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The Cartel is Coming for Rheumatology

Eric Dein, MD

"What Do Blockbuster Drugs & The Black Market All Have in Common?" asked Dr. Madelaine Feldman at RheumNow Live 2025. They thrive, she explained, on market exclusivity "... until they don't." At first glance, the pharmaceutical marketplace may not appear like a crime drug ring, but Dr. Feldman of Tulane University described how sinister forces of market manipulation have negatively impacted patient care for years.

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Hepatitis B (Keep)

AGA Guideline: Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals

Jack Cush, MD

The American Gastroenterology Association has published its revised clinical practice guidelines for the prevention and treatment of hepatitis B virus (HBV) reactivation in at-risk patients, particularly those with immune-mediated disease, receiving immunomodulatory therapy and steroids.

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Celecoxib Lowers Colon Cancer Recurrence Risk

Jack Cush, MD

The Alliance for Clinical Trials in Oncology today announced the results of a data analysis from a randomized phase III clinical trial involving patients with stage III colon cancer, which found that adding the drug celecoxib

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Weak Data (1.24.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com, and features Dr. Charity Dean, the Keynote speaker at RheumNow Live 2025, and why she is an inspiration.

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Fallen Angels (1.17.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com; and pays homage to colleagues who passed away in 2024.

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Bah Humbug Vitamin D (12.20.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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54K Peptic Ulcers Annually (12.13.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com

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Palmar fasciitis & polyarthritis syndrome (PFPAS). JAMA case 50yoM w/ progressive hand swelling, stiffness, thickening, erythema, hepato-splenomegaly. Skin Bx dermal fibrous tissue. WBC 152k, LDH 889, lead to CML dx made by BM Fx (myeloid-erythroid ratio 21 w/ myeloblasts). +… https://t.co/7gj3mvOSqs https://t.co/56tLd1jsNf
Dr. John Cush RheumNow ( View Tweet)
Leeds study of 19 pts at-risk for RA (ACPA+ & arthralgia) finds low-diversity gut microbiome & in the 10 mos preceding the transition to RA, microbiome becomes more unstable w/ accumulation of Prevotellaceae, particularly Prevotella copri https://t.co/Va9Z0NWHj9 https://t.co/ciM7QtEF5S

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Dr. John Cush RheumNow ( View Tweet)
Leeds study of 19 pts at-risk for RA (ACPA+ & arthralgia) finds low-diversity gut microbiome & in the 10 mos preceding the transition to RA, microbiome becomes more unstable w/ accumulation of Prevotellaceae, particularly Prevotella copri https://t.co/rbYMCl1FcO https://t.co/LWqppg36cn

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Dr. John Cush RheumNow ( View Tweet)
Retrospectively review of 165 #EGPA pts, GI manifestations were assoc w/ Eosinophils > 19.5%, weight loss, & myalgia; & included abdominal pain (78%), diarrhea (40%), N/V (33%); GI hemorrhage (27%), ulcers (17%), obstruction (10%), & pancreatitis (6%) https://t.co/EzsGcFs2l2 https://t.co/mQrgjTG6NV

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Dr. John Cush RheumNow ( View Tweet)
54K Peptic Ulcers Annually (12.13.2024) https://t.co/18FiQx1YQA https://t.co/32UZi9XafS

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Dr. John Cush RheumNow ( View Tweet)
If high +ANA and NO #rheumatic #disease LOOK 👀 at #LIVER #Autoimmune #hepatitis And #alcoholic #liver #dx #ACRBest #ACR24 @rheumnow abst#0627 https://t.co/0bwfgNnB0e

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Dr. John Cush RheumNow ( View Tweet)

To Behcet’s or not to Behcet’s? -Aphtous ulcers have unique features(broad ddx) -Oral+Genital ulcers=CAP not necessary BD. -Pathergy test ⬆️specific and not limited to skin! -Pulmonary arterial aneurysms=almost pathognomonic. -Do not get confused by HLAs. #ACR24 @RheumNow… https://t.co/3nWgILNVYw

Dr. John Cush RheumNow ( View Tweet)

95 IBD pts had Magnetic resonance enterography (MRE). While 6/95 (6.3%) developed IBD-arthritis (mean 11 mos), finding Sacroiliitison MRE did not increase this risk. IBD arthritis risk was linked to arthralgia (OR 84) & extraintestinal manifestations (OR 7.4)… https://t.co/NGWGKn75jG https://t.co/IqY6XHWqqy
Dr. John Cush RheumNow ( View Tweet)
54K Peptic Ulcers Annually (12.13.2024) Dr. Jack Cush reviews the news and journal reports from the past week on https://t.co/V10S4oVFsv https://t.co/rHw1qgxzIP https://t.co/cOdGQ5cAPD

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Dr. John Cush RheumNow ( View Tweet)
Avacopan, a C5aR antagonist, for Rx of ANCA-Assoc GPA & MPA. Main warning for liver AE. In RCTs, abnl LFTs seen in 11.6-13.3% and 4.2% D/C drug for liver probs. Recent Japanese report of 22 AAV pts with AVACO Liver injury seen in 9 pts - Severe, incr total bilirubin in 4, 1 pt… https://t.co/LyuIQhwOoQ https://t.co/TAmQ9vph4V
Dr. John Cush RheumNow ( View Tweet)
Safety of Acetaminophen in the Elderly New research, led by experts at the University of Nottingham, has found that repeated doses of paracetamol in people aged 65 and over, can lead to an increased risk of gastrointestinal, cardiovascular and renal complications.… https://t.co/rLchNTh6C8 https://t.co/y2DUx6TQR0
Dr. John Cush RheumNow ( View Tweet)
In US, peptic ulcer disease affects 1% of population w/ ~ 54 000admitted to hospital annually w/ bleeding peptic ulcers. But only 10% of PUD pts present w/ upper abdominal pain. Prime causes are Helicobacter pylori infection (42%) & NSAID use (36%) https://t.co/0VvA7lI0MQ https://t.co/YWv4SDNVLC

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Dr. John Cush RheumNow ( View Tweet)
JAMA Images in Dermatology - Palmar Fasciitis and Polyarthritis Syndrome -- 50yoM w/ 6 mo. hx of hand/finger swelling, stiffness, thickening, and erythema, impairing mobility. Also found to have hepato-/splenomegaly, WBC 151K, LDH 889; abnl BM Bx. Pt dx w/ palmar fasciitis & CML… https://t.co/1Z9Oz0sRa7 https://t.co/HRSJcv4lzZ
Dr. John Cush RheumNow ( View Tweet)
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