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Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com. Today we cover GLP-1 agonists, acupuncture, what JAKs won’t do & an FDA Pink Slip.
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A multicenter study investigated the association between hydroxychloroquine (HCQ) dosage and COVID-19 mortality among hospitalized patients from multiple medical centers in China. The analysis focused on dose effects of HCQ on mortality.
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What do you need to know about scleroderma-related lung fibrosis as a practicing rheumatologist? Here are takeaways from these guidelines and my practice.
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JAMA has published a systematic review and meta-analysis of head-to-head studies showing there was no meaningful difference in safety events observed when taking either JAK inhibitor (JAKi) vs TNF antagonist (TNFi) therapies for the treatment of immune-mediated
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Deane et al has published the results of the STOP-RA trial, demonstrating that 12 months of hydroxychloroquine (HCQ) did not prevent the development of clinical RA at 36 months.
NDT
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Optimal glucocorticoid therapy in lupus nephritis
🔓https://t.co/e6SjmOrRpw
➡️This review provides an in-depth analysis of glucocorticoid therapy for lupus nephritis, a severe manifestation of systemic lupus erythematosus that affects up to 51.7% of patients https://t.co/JftCQiFif1
TheDaoIndex
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Infections cause high morbidity & mortality in our immunocompromised rheum patients: vaccinations are essential to keep them healthy.
Best time to administer vaccines?
1. Before immunosuppression
2 during periods of dz control
3. >1 vaccines need pt input
@LCalabreseDO #CCRW25 https://t.co/oBgXlIk1TY
Dr. John Cush
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This is a pivotal trial. 187 pt w/ incomplete lupus (ANA+ plus 1-2 criteria, but not qualifying as SLE) shows that HCQ does not prevent progression to SLE! Congrats to these researchers lead by Nancy Olsen et al. https://t.co/NnrA8ohiGX
Dr. John Cush
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August 29, 2025, FDA has terminated the Arthritis Advisory Committee, citing infrequent meetings & that the effort and expense of maintaining the committee “is no longer justified.”
The committee last met on 5/6/21 to review avacopan - that was subsequently approved. REALLY? https://t.co/w3Z6TszeWZ
Dr. John Cush
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SARD-ILD and serious infection risk: The elephant in the room
Interstitial lung disease (ILD) remains one of the largest unmet clinical needs across many systemic autoimmune rheumatic diseases (SARD). ILD is highly prevalent across systemic sclerosis, mixed connective tissue https://t.co/oxIteGfUTd
Dr. John Cush
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CDC 2025–26 Updates to Influenza Vaccination.
- Most are trivalent inactivated (IIV3s) or vaccines (RIV3), few live virus(LAIV3)
- FDA approved FluMist (LAIV3) for self-administration (ages 2-49)
- If <18yrs, Flu vax should thimerosal free
2023/24 Flu vax prevented 7900 deaths, https://t.co/hjLBGKWNDr
Dr. John Cush
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STOP-RA: Hydroxychloroquine Fails in ACPA+ Arthralgia
Deane et al has published the results of the STOP-RA trial, demonstrating that 12 months of hydroxychloroquine (HCQ) did not prevent the development of clinical RA at 36 months.
https://t.co/HLLhwgcVrS https://t.co/MKpeXhVdoe
Dr. John Cush
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August 29, 2025, FDA has terminated the Arthritis Advisory Committee, citing infrequent meetings & that the effort and expense of maintaining the committee “is no longer justified.”
The committee last met on 5/6/21 to review avacopan - that was subsequently approved. REALLY? https://t.co/w3Z6TszeWZ
Dr. John Cush
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Nitazenes — a class of highly potent synthetic opioids — are rapidly emerging as a major contributor to the overdose crisis; they are over 20 times more potent than fentanyl. Nitazenes are an illegal Schedule I drug that are rapidly spreading in the illicit drug market
Dr. John Cush
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There is no criteria for infection-induced Antiphospholipid syndr (APS). aPL & aCL abs have been reported w/ COVID, HCV, HIV, EBV, varicella-zoster, & CMV. infections may induce transient aPL positivity without over APS, but may precipitate APS or catastrophic APS (CAPS).
sheila
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GCs have potent anti-inflammatory effects but it’s long term complications can be catastrophic.
In SLE pts, it shows a 3-fold increased risk of organ damage for each addtl 1mg of Pred/day.
📌Aim for short duration of use with lowest effective dose
@RheumNow #APLAR25 https://t.co/UugrcX073Z
Dr. John Cush
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Target trial emulation looked at CV (MACE) events in 18,120 propensity score–matched adults with gout starting allopurinol who were given NSAIDs or colchicine for prophylaxis. MACE & CV death were signif. higher w/ NSAIDs vs Colchicine (HRs of 1.56 and 2.50), respectively. https://t.co/0T8slmPBng
Dr. John Cush
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Hospital for Special Surgery (HSS) reports that ear acupuncture applied during hip replacement surgery reduces pain and lessens opioid use over the weeks to follow. https://t.co/lOrwb1DzW5 https://t.co/6rkHNTwaAl
Dr. John Cush
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SMART study - Single vs. Split Dose Methotrexate in RA
Split dose weekly, oral methotrexate (MTX) was shown to be superior to single dose MTX in treating active rheumatoid arthritis (RA) patients.
https://t.co/JN5wPGNjao https://t.co/lizsrtVHwf
sheila
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‼️More reasons why we should avoid steroids in #lupus patients
@RheumNow #APLAR25 https://t.co/a5IeutJ5mi
