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Rheumatology: Believe It or Not (4/25/2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?

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Stills,continuum

Unmet Needs in Still’s disease

Jack Cush, MD

In February 2023, an expert consensus panel of pediatric and adult rheumatologists met to address challenges in Still’s disease (SD), including systemic juvenile idiopathic arthritis and adult-onset SD. They addressed four main topics: (1) early recognition and diagnosis of SD; (2) pathogenetic pathways and possible biomarkers for diagnosis and response; (3) refractory disease and risk factors, and (4) treatment of SD and its complications.

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Better Responses with Chronotherapy for Baricitinib

Jack Cush, MD

A nonrandomized, open-label, controlled trial has shown superior efficacy when baricitinib was given at night (instead of day); attesting to the benefits of chronotherapy - selective dosing meant to target the body's diurnal variations.

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Funding.money.research

ACR & Arthritis Foundation Denounce the Dismantling of Vital Health Programs

Arthritis Foundation and ACR

As organizations representing nearly 60 million adults and children living with arthritis in the United States and the rheumatologists and health care professionals who treat them, we are deeply alarmed by this week’s dismantling of multiple branches of the Centers for Disease Control and Prevention (CDC) that manage essential research and public health programs critical to the well-being of millions of people living with chronic conditions. 

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Osteoarthritis Risky Business (4.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com.  Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.

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The Increasing Cost of First-Line Biologics for Plaque Psoriasis

Jack Cush, MD

A national commercial claims analysis of first-line use of biologics in biologic−naive plaque psoriasis patients found a near doubling of net treatment costs from 2007 to 2021 ($21 236 to $47 125).

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A review of 18 guideline recommendations on DMARDs in pregnancy & reproductive health. There were recs. DMARDs & pre-conception (56%), lactation (67%), male fertility (33%), & use of csDMARDs (72%), bDMARDs(72%), tsDMARDs (28%); less recs for b/tsDMARD use https://t.co/tKGCXrbOuc
Dr. John Cush RheumNow ( View Tweet)
Retrospective EGPA study of mepolizumab Rx 45 pts Rx initially w/ 300 mg/4 weeks, 27% switched to 100 mg/4 wks after 26 mos & 50% maintained complete remission without GC. Other half had sinonasal Sxs Rx w/ increased MEP dose orlocal therapy. https://t.co/H8ftg136Ez https://t.co/CKchbGpq20

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Dr. John Cush RheumNow ( View Tweet)
Piperacillin effectively treats Lyme disease at 100-times lower dose than doxycycline https://t.co/NQXG7FRtwh https://t.co/YcIYJqorKX https://t.co/e7UCG0z4wL

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Dr. John Cush RheumNow ( View Tweet)
An emulation trial shows that Humira biosimilars (Amjevita & Imraldi) were equivalent to Humira in psoriasis & achieving PASI <=2, both for new biologic starts and for biologic switchers. https://t.co/8lTGGs2rbP https://t.co/T6rTJ5ESj2

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Dr. John Cush RheumNow ( View Tweet)
CDC's Committee on Immunization (ACIP) met and recommended: 1. Expand strains for meningococcal vax 2. Lower age for RSV vax > 50y 3. Rec. chikungunya vax for certain travelers - Flu & Covid Vax to be up next mtg 6/25 https://t.co/jInnR5JSxS https://t.co/PXg0HDLgnL https://t.co/Vro5mbjG9R

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Dr. John Cush RheumNow ( View Tweet)
If you see women with inflammatory arthritis who are pregnant or planning a pregnancy, the MAMA Study may be recruiting at an obstetric unit near you. To find out what is happening, visit @TheMAMAStudy, https://t.co/N8B5MpTsRx, or email mama@npeu.ox.ac.uk. @NPEU_CTU @NPEU_Oxford https://t.co/lQdgUiZ0Cb

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BSR RheumatologyUK ( View Tweet)
Retrospective EGPA study of mepolizumab Rx 45 pts Rx initially w/ 300 mg/4 weeks, 27% switched to 100 mg/4 wks after 26 mos & 50% maintained complete remission without GC. Other half had sinonasal Sxs Rx w/ increased MEP dose orlocal therapy. https://t.co/M4Gp52QdwQ https://t.co/zb13fuKhpH

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Dr. John Cush RheumNow ( View Tweet)
The Increasing Cost of First-Line Biologics for Plaque Psoriasis A national commercial claims analysis of first-line use of biologics in biologic−naive plaque psoriasis patients found a near doubling of net treatment costs from 2007 to 2021 ($21 236 to $47 125). Despite the https://t.co/mWXz2o0mwz
Dr. John Cush RheumNow ( View Tweet)
Is High Dose Aspirin Needed in Kawasaki Disease (KD)? Does aspirin add any advantage to intravenous immunoglobulin (IVIG) alone in children with KD? A randomized clinical trial IVIG alone was not inferior to IVIG plus aspirin, suggesting that high-dose aspirin during initial https://t.co/uuCgDmgNif
Dr. John Cush RheumNow ( View Tweet)
Phase 3 trial shows inebilizumab reduces flares in IgG4-related disease (10% vs 60% in placebo; HR 0.13, p<0.001) and boosts remission rates without background immunosuppressants. CD19+ B-cell depletion shows promise as a new treatment. #Rheum @RheumNow https://t.co/7iSyPfnMV0 https://t.co/M51b0dipMs

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Natasha Salman, DO DrNatashaSalman ( View Tweet)
FDA reports higher rate of allergic/hypersensitivity type reactions w/ certainlots of Immune Globulin Intravenous (IGIV) and Immune Globulin Subcutaneous (IGSC) ; these have voluntarily withdrawn by the manufacturers https://t.co/j0yVBodLtW https://t.co/k7s4LtLnyu

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Dr. John Cush RheumNow ( View Tweet)
FDA reports higher rate of allergic/hypersensitivity type reactions w/ certainlots of Immune Globulin Intravenous (IGIV) and Immune Globulin Subcutaneous (IGSC) ; these have voluntarily withdrawn by the manufacturers https://t.co/N73Cc8rfAS https://t.co/OTROyomvv8

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Dr. John Cush RheumNow ( View Tweet)
Pregnancy-Related Deaths in the US A CDC cross-sectional national study showed an increase in pregnancy-related deaths in the US from 2018 to 2022, with highest rates among American Indian, Alaska Native women, and non-Hispanic Black women. https://t.co/H1s649GyiL https://t.co/MXnrQrAcrT

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Dr. John Cush RheumNow ( View Tweet)
Summary of the updated BSR Axial Spondyloarthritis for biological and targeted synthetic DMARD guidelines 2025 @RheumatologyUK #axialspondyloarthritis Full paper available at: https://t.co/LytDiHjawi https://t.co/iaHzD1BQRe

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
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