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A Patient’s Plea for a New Paradigm in Autoimmune Disease
A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?
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Breaking the Rules: Dual-Advanced Combinations in Rheumatology
For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes.
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Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis
Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.
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More Comorbidity in Difficult to Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
HLA-B27 in PsA: assoc w/ earlier onset, axial Dz, enthesitis, systemic inflammation. Study of 333 CASPAR PsA pts - 12% HLA-B27 positive--earlier onset (43 v 49), axial (46 v 24%), enthesitis (33 v 18%). No signif differences in sex, dactylitis, uveitis, Rx responses, https://t.co/ALP6AnygSf
Dr. John Cush RheumNow ( View Tweet)
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/TmoodnuJTe
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24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/pAEqYJIKaw
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Taiwan, real-world study 267 RA new DMARD starts w/ tofacitinib (145) or TNFi (122). Post adjustments; no significant difference in Efficacy, AEs, Serious AE (20 v 21%), MACE (0 v 0.8%), CA (2% vs 0.8%), deaths (1.4% vs 3.3), SIE (13% vs 8.2%) or H zoster (12% v 3%) https://t.co/XLsdfKyeGx
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French prospective study of pregnancy in 94 RA & 124 SpA pts. RA more likely to flare 1st 6 mos postpartum (62 v 43%), while SpA remained stable in preg & postpartum. bDMARD continuation during pregnancy was more frequent in SpA; 55-60%restarted bDMARD postpartum. https://t.co/usKHS4wYbN
Dr. John Cush RheumNow ( View Tweet)
Great Lectures; Great Presentations
Dr. Jack Cush lectures on giving a great presentation; based on 40 years of lecturing in Rheumatology.
https://t.co/AvW8Z7bhkl https://t.co/LeI7oPDRan
Dr. John Cush RheumNow ( View Tweet)
JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/cq3CuIuMKX
Links:
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By @RheumattDoc
#Psoriasis and nail changes
#PsA #PsoriaticArthritis #enthesitis #dactylitis https://t.co/rxH2zrGBwC
Dr Gurdeep S Dulay gurdeep_dulay ( View Tweet)
U.S. spending on prescription drugs in 2025 jumped 13% to $915 billion=projected to surpass $1 trillion in 2026, according to ASHP/USA today. One major reason– the popularity of the weight-loss and diabetes drugs tirzepatide and semaglutide. https://t.co/EQ9yFCCdBp https://t.co/cig1jNp6NF
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Steroids
Corticosteroids remain a cornerstone of rheumatologic therapy — rapidly effective but chronically dangerous, as their power to suppress inflammation through inhibition of prostaglandins, lipoxygenase, pro-inflammatory cytokines, and proteases comes at the cost of a https://t.co/fKGgYF3yWA
Dr. John Cush RheumNow ( View Tweet)
RCT 120 mod-severe hip OA (KL 2-4) pts Rx w/ THA +rehab or exercise. @12 mos. THA had signif. better pain, function & HRQoL vs exercise program alone (WOMAC total -30.9 vs -3.7). (38% of exercise/conservative grp needed THA) https://t.co/6vvRAr6isf https://t.co/VOYgS3PPwr
Dr. John Cush RheumNow ( View Tweet)
DERM on RheumNow PODCAST (April 2026)
The Derm on RheumNow podcast is a collection of Citations and Content curated for dermatologists – addressing Psoriasis, PsA, CLE, vasculitis, HS, other CTD skin disorders. dermatology drugs, biologics, JAKs - their use, efficacy and side https://t.co/SlCGA364gj
Dr. John Cush RheumNow ( View Tweet)
COVID Virus Persistence with DMARD Use
Drugs commonly used to treat systemic autoimmune rheumatic diseases (SARDs) may prolong SARS-CoV-2 circulation after COVID-19 infection in patients with these conditions, with researchers documenting substantially increased viral antigen https://t.co/szeILIbmjF
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Among 1074 #PsA tested annually, RF positivity was found in 16.1% overall (5.1% RF+ at baseline). RF+ rediced odds of MDA (OR 0.53) w/ incr risk of bDMARD discontinuation (OR 2.65) https://t.co/AmG6hkWABW https://t.co/MYhkfxAh0r
Dr. John Cush RheumNow ( View Tweet)
FDA Targeting the Safety of Avacopan
The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market. https://t.co/Otl0WQaOqo
Dr. John Cush RheumNow ( View Tweet)
