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The Cartel is Coming for Rheumatology

Eric Dein, MD

"What Do Blockbuster Drugs & The Black Market All Have in Common?" asked Dr. Madelaine Feldman at RheumNow Live 2025. They thrive, she explained, on market exclusivity "... until they don't." At first glance, the pharmaceutical marketplace may not appear like a crime drug ring, but Dr. Feldman of Tulane University described how sinister forces of market manipulation have negatively impacted patient care for years.

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Kavanaugh RNL 25

Combination biologics in PsA: are we there yet?

Adela Castro, MD

Despite various and efficacious options for management of PsA there is still an unmet need for patients with inadequate responses to current therapies or difficult-to-treat disease. The role of dual biologic therapy targeting different inflammatory pathways has become an area of great interest in the field.

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RheumNow Podcast square

Valentine RNL 2025 Review (2.14.2025)

Jack Cush, MD

Dr. Jack Cush reviews highlights from RheumNow Live 2025 held in Dallas, TX on Feb. 8-9, 2025.

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AI

Will AI put me out of a job?

Adela Castro, MD

The development of AI and other technologies brings new possibilities for optimizing diagnosis, management and has potential for improving outcomes in RA. At RheumNow Live 2025, Dr. Jeff Curtis, University of Alabama at Birmingham, presented a talk on, "AI applied to Rheumatoid Arthritis Care: Practically (Not) Perfect".

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lupus SLE

Obinutuzumab Efficacy in Active Lupus Nephritis

Jack Cush, MD

A phase 3, randomized controlled trial of an anti-CD20 monoclonal antibody, obinutuzumab, was shown to be effective and safe in patients with active lupus nephritis.

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SLE pts have increased risk of atherosclerotic cardiovascular disease (ASCVD). Systemic inflammation & glucocorticoid exposure are significant drivers of ASCVD in SLE. Screening recommended - Framingham Risk Score, ACC/AHA risk score & others reviewed https://t.co/jJHNJOU606 https://t.co/JJxiBczMwi

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Dr. John Cush RheumNow ( View Tweet)
Survey on Corticosteroid (CS) use in PFAPA syndrome included 144 MDs (67% pedi-Rheums); 92% use CS in PFAPA flares. 42% expected a response w/in 12 hrs. 31% use CS ‘routinely. Med literature cites Prednisone as most preferred CS (48%). Response to CS ~ 95% https://t.co/V1wkhNaNAP https://t.co/YILAlKrUcQ

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Dr. John Cush RheumNow ( View Tweet)
That's not my problem - or is it? Multimorbidity in RA RA can look so easy on the television commercials where patients appear young, healthy, and vibrant on the advertised treatment. https://t.co/B7WUiysNSE https://t.co/nczmoIBfOb

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Dr. John Cush RheumNow ( View Tweet)
Janet Pope @Janetbirdope Dispel the #myth #rheumatoid #arthritis is NOT Just a disease of Young and middle aged Elderly PREVALENT #RA Pts and 👇 INCIDENT Pts in >65yrs is skyrocketing 🚀 Need #Rx goals and equitable #Rx Uma Makris #RNL2025 https://t.co/3IsVKTSEyy

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Dr. John Cush RheumNow ( View Tweet)

Adela Castro @AdelaCastro222 Are your patients aging with RA, or are they diagnosed with Late Onset RA (LORA)? -LORA pts tend to present acutely -High inflammatory markers~PMR Like -Seronegative/Decreased titers of RF/CCP @UnaMakris #RNL2025 https://t.co/tLrGBV6P1i https://t.co/53HVvUmrG4

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Dr. John Cush RheumNow ( View Tweet)
TheDaoIndex @KDAO2011 Late onset RA (LORA) aka RA diagnosed at an older age — pts have higher inflammatory markers, presents like PMR; they also have polypharmacy, comorbidities, frailty, etc that can complicate management @UnaMakris #RNL2025 @RheumNow #GeriRheum… https://t.co/E2WFwfCsWD https://t.co/tKF0OnUFQH
Dr. John Cush RheumNow ( View Tweet)
Obinutuzumab Efficacy in Active Lupus Nephritis A phase 3, randomized controlled trial of an anti-CD20 monoclonal antibody, obinutuzumab, was shown to be effective and safe in patients with active lupus nephritis. https://t.co/e1cDvJcC9g https://t.co/HUDd1ocAvc

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Dr. John Cush RheumNow ( View Tweet)
Eric Dein @ericdeinmd AI models require good Positive Predictive Value (PPV) But: PPV decreases as prevalence decreases - In choosing a successful biologic: Harder to predict more challenging patients (multiple failures, co-morbidities, etc) - ACR50 non-response is higher J… https://t.co/eAOR0jFmO3 https://t.co/TB6Ecd8nZh
Dr. John Cush RheumNow ( View Tweet)
-HS ttx👇 1. Lifestyle changes: smoking cessation, obesity. 2. Management of comorbidities. 3. 🔍HS- related autoimmune disorders. 4. FDA approved biologics: -Adalimumab (PIONEER 1&2) -Secukinumab (SUNRISE, SUNSHINE) -Bimekizumab (BE HEARD 1&2) "Theres no such… https://t.co/G5Voxrm3Kt https://t.co/dLGtoFZMd1

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Adela Castro AdelaCastro222 ( View Tweet)
Combination therapy in PsA . Regulatory and reimbursement issues may inhibit such strategies (and potential adverse event concerns) but anecdotal evidence would suggest a role in difficult to treat cases. @RheumNow #RNL2025 https://t.co/IIoUiJyP95

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Richard Conway RichardPAConway ( View Tweet)
#RNL2025 @RheumNow JAKi in DM: @JuliePaikMD- 10 DM pts open label on JAKi. 7/10 improved from mod/severe to mild. In 96wk extension, 6 of 7 continued response 145 case reports for tofa, bari, ruxolitinib. Role in helping calcinosis? Pruritu? Brepocitinib (JAK1/TYK2i) study

Eric Dein ericdeinmd ( View Tweet)

#HOT #topic Will #Rx of #PsO PREVENT onset of #PsA Well, maybe 🤔 Alexis R Ogdie ⁦@RheumNow⁩ #RNL2025 70% of #psoriatic #arthritis is preceded by #psoriasis Still a bit of a debate re prevention of PsA https://t.co/7bce8kcjdr

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Janet Pope Janetbirdope ( View Tweet)
FDA has approved Journavx (suzetrigine) 50 mg tablets, 1st in-class non-opioid analgesic, to treat moderate to severe acute pain in adults. Journavx reduces pain by targeting a pain-signaling pathway involving sodium channels in the peripheral nervous system, before pain signals… https://t.co/qjtr4yz8Ot https://t.co/RUZmLgsmTv
Dr. John Cush RheumNow ( View Tweet)
Break a leg! Or a #hip #AVN risk occurs even at 1 month of high / moderate dose #glucocorticoids Shown by Michelle Petri @RheumNow #RNL2025 Risk in SLE is likely 👇 #disease #activity And #steroids #SLE #systemic #lupus #erythematosus #steroids https://t.co/4EsQw9tY1u

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Janet Pope Janetbirdope ( View Tweet)
Even a #SLE expert who wants all #lupus Pts on No #chronic #prednisone Realizes you can’t get everyone off #glucocorticoids 18% May be on chronic #steroids But she keeps trying to taper Michelle Petri #RNL2025 @RheumNow https://t.co/SNP6Eep731

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Janet Pope Janetbirdope ( View Tweet)
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