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3 Months of Romosozumab in Postmenopausal Osteoporosis

Jack Cush, MD

A report in The Lancet Diabetes & Endocrinology suggested that 3 months of romosozumab (ROMO) followed by denosumab is as effective at increasing hip bone mineral density (BMD) as the standard 12-month course.

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Early vs Delayed Belimumab in Lupus

Jack Cush, MD

An economic evaluation of early vs delayed use of the Blys inhibitor, belimumab (BEL), in systemic lupus erythematosus (SLE) has shown both cost effectiveness and clinical utility of early BEL initiation in active lupus patients.

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A Modern Approach to Osteoporosis Management

Adela Castro, MD

Currently, fewer than half of patients diagnosed with osteoporosis receive appropriate pharmacologic therapy. This treatment gap reflects several challenges in osteoporosis management, including limited disease awareness, barriers to medication access, clinician discomfort with therapy selection, and uncertainty regarding the optimal timing of treatment initiation.

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Together PSO Trial - Combination Ixekizumab and Tirzepatide

Jack Cush, MD

Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over IXE alone.

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Can I Use JAK Inhibitors During Pregnancy?

Jack Cush, MD

In 2020, the ACR Recommendations on Reproductive Health notably avoided firm guidance on the use of JAK inhibitors (JAKi) during pregnancy stating, "There is no available evidence regarding use or safety of the new small- molecule agents, tofacitinib, baricitinib, and apremilast, during pregnancy."

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July 2024 survey of 143 women (18-45 yrs) with rheumatic disease shows only 63% used effective contraception. In those previously pregnant, 33% experienced an unplanned pregnancy, highlighting contraceptive failure. https://t.co/tR6976vmJp https://t.co/1XRkQfWL5r

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Dr. John Cush RheumNow ( View Tweet)
Real-world study of 1202 #PsA pts shows that secukinumab retention rates were lower w/ smoking (79%/73%/72% in never/former/current smokers) but not w/ obesity (72%/77%/77% in normal/overweight/obese), Adh HR signif. higher w/ former (1.32) & current smokers (1.27) https://t.co/1REWmod73W
Dr. John Cush RheumNow ( View Tweet)
Review of Calcinosis Cutis - Surgical intervent. most effective (excision, curettage, laser ablation, etc). Medical measures inconsistently, partially effective, best if used early & localized (CCB, TCN, probenecid, immunomodulation, biologics, colchicine, NA thiosulfate, & JAKi https://t.co/rv0hQBv6nX
Dr. John Cush RheumNow ( View Tweet)
Referral Rules to Live By (2.20.2026) Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow. Highlights include referral rules, combination biologics in psoriasis, and don't use JAK inhibitors in pregnancy. https://t.co/thzetw5jwa https://t.co/HTjWyqFqDZ

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Dr. John Cush RheumNow ( View Tweet)
Paradoxical Reactions, Target Selection & the Future of Imaging in Psoriatic Care At RheumNow Live, Dr. Joseph Merola presented a compelling discussion on paradoxical immune reactions in psoriatic disease. He began with a case of a 60-year-old woman with mild psoriasis who, https://t.co/AVIOO42vfP
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC Given rising resistance, effective first-line regimens and adequate duration (14 days) are critical. PPI-based quadruple regimens remain highly effective when patients can adhere. #RNL26 https://t.co/bxqMbPFegt
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAConway Data from Scott Matson's group showing that immunosuppressing RA-ILD (agnostic to agent) results in stabilisation of the previous downward trajectory of pulmonary function tests. #RNL26 https://t.co/TMNeCsPDep
Dr. John Cush RheumNow ( View Tweet)
RT @RichardPAConway UIP pattern RA-ILD is where the big problem is. We are less good at treating this. Perhaps the newer agents such as nerandomilast will change this? #RNL26 https://t.co/lzKFulaomD
Dr. John Cush RheumNow ( View Tweet)
Can I Use JAK Inhibitors During Pregnancy? Short answer: Not yet. https://t.co/E9yrWR5zTG https://t.co/NLy6OibkYH

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Dr. John Cush RheumNow ( View Tweet)
RT @richardPAConway Target trial emulation from Dr Sparks group in RA-ILD. Abatatacept and JAKi seem to be better than RTX. TNFi and IL-6i appear similar to RTX. Thought provoking! #RNL26 https://t.co/vmg7ot9m8b
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAConway Data from Scott Matson's group showing that immunosuppressing RA-ILD (agnostic to agent) results in stabilisation of the previous downward trajectory of pulmonary function tests. #RNL26 https://t.co/MoYoM0K1cs
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD #RNL26 Paradoxical psoriasis with TNF Highest in infliximab Seen highest in IBD, particular Crohn's Palmopustular is most common manifestation May have overlap appearance with psoriaform with eczema, histology with psoriaform spongiotic dermatosis with https://t.co/SKQZgbLQUS
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD #RNL26 Prosthetic joint infection vs flare? - PJI risk 50-80% higher in RA (OR 1.47-1.8) - Immunosuppressants, intra-artic injections, RA activity, BMI incr risk - Delay in diagnosis https://t.co/XTozafDQyf
Dr. John Cush RheumNow ( View Tweet)
FDA has Changed labels for 6 Menopausal Hormone Therapies (HRT) removing black box warnings for CV dz, breast CA, & dementia. 1st six HRTs includes estrogen-& progestogen-only Rx:Prometrium, Divigel, Cenestin, Enjuvia, & combo Rx Bijuva, & topical Estring. https://t.co/ZpcKkzYPKn https://t.co/f9XbmlKZNo

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Dr. John Cush RheumNow ( View Tweet)
Genentech announced results of Phase III, MAJESTY OL study of obinutuzumab vs tacrolimus in 142 pts w/ primary membranous nephropathy & found signif more complete remissions at 2 yrs in obintuzumab Rx pts. Obintuzumab (Gazyva) if FDA approved for lupus nephritis. https://t.co/maJbvUCkBe
Dr. John Cush RheumNow ( View Tweet)
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