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Early vs Delayed Belimumab in Lupus

Jack Cush, MD

An economic evaluation of early vs delayed use of the Blys inhibitor, belimumab (BEL), in systemic lupus erythematosus (SLE) has shown both cost effectiveness and clinical utility of early BEL initiation in active lupus patients.

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Referral Rules to Live By (2.20.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Highlights include referral rules, combination biiologics in psoriasis and don't use JAK inhibitors in pregnancy.

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Referrals - Orthopedics or Rheumatology?

Jack Cush, MD

“Orthopedics or rheumatology, who should I see?" A question, often asked with urgency, posed by those who genuinely don’t know who to see for a musculoskeletal (MSK) complaint.  Inquiring patients, family, or other physicians may be one forum for such a request. Another occurs in the hospital and clinic when referrals for MSK issues can go in either direction.  How would you guide such requests?  And what would your answers be based on?

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A Modern Approach to Osteoporosis Management

Adela Castro, MD

Currently, fewer than half of patients diagnosed with osteoporosis receive appropriate pharmacologic therapy. This treatment gap reflects several challenges in osteoporosis management, including limited disease awareness, barriers to medication access, clinician discomfort with therapy selection, and uncertainty regarding the optimal timing of treatment initiation.

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Can I Use JAK Inhibitors During Pregnancy?

Jack Cush, MD

In 2020, the ACR Recommendations on Reproductive Health notably avoided firm guidance on the use of JAK inhibitors (JAKi) during pregnancy stating, "There is no available evidence regarding use or safety of the new small- molecule agents, tofacitinib, baricitinib, and apremilast, during pregnancy."

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Maui Potpourri (2.13.2026)

Jack Cush, MD

Dr. Jack Cush reviews the hot item takeaways from last week's RheumNow.Live 2026.

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Obesity, Surgery, and Optimizing Patient Care

Eric Dein, MD

Rheumatologic care involves multidisciplinary approaches and collaboration with specialties to treat complex, systemic diseases. While many Pods at RheumNow Live are disease specific, the Pod II focused on Advancing Practice on important and emerging areas affecting rheumatologic patients. This session focused on two major areas of need: obesity and peri-operative management.

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Prevention in Lupus and Therapeutic Evolution in Sjögren’s explores the proactive approach in autoimmune diseases, moving from theory to empirical evaluation. Recent discussions on incomplete lupus and the SMILE trial, along with advancements in Sjögren’s treatments, underscore https://t.co/KY9nHnpkxk
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAConway Data from Scott Matson's group showing that immunosuppressing RA-ILD (agnostic to agent) results in stabilisation of the previous downward trajectory of pulmonary function tests. #RNL26 https://t.co/TMNeCsPDep
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAConway Data from Scott Matson's group showing that immunosuppressing RA-ILD (agnostic to agent) results in stabilisation of the previous downward trajectory of pulmonary function tests. #RNL26 https://t.co/MoYoM0K1cs
Dr. John Cush RheumNow ( View Tweet)
Comorbidity & Health Management https://t.co/cSwCEDKL28 https://t.co/WP7yIdWPVY

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Dr. John Cush RheumNow ( View Tweet)
Dermatomyositis outcomes w/ 2475 pts (claims) & 1196 pts (EHR). Half had myositis panels & 35% had + MSAbs. Steroid use common in 69% & 74%. HCQ, MTX, MMF. Outocmes (per 1000PYs) wereL all-cause hospitalisation 92, malignancy 15.3, ILD 6.4, and myocarditis 2.1 https://t.co/DJqKGNGX76
Dr. John Cush RheumNow ( View Tweet)
UK Biobank registry analyzed assoc. betw sleep duration, insomnia, & shift with osteoarthritis endpoints (KOA, HOA, TKA, THA) - all incr/highest in pts w/ <6 hrs nightly sleep. Night shift workers had 24% higher knee OA risk (HR=1.24) & 28% higher TKA risk (HR=1.28). https://t.co/UnxXH2I92R
Dr. John Cush RheumNow ( View Tweet)
RT @RichardPAConway Comparative survival in incident RA-ILD 1955-1995 vs 1999-2014. We are getting better, althoug need to take into account the general survival improvement also. More work to do! #RNL26 https://t.co/VwV33tHgR8
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD #RNL26 @RheumNow Uzma Haque GLP1 on pts with  SLE and diabetes Retrospective study - major improvements in MACE HR 0.66 VTE HR 0.49 Renal progession HR 0.77 Mortality HR 0.26 A major tool for rheumatic care! https://t.co/qR3HKfsugZ
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC Baseline serum urate &gt;8–9 mg/dL strongly predicts worse flares, hospitalizations, and joint damage over years. Urate level should inform urgency and intensity of therapy. #RNL26 https://t.co/4RBVXZxCCX
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD #RNL26 GLP on Knee OA STEP 9 Trial - 68 wk Mean WOMAC improved by 41.7 pts, compared to 27.5 in PBO, improved SF-36 7% stopped due to side effects https://t.co/LJzGzzlgq6 https://t.co/5ybyUdfNjZ

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Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD #RNL26 Dx Modification of OA @Tuhina_Neogi Challenge in drug develop: Models in young animal, not like human OA Trial enrollment in pts w late, establ OA- not early interv tx Many paths to OA - target mechanism to correct pt Slow progress of dx, $$ Endpt? Sx or

Dr. John Cush RheumNow ( View Tweet)

RT @ericdeinMD #RNL26 Placebo in Rheumatology - STEP talk Kerschbaumer What plays role in PBO? Treatment adherence effect w better background therapy - may appear to be PBO Impact in globalization of recruitment patterns, affects background PBO Education of pts bridges gap

Dr. John Cush RheumNow ( View Tweet)

RT @Gibson_RheumPAC Obesity doesn’t just increase risk of rheumatic diseases-it worsens outcomes. Patients with obesity have higher disease activity, poorer biologic response, and 20–25% lower remission rates in inflammatory arthritis. #RNL26

Dr. John Cush RheumNow ( View Tweet)

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