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A Review of Hydroxychloroquine Ocular Toxicity

Jack Cush, MD

While hydroxychloroquine (HCQ) is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal toxicity, risk stratification, and evidence-based screening protocols and how the drug can be used and monitored.

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A Patient’s Plea for a New Paradigm in Autoimmune Disease

Jack Cush, MD

A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?

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Tavneos

FDA Targeting the Safety of Avacopan

Jack Cush, MD

The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market.

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Follow the Money (4.23.2026)

Jack Cush, MD

Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week. 

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Aspirin Cardiovascular Prevention in Giant Cell Arteritis

Jack Cush, MD

A retrospective target trial emulations has shown that low-dose aspirin (ASA) given with a giant cell arteritis (GCA) diagnosis is associated with a lower risk of major adverse cardiovascular events (MACE), but a higher risk of GI bleeding.

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Adjunctive Prednisolone for Kawasaki Disease

Jack Cush, MD

An NEJM study has shown that glucocorticoids provide no added benefit when added to standard primary treatment in Kawasaki disease patients.

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Still's Disease Update

Jack Cush, MD

Arthritis Research & Therapy has published an overarching review of Still's disease - claiming it to be a single acquired and complex autoinflammatory disease in which both pediatric and adult forms share core pathogenic mechanisms, genetic associations and clinical presentations, with minor differences between children and adults who are afflicted.

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Litifilimab in Cutaneous Lupus Erythematosus

Jack Cush, MD

Biogen has announced positive results of their Phase 2 study, evaluating litifilimab in patients with active cutaneous lupus erythematosus (CLE), presented at the recent American Academy of Dermatology (AAD) Annual Meeting.

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Screening High Risk Myositis Patients for Cancer

Jack Cush, MD

An Italian retrospective study of 411 idiopathic inflammatory myopathies (IIM) patients applied IMACS criteria to assess the risk of cancer and found significantly more cancers in those at high risk.

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Top Four and More (4.10.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.

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Supposedly there's a shortage of Infectious Dz specialists & Fellowship applic are down. Survey of 380 Int. Med residents (41 prgs) shows ID interest signif assoc w/ exposure to ID in Yr 1 & 2, outpt clinics, ID- research. https://t.co/AUkiIvsuaV https://t.co/pOqkBhy93U

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24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/pAEqYJIKaw
Dr. John Cush RheumNow ( View Tweet)
FDA Targeting the Safety of Avacopan The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market. https://t.co/Otl0WQaOqo
Dr. John Cush RheumNow ( View Tweet)
Severe thrombocytopenia (TP) assoc w/ severe APS & increased mortality. Retro study of 432 #APS pts - 142 w/ TP (33%): 13% severe TP (<50L G/L). Severe TP assoc w/ ITP & CAP -had higher mortality https://t.co/7f8VpIcEJy

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Chinese study of 371 pts w/ Autoimmune hepatitis (AIH) - extrahepatic autoimmune diseases (EADs) seen in 24% -Sjogren’s & autoimmune thyroid dz (9% each). ANA+ independently assoc w/ EADs (OR 2) https://t.co/NVz8MWbJch https://t.co/tjCzaDcUFI

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Dr. John Cush RheumNow ( View Tweet)
Severe thrombocytopenia (TP) assoc w/ severe APS & increased mortality. Retro study of 432 #APS pts - 142 w/ TP (33%): 13% severe TP (<50L G/L). Severe TP assoc w/ ITP & CAP -had higher mortality https://t.co/p0bvLKupUe

Links:

Dr. John Cush RheumNow ( View Tweet)

Systematic review of plasma exchange (PE) in myositis (IIM) - 35 studies (mostly observational), 473 IIM pts (361 Rx w/ PE). Many reported improvements (publication bias). 7 comparative RCTs show no mortality benefit (severe ILD) (RR 0.41, 95% CI 0.16–1.06, I2 = 70%) https://t.co/ox0pdUL3Ek
Dr. John Cush RheumNow ( View Tweet)
ILD in RA – Dr. Jeffrey Sparks In this https://t.co/4UQlqwujiR 2026 podcast, Dr. Jeffrey Sparks reviews the latest advances shaping diagnosis and management of ILD in RA. 🎧 Listen here: https://t.co/U5cZVlgAka #Rheumatology #ILD #RNL2026 https://t.co/LidiS3Wj9d

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Dr. John Cush RheumNow ( View Tweet)
Predictors of Calcinosis Cutis in Systemic Sclerosis Calcinosis cutis (CaC) is a common and disabling non-lethal manifestation in systemic sclerosis (SSc). This study used SSc patients from the EUSTAR database to clinically characterize patients and identify risk factors for https://t.co/uXbcCa04Lv
Dr. John Cush RheumNow ( View Tweet)
VEXAS Syndrome - A Review Beck et al has published a review of the VEXAS syndrome in The Lancet, focusing on the pathogenesis, spectrum, and treatment strategies. https://t.co/Nik0TJm6Qu https://t.co/WS35PRnbBv

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Dr. John Cush RheumNow ( View Tweet)
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