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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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Follow the Money (4.23.2026)
Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week.
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Malignancies Not Increased with Biologic Therapies
The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo.
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What’s New PsA? (4.3.2026)
Dr. Jack Cush reviews the news and major articles from this week, including FDA safety warnings, reports from AAD, PsA trials.
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Ixekizumab With Tirzepatide Efficacy in Obese Psoriatic Arthritis
The TOGETHER-PsA trial has demonstrated the efficacy and safety of ixekizumab (IXE) administered with tirzepatide (TZP) in adult active psoriatic arthritis (PsA) patients who were overweight or obese.
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)
By @RheumattDoc
#Psoriasis and nail changes
#PsA #PsoriaticArthritis #enthesitis #dactylitis https://t.co/rxH2zrGBwC
Dr Gurdeep S Dulay gurdeep_dulay ( 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)
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)
Review of GLP-1 Receptor Agonists in Psoriasis
Psoriasis is a chronic immune-mediated inflammatory disease plaqued by systemic comorbidities that increase morbidity, mortality, and treatment complexity. Obesity is a significant contributor to psoriatic disease. https://t.co/R1Uutdjcvz
Dr. John Cush RheumNow ( View Tweet)
Are uveitis and psoriasis independently associated with greater spinal radiographic progression in ankylosing spondylitis? Test your knowledge in the latest RheumIQ quiz at https://t.co/N5rfozh757 https://t.co/PjY1iuLv0X
Dr. John Cush RheumNow ( View Tweet)
TRACE study of 90 axSpA pts Rx w/ either TNFi or secukinumab (150 or 300 mg)- at wk 56, 59% achieved clinical-remission & 43% achieved w56-MRI-remission (SPARCC) w/ benefits by wk 4. Predictors of clinical remission: ASDAS & BMI (@wk16); none @wk56 https://t.co/CEsAeRMvUE https://t.co/SfSAm3u4IM
Dr. John Cush RheumNow ( View Tweet)
Comorbidity burden, uveitis, & psoriasis independently assoc w/ greater spinal radiographic progression in AS. Study3,441 pts (75% male; 84% B27+). Progression greater w/ 2+ comorbidities & uveitis, & PSO https://t.co/7Zh5SlMKc0 https://t.co/lmonP5YrcV
Dr. John Cush RheumNow ( View Tweet)
Simulation cost-effectiveness/QOL study compared Rx of psoriasis w/ biologics, phototherapy, or step-therapy Rx. Biologics had best QOL gains; step-therapy Rx similar w/ less variability & lower costs; phototherapy was cost-effective for payors. Pts had highest willingness to pay https://t.co/RyNooKhgQh
Dr. John Cush RheumNow ( View Tweet)
Couldn’t attend https://t.co/4UQlqwujiR 2026?
You can now watch the entire meeting On Demand.
This high-impact program features leading experts discussing:
• RA outcomes and pathogenesis
• Obesity, inflammation, and rheumatic disease
• Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3
Links:
Dr. John Cush RheumNow ( View Tweet)
What’s New PsA? (4.3.2026)
Dr. Jack Cush reviews the news and major articles from this week, including FDA safety warnings, reports from AAD, PsA trials.
https://t.co/Ew1wAFDfa1 https://t.co/AJfqqEAdik
Dr. John Cush RheumNow ( View Tweet)
Ixekizumab With Tirzepatide Efficacy in Obese Psoriatic Arthritis
The TOGETHER-PsA trial has demonstrated the efficacy and safety of ixekizumab (IXE) administered with tirzepatide (TZP) in adult active psoriatic arthritis (PsA) patients who were overweight or obese. https://t.co/KFwfi9FaAh
Dr. John Cush RheumNow ( View Tweet)
AFFINITY Study - Combination Biologic Therapy in PsA
A pilot trial assessed the efficacy and safety of the guselkumab+golimumab (COMBO) combination versus GUS monotherapy in active PsA (failing a prior tumor necrosis factor inhibitor (TNFi-IR) and showed superiority in ACR 50 https://t.co/f2CB8FnZMB
Dr. John Cush RheumNow ( View Tweet)
Moral Distress (3.27.2026)
Dr. Jack Cush reviews the journal reports and news from RheumNow. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
https://t.co/LdNcsUcHc2 https://t.co/tRYeDhQ3hC
Dr. John Cush RheumNow ( View Tweet)
AXIS is an Intl prospective study of 409 psoriatic arthritis pts - found Axial involvement in 27.4% of pts. Axial PsA signif younger (45 vs 47.6 yrs) , male (56% vs 51.5%), more B27 positivity (22% vs 11%), inflammatory back pain (75% vs 43%), & ^CRP (53% vs 37%) https://t.co/XY5pf4BNNm
Dr. John Cush RheumNow ( View Tweet)
