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Early DMARD Initiation Benefits in Psoriatic Arthritis

Jack Cush, MD

Mease et al has published the results of a cohort study showing early initiation of disease-modifying antirheumatic drugs (DMARDs) in patients with psoriatic arthritis (PsA) resulted in better outcomes compared to late initiation.

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Immunomodulators in the Treatment of Autoimmune Hepatitis

EurekAlert!

Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on histology.

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ICYMI: Consensus Against Interventional Injections for Chronic Spinal Pain

Jack Cush, MD

BMJ has published a clinical practice guideline resulting from the work of an international, multidisciplinary panel addressing chronic spine pain (≥3 months duration) not associated with cancer or inflammatory arthropathy. This is a chronic (not acute) spine pain guideline.

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ICYMI: Should Lupus Nephritis Receive PJP Prophylaxis?

Jack Cush, MD

A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and risk factors.

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ICYMI: Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs

Jack Cush, MD

A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (compared with TNFis).

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Hepatitis B (Keep)

ICYMI: 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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ICYMI: TNF Inhibitor Drug-Induced Lupus

Jack Cush, MD

A study from the FDA's adverse event reporting system (FAERS or Medwatch) database identified cases of drug induced systemic lupus erythematosus (SLE) in patients receiving tumor necrosis factor-α (TNF-α) inhibitors - a paradoxical reaction to common antiinflammatory biologic agents.

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Review of 104 irAE pts rx w/ JAK inhib. (82% tofacitinib). Checkpoint inhib was for Lung (20%), gastric (17%) & melanoma (16%). JAKi indications: myocarditis (70%), myositis (33%), hepatitis (24%). JAKi potentially effective esp in irAE pts unresponsive to cytokine Rx. https://t.co/8ezpAOzpRh
Dr. John Cush RheumNow ( View Tweet)
Efficacy and safety of deucravacitinib up to week 52 in the POETYK PsA-2 study •ACR20 at W16: 54.2% (deucravacitinib) vs 39.4% (placebo), p=0.0002 •PASI75: 40.9% vs 15.4%, p<0.0001 •MDA: 25.6% vs 14.7%, p=0.0007 •FACIT-F: +2.5 vs +1.8 •SAE: 1.9% (low) TYK2 inhibition shows https://t.co/PLJytueZDt
Dr. John Cush RheumNow ( View Tweet)
🎩REGENCY: Obinutuzumab + standard therapy improved renal outcomes in #lupus nephritis across all tested response definitions (REGENCY, BLISS-LN, AURORA-1). Week 76 CRR consistently 13–16% higher vs placebo. Results hold despite variable thresholds. @RheumNow #EULAR2025 #OP0006

Dr. John Cush RheumNow ( View Tweet)

What happens in pre-RA when you stop #abatacept after 1 yr Rx At 6 yrs approx 60% on #Placebo V 50% who initially got #ABA Prolonged damped effect of development of #RA NNT for 1 yr is ~10 with a range as low as 6 #EULAR2025 @RheumNow @eular_org Abst#OP0004 https://t.co/eCXEWQhvWM
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Early intensive therapy in PsA. STAMP RCT in early PsA: •ACR50 at 3mo: 43% (early secukinumab) vs 22% (SoC) •MDA at 3mo: 48% vs 25% •PASI90 at 3mo: 60% vs 22% By 12months: outcomes similar, but early secukinumab led to faster control and fewer therapy escalations. https://t.co/Mn0uW3cckf
Dr. John Cush RheumNow ( View Tweet)
Secukinumab fails in GCA phase 3 RCT. Novartis announced top-line results from the GCAptAIN study evaluating secukinumab in adults with newly diagnosed or relapsing GCA. In a steroid taper RCT, the endpoint was sustained remission at Wk 52 compared to placebo https://t.co/JuMDPvznCn
Dr. John Cush RheumNow ( View Tweet)
First FcRn inhibitor in #IIM: In #ALKIVIA, SC efgartigimod PH20 improved TIS vs placebo at 24wks (50.45 vs 35.65, p=0.0004), with faster time to TIS≥20 (30 vs 71.5d) & TIS≥40 (113d vs NE). More major responders too (TIS>60: 34% vs 9.5%). #EULAR2025 #OP0002 https://t.co/ulxtL1NX2Y
Dr. John Cush RheumNow ( View Tweet)
If you successfully taper off DMARDs in RA patients in remission, do you risk bringing new joints in the mix? Leiden post-hoc trial: these patients don’t do worse than those who never get off drug. Drug-free remission tricky but new joints not a worry. #EULAR2025 @RheumNow https://t.co/bwXgrB875k
Dr. John Cush RheumNow ( View Tweet)
Clinical determinants of multiple drug failure in D2T RA 2000+ RA cohort 250+ refractory -Low financial status -Cancer Hx -CV comorbidities -Chronic use of NSAID or GCs Protective: Regular participation in leisure activities #POS0030 @RheumNow #EULAR2025 https://t.co/mdePGkHU82
Dr. John Cush RheumNow ( View Tweet)
Glucocorticoid Tapering in SLE Dr. Yuz Yusof discusses abstract POS1224 presented at the 2025 EULAR meeting in Barcelona, Spain. https://t.co/oI992YLvnB https://t.co/mPmMxcpMey

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Dr. John Cush RheumNow ( View Tweet)
Rituximab - Super Responders Exist in SLE Dr. Yuz Yusof reports on abstract POS0325 presented at the 2025 EULAR meeting in Barcelona. https://t.co/LkYzMtsErn https://t.co/awRhQmbhoT

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Dr. John Cush RheumNow ( View Tweet)
Pregnancy in SLE: Risks Extend Beyond Clinical Concerns Pregnancy in patients with systemic lupus erythematosus (SLE) continues to carry significantly elevated risks, with maternal mortality rates nearly five times higher than in the general population. https://t.co/3G7Eftt0Kg https://t.co/X3SUl6FTHO

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Dr. John Cush RheumNow ( View Tweet)
FDA has approved a SC autoinjector of Benlysta (BEL) for use in pediatric lupus nephritis & pts > 5rs of age for SLE and active LN. BEL SC dosing for Pediatric SLE: 200 mg qwk (>40 kg) or 200 mg EOW (q2wk) if 15-40 kg. https://t.co/zrskHdw9Jx https://t.co/jkqygmfJPv

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Dr. John Cush RheumNow ( View Tweet)
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