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Ortho v Rheum

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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osteoporosis.OP_.Drugs_.jpg

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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Merola RNL26 Shot

Paradoxical Reactions, Target Selection & the Future of Imaging in Psoriatic Care

Audrey Gibson, PA-C

From paradoxical psoriasis to IL-23 vs IL-17 to imaging in PsA, speakers in RheumNow Live's "Decisions in Psoriatic Arthritis" pod delivered valuable, clinically relevant education.

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Slim,waist,obese,obesity

Together PSO Trial - Combination Ixekizumab and Tirzepatide

Jack Cush, MD

Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over IXE alone.

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pregnancy,embryo,fetal

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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Population survey of 21 000 US adults, 62.3% reported recent use of any OTC or prescription meds. Past-7-day prevalence of any OTC medication was equal to RX med use (46%) and increased use with age among both male and female individuals. https://t.co/xeWBQ0DnlB https://t.co/c8lqXOmAaT

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Dr. John Cush RheumNow ( View Tweet)
Early: BITE compassionate use CD19×CD3 T cell engager blinatumomab in 5 antisynthetase myositis & BCMA×CD3 teclistamab in 5 scleroderma pts, all Tx refractory. Both showed rapid clinical, serologic, histologic benefits, with cytokine release syndr as AE of concern https://t.co/CTppiWim0a
Dr. John Cush RheumNow ( View Tweet)
Together PSO Trial - Combination Ixekizumab and Tirzepatide Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over https://t.co/YWCjN2NyGM
Dr. John Cush RheumNow ( View Tweet)
Can I Use JAK Inhibitors During Pregnancy? Short answer: Not yet. https://t.co/E9yrWR5zTG https://t.co/NLy6OibkYH

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Dr. John Cush RheumNow ( View Tweet)
RT @richardPAConway Target trial emulation from Dr Sparks group in RA-ILD. Abatatacept and JAKi seem to be better than RTX. TNFi and IL-6i appear similar to RTX. Thought provoking! #RNL26 https://t.co/vmg7ot9m8b
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 The new kid on the block in RA-ILD (and other PPF). Nerandomilast, an anti-fibrotic with additional anti-inflammatory/immunomodulating functions. Demonstrated significant mortality benefit in ILD. #RNL26 https://t.co/8DU3WyPQGy
Dr. John Cush RheumNow ( View Tweet)
RT @RichardPAConway ACR/Chest and EULAR/ERS guidelines for RA-ILD presented by Dr Sparks. I'm posting the one I use ;) #RNL26 https://t.co/a6vwQWbjE7
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD #RNL26 Paradoxical psoriasis with TNF Highest in infliximab Seen highest in IBD, particular Crohn's Palmopustular is most common manifestation May have overlap appearance with psoriaform with eczema, histology with psoriaform spongiotic dermatosis with https://t.co/SKQZgbLQUS
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD #RNL26 Prosthetic joint infection vs flare? - PJI risk 50-80% higher in RA (OR 1.47-1.8) - Immunosuppressants, intra-artic injections, RA activity, BMI incr risk - Delay in diagnosis https://t.co/XTozafDQyf
Dr. John Cush RheumNow ( View Tweet)
What did you miss at RheumNow Live 2026? Our Poster Hall features new data across: • Psoriatic Arthritis • Systemic Lupus Erythematosus • Lupus Nephritis • Vasculitis • Polymyalgia Rheumatica • Axial Spondyloarthritis From Phase III trials to real-world evidence, these

Dr. John Cush RheumNow ( View Tweet)

Spectrum of skin Sxs in 518 pts w/ Stills dz from AutoInflammatory Dz Alliance (AIDA) Network Registry dedicated to Still’s disease includes Salmon evanescent rash (64%), macules (7.7%), urticaria (6%), persistent pruritic papules & plaques (PPPP) (4.8%) https://t.co/DW9NoaxNPP https://t.co/U5GrCutYT0

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Dr. John Cush RheumNow ( View Tweet)
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