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Juvenile Idiopathic Arthritis - NEJM Review

Jack Cush, MD

Sandborg et al. has published an overview of juvenile idiopathic arthritis (JIA) - its classification, biology, genetics, , clinical presentations and treatment advances in the New England Journal of Medicine (NEJM).

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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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A New RA Approval (8.1.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and a new treatment for RA from the FDA.

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Options for Refractory axSpA or PsA

MedPage Today

Although most patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) didn't respond adequately to the interleukin-17 (IL-17) inhibitor ixekizumab (Taltz), enough did that it should still be considered in such cases, a Danish registry study indicated.

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Retrospective review of 9 #RA pts w/ elevated liver enzymes who were Rx w/ TNF inhibitor (4 adalimumab, 5 etanercept; 78% female, median BMI 37). Over 3 yrs F/U, LFTs declined, fibrosis scores (FIB-4) signif decreased; albumin & bilirubin remained stable https://t.co/Hcwa3qaupv https://t.co/OwGY5jxxyZ

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Potentially novel RA vaccine of recombinant HLA-DRB1 04:01 bound to type II collagen (COL2) peptide COL2259-273 that was chemically modified at glycine position 265 & shows to suppress collagen induced arthritis in human DRB1 04:01-expressing mice https://t.co/TtBt49DQDa https://t.co/qMXzmvNc1b

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Dr. John Cush RheumNow ( View Tweet)
A New RA Approval (8.1.2025) Dr. Jack Cush reviews the news, journal reports and a new treatment for RA from the FDA https://t.co/hHNvdOKp2z https://t.co/lUAZM7bY7X

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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)
Large metanalysis of TNFi use in immune-mediated inflammatory diseases (45 studies, 150K pts) shows no increased risk of de novo heart failure (HF), and no significant risk of HF worsening w/ TNFis. https://t.co/9sRVsMZ1kv https://t.co/Kapg9ZwVGf

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Dr. John Cush RheumNow ( View Tweet)
French retrospective observational study of Bx/CT/PET Dx of 380 #GCA pts found 7.6% (29) w/ Nl baseline CRP < 10 mg/L at Dx. GCA w/ low CRP had less fever, more ocular Dz (ant ischemic optic neuropathy 28 vs 13%), & limb claudication (24 vs. 8%) but equal relapse rates https://t.co/fPy92NjJzS
Dr. John Cush RheumNow ( View Tweet)
CCL17 is a downstream mediator of GM-CSF. Drug repurposing review of FDA approved Rx shows 5 Rx w/ anti-CCL17 effects - fluoxetine, ractopamine, ponesimod, terbutaline & etravirine, w/ inhibition of STAT5, IRF4 & CCL17 & shows antiinflamm effects in RA animal model https://t.co/2aTyZMWPJn
Dr. John Cush RheumNow ( View Tweet)
TriNetX study of E-health record study of ~53k transcatheter aortic valve intervention (TAVI) pts. 705 were on preoperative colchicine - these had signif reduction of post-TAVI heart block and AV/LBBB (RR 0.867 [95% CI, 0.756–0.994]) @ 1 month, but not at 6 months https://t.co/9tI2KFY7u7
Dr. John Cush RheumNow ( View Tweet)
HCQ Preserves Renal Function in Lupus Nephritis Lupus nephritis (LN) patients on long-term therapy with hydroxychloroquine (HCQ) showed significantly less decline in renal function, compared with patients treated otherwise, a 10-year retrospective study indicated. https://t.co/YpJGpAysUQ
Dr. John Cush RheumNow ( View Tweet)
MTX or TNFi use in elderly #RA pts w/in a year of Dx of melanoma was not associated with increased mortality. This included melanoma in situ (48%), localized (47%) and regional (5%) melanoma. Steroid use however was assoc w/ reduced survival. https://t.co/QOXfEf51S1 https://t.co/GZ5dedEMfM

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Dr. John Cush RheumNow ( View Tweet)
Rituximab is not Superior in EGPA A cohort study of Eosinophilic Granulomatosis With Polyangiitis (EGPA) patients from the French Vasculitis Study Group failed to show superiority of rituximab compared to conventional strategy with glucocorticoids (GS) alone or in combination https://t.co/h4B20Ngamj
Dr. John Cush RheumNow ( View Tweet)
FDA is evaluating the safety of Vyvgart Hytrulo, ((efgartigimod) used to treat AChR Ab positive generalized myasthenia gravis (gMG). But in clinical trials there are reports of "severe worsening of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP)” https://t.co/KN7ZZ2LWPW
Dr. John Cush RheumNow ( View Tweet)
PMR & GCA not assoc w/ increased mortality, Norway study of 274 isolated PMR (mean age 72 yrs) & 63 GCA (age 72 yrs) pts. After mean F/U 13.7 yrs 96% were deceased. Standardized mortality ratio was Not incr for PMR (0.97)or GCA (1.10), but men w/ PMR had , lower all-cause https://t.co/wbiVhjCimk
Dr. John Cush RheumNow ( View Tweet)
Danish childhood vaccination registry study (1997-2020) found among 1,224,176 children w/ vaccination before age 5, w/ aluminum containing vaccines against an DPT, poliovirus, Hib (DTaP-IPV/Hib), PCV, etc found no increased risk of autoimmune dz by 8 yrs of https://t.co/9IR6AmlIT9
Dr. John Cush RheumNow ( View Tweet)
HCQ Preserves Renal Function in Lupus Nephritis Lupus nephritis (LN) patients on long-term therapy with hydroxychloroquine (HCQ) showed significantly less decline in renal function, compared with patients treated otherwise, a 10-year retrospective study indicated. https://t.co/dB6G34c6Mw
Dr. John Cush RheumNow ( View Tweet)
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