARDs). The authors provide guidance in the form of an easy acronym, A B C D E, which covers both diagnostic and therapeutic considerations.

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Why does obesity worsen Rheumatic disease?

Dr. John Cush RheumNow ( View Tweet)

True or False: In a Korean National Health Insurance study, gout patients on allopurinol had a significantly higher risk of fractures, with the highest risk seen in those with low adherence. Did you get it right? Take this week's RheumIQ and see: https://t.co/UaXqHKWizt. https://t.co/7nILMVUeGw

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NEW FROM EULAR: A real-world analysis of predictors of IBD in PsA. 🔎 In patients with PsA, signs and symptoms of IBD may appear before diagnosis, but do we know what to look for? Explore the poster: https://t.co/JX0Y0AQ07N Sponsored by AbbVie Medical Affairs + Health Impact. https://t.co/zx9kjsiZfZ

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Dr. John Cush RheumNow ( View Tweet)
Ro52 Abs in idiopathic inflammatory myopathies (IIM). From 2,126 IIM China/Japan pts, Ro52 positivity was common (46%), esp in MDA5+ DM & anti-synthetase syndr (ASyS) & was assoc w/ high freq of ILD, rapidly progressive ILD, and poor prognosis. https://t.co/TA4gSnZax1 https://t.co/riYs5YJwQV

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QD Clinic: The Weight Behind Delay in Diagnosis Dr. Antoni Chan, London, discusses a case of a patient with ankylosing spondylitis whose weight delayed the diagnosis and treatment of AS. This QD Clinic is presented as part of RheumNow's "The Obesity Imperative" campaign, https://t.co/fDozAaX64j
Dr. John Cush RheumNow ( View Tweet)
“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis The proposed approach to D2T-RA is based on the EULAR definition (having failed 2 or more b/tsDMARDs). It is estimated that up to 20% of RA patients meet this D2T-RA definition and can be plagued by active or https://t.co/o39IREvjI4
Dr. John Cush RheumNow ( View Tweet)
Cochrane systematic review of LBP Rx (8 RCTs, 501 cLBP pts) show that Lumbar supports may result in a small reduction in pain intensity if given w/ NSAIDs, but may offer little to no benefit for pain intensity & disability if used alone. Insufficient evidence to support their https://t.co/6Vq4CPXLvE
Dr. John Cush RheumNow ( View Tweet)
NY Times reports Gallop poll: 15% Americans have used a wt-loss drug (11% currently taking) - up from 3% in 2024. These have been approved for use in NIDDM, weight loss, liver Dz, CV risk reduct. & sleep apnea. Also obesity in USA is fell to 36.4%, after peak of 39.9% in 2022. https://t.co/ghxUEcuoGr
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Lupus Research Alliance has awarded >$2 million in 2026 awards to studying innovative lifestyle interventions for people living with lupus. This includes studies on ginger supplementation, physical activity, and a whole health online programs https://t.co/C45y9laeHN https://t.co/6ifbPMWNt9

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Dr. John Cush RheumNow ( View Tweet)
MSK problems w/ Mobile gaming addiction (MGA)? Study of 364 Jordanian med students showed 9% had MGA- these has signif more UE MSK pain (71% vs 48%; p 0.012) vs nonaddicts. Elbow pain (41%) best predictor of MGA, but also neck (85%), upper back (65%), wrists (41%). https://t.co/51AWgHjrGC
Dr. John Cush RheumNow ( View Tweet)
VA (VARA) registry study of 2723 RA pts showed frailty was independently associated with increased cancer incidence. Age-adjusted CA incidence rates (per 1,000PYs) were 12.3 (robust), 15.5 (pre-frail), and 19.9 (frail). CA mortality rates were 7.8, 10.6, & 9.8/1,000PYs https://t.co/Ex52R56oT1
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Necrotizing arteritis is rare w/ IgA Vasculitis (IgAV). Review compared 30 IgAV-NA to 257 adult IgAV & 196 PAN pts. Overall IgAV-NA is a severe IgAV phenotype with life-threatening complications & should prompt vascular imaging and intensified immunosuppression. IgAV-NA had more https://t.co/XdPbGX770D
Dr. John Cush RheumNow ( View Tweet)
The global inflammatory myopathies market size was valued at USD 1.81 billion in 2025 and is expected to reach USD 2.67 billion by 2033 (CAGR of 5.00%). This applies to: Polymyositis, Dermatomyositis, Inclusion Body Myositis, Juvenile Myositis, Corticosteroids, https://t.co/vb7zfM76pO
Dr. John Cush RheumNow ( View Tweet)
Korean National Health Insurance claims study of 4,107 newly Dx gout on allopurinol x 24 mos (vs non-gout controls). Gout significantly higher risk of fractures (aHR 5.52_; 95% CI 4.19–7.26), highest in those with low-adherence to allopurinol (aHR 5.91). Consistent trends seen https://t.co/cTO4lGtYAy
Dr. John Cush RheumNow ( View Tweet)
Rheum Survey> What effect does obesity have on #Lupus pts?

Dr. John Cush RheumNow ( View Tweet)

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