All News
MTX Fails Knee OA (6.6.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com
Read Article
Let the young know they will never find a more interesting, more instructive book than the patient himself." – Giorgio Baglivi
Dr. John Cush RheumNow ( View Tweet)
Do SGLT2 and GLP-1 therapies have a role in Lupus?
Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) and Glucagon-like peptide-1 receptor agonists (GLP1-RA), initially developed to lower glucose in Type 2 Diabetes, also provide cardiovascular and renal protection for patients https://t.co/JxnbgeqgOp
Dr. John Cush RheumNow ( View Tweet)
SLE Treatment Landscape: Abundance or Overload?
Imagine a world where the multiple drugs in Phase 2 and 3 trials actually get approved, and we get access to them? I know you may be thinking that I am overly optimistic, but there are so many drugs in development in lupus that we https://t.co/xLgSU4ZLgP
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 12 trials, 12 902 adults hospitalized w/ COVID betw May, 2020 & March, 2022 (7 Bari, 3 Tofa, 2 Ruxo). Fewer deaths in those on JAKi (11·7% vs 13·2%; aOR 0·67 [95% CI 0·55–0·82]; high-certainty evidence); 39 fewer deaths/1000. JAKs had less mechanical ventilation https://t.co/QSMRo3RcRr
Dr. John Cush RheumNow ( View Tweet)
Systematic review of JAK inhibitor use in systemic sclerosis - 18 articles/87 SSc pts (80%F; ages 13–78 yrs). JAKi (83% tofa) mostly used for ILD & Skin Dz (45%) or GI+Skin Dz (39%). 87.5% improved, w/ 6% relapsed. Adverse events in 50% (20% infx). We need RCTs! This could be a https://t.co/lNFEX08Vn3
Dr. John Cush RheumNow ( View Tweet)
Blau syndrome -a rare autoinflammatory Dz w/ triad of granulomatous dermatitis, arthritis, & uveitis (may cause blindness); from a NOD2 gain-of-function mutations. Onset age 2-4 yrs. Early biologics (esp TNFi) may prevent joint complications; but metanalysis shows no preferred https://t.co/wYTNv50tqM
Dr. John Cush RheumNow ( View Tweet)
IL-40 is elevated in systemic sclerosis (SSc). Study of serum (90 SSc vs controls/HCs), Skin Bx (5 SSc v 5 HCs). IL-40 signific. upregulated in the skin & correl. w/ ESSG (r = 0.37), GI dz; also w/ serum IL-8, TGF-β1. IL-40 functionally linked to activated B cells, PMNs, T https://t.co/XsSFXgBxuD
Dr. John Cush RheumNow ( View Tweet)
PETRI-isms: "The patient is always right (even when they are wrong)." - Dr. Michelle Petri
Dr. John Cush RheumNow ( View Tweet)
Methotrexate Fails in Knee Osteoarthritis
We'll be blunt: methotrexate flopped in a randomized placebo-controlled trial among patients with osteoarthritis (OA) of the knee.
https://t.co/Y9elFXTkhN https://t.co/oqDDVPGbh7
Dr. John Cush RheumNow ( View Tweet)
135 pts w/ neurologic autoimmune dz (MS, GBS, myasthenia gravis) who had cancer & Rx w/ checkpoint inhibitors (ICI) showed exacerbations in SOME - 18% of MS pts, but 67%of MG, latter often w/ hospitalization (50%) or death (17%). GBS faired well w/ ICI Rx. https://t.co/RksC6QXce0 https://t.co/HbwYDVrIAt
Dr. John Cush RheumNow ( View Tweet)
In 2019 there was an estimated 273,000 coccidioidomycosis cases in the USA; 23,000 hospitalizations and 900 coccidioidomycosis-associated deaths. Mostly from endemic states California & Arizona. https://t.co/JXPs8B4Dwb https://t.co/90e1TYxGoW
Dr. John Cush RheumNow ( View Tweet)
Positive results from Phase 2b RENOIR RCT of Rosnilimab, an agonist targeting PD-1+ T cells. 432 RA pts on MTX or csDMARDs, Rx w/ 6 mos of PBO vs ROS (100 or 200 mg q4wk or 600 mg q2wk). All 3 doses of rosnilimab achieved significant reductions DAS-28 CRP at Wk 12 https://t.co/6nF8KPRK2f
Dr. John Cush RheumNow ( View Tweet)
Systematic review of fibromyalgia & sleep quality - 47 RCTs, 11094 pts showed CBT for insomnia had a significant improvement in sleep quality; but CBT for pain had no impact. Only moderate improvement w/ pregabalin, sodium oxybate; but no effect w/ amitriptyline, milnacipran, https://t.co/AEqbShRh6e
Dr. John Cush RheumNow ( View Tweet)
UK Natl Early Inflammatory Arthritis Audit (5/18-11/19) compared 2120 PsA & RA (1:1). PsA had longer Sx to referral wait (112 v 89 days; HR 0.87), longer delay in Dx (HR 0.8), PsA less DMARD use at baseline (54% v 69%) & higher DAS28 results at 3 mos (+0.27) https://t.co/ObssKGcomq
Dr. John Cush RheumNow ( View Tweet)
Single-centre retrospec study of 39 Juvenile Dermatomyositis pts Rx w/ JAKi. Partial/complete Clin inactive Dz achieved in 32/39 w/in 6 months w/ steroid reduction and W/D of other DMARDs. Only TIF1γ) Ab (+) was assoc w/ nonresponse to JAKi (P < 0.001). 5 w/ H. Zoster
Dr. John Cush RheumNow ( View Tweet)
Psychological Bulletin has published that invalidating (gaslighting) pts Sxs can have harmful consequences. Includes pts dx w/ Ehlers-Danlos, endometriosis, fibromyalgia, ME/CFS, POTS, Gulf War, IBS, long Covid, multiple chemical sensitivity, SLE, and vulvodynia.
Dr. John Cush RheumNow ( View Tweet)
Sacroiliitis is a rare adverse reaction of isotretinoin. Review of 67 pts finds median age 21 yrs, onset median 2.5 mos (0-24) post isotretinoin. Sxs: LBP 70%) & hip pain 45%. Dx by MRI (73%) w BME. Full recovery 81% isoretinoin D/C & NSAIDs (< 10% biologics)
Dr. John Cush RheumNow ( View Tweet)
PPACMAN Consensus Recs. for CV risk in PSO/PSA published for Rheums/Derms/PCPs
- check BP, Wt, Lipids, Cr.
- Look for HTN, DM, smoking, obesity, metabolic synd.
- Risk stratify w/ hsCRP, Lipids
- Lifestyle management https://t.co/MkgYopTNAX https://t.co/fplKbua9Z2
Dr. John Cush RheumNow ( View Tweet)
Review of ARF & Post-streptococcal reactive arthritis (PSRA) following Group A strept infxn. Early Dx & Rx of Strept can prevent ARF & PSRA. PSRA is a sterile arthritis, bimodal age onset, lower extrem arthritis, usually resolves without lasting sequelae https://t.co/ld208yf0Zk
Links:
Dr. John Cush RheumNow ( View Tweet)
