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ANA Pollution (2.06.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and regulatory news from this past week on RheumNow.com

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FDA vs. Amgen: At Odds Over Avacopan

MedPage Today

The FDA has requested that Amgen voluntarily withdraw avacopan (Tavneos), a treatment for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, but the company said it has no plans to pull the drug from the market.

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Funding.money.research

ACR Applauds Recent Government Funding

ACR

The American College of Rheumatology (ACR) today applauded the recent passage of the Congressional CY 26 funding package that includes several important provisions, including extending Medicare telehealth payment flexibilities, improving transparency in pharmacy benefit management (PBM) practices

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RA,polyarticular,black,rheumatoid

ALTO: Long-Term Abatacept Outcomes in At-Risk RA

Jack Cush, MD

Lancet Rheumatology has published the ALTO results - long term outcomes of the APIPPRA trial, demonstrating that treatment with abatacept (ABA) in at risk patients can delay progression to rheumatoid arthritis (RA) for up to 4 years.

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artangiogca.jpg

Giant Cell Arteritis Outcomes in Canada

Jack Cush, MD

A retrospective cohort study of patients with giant cell arteritis (GCA) demonstrates relapses are common and seen in nearly half of patients, were common after treatment is stopped and is not effectively averted by methotrexate (MTX).

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Pain,FM,fibromlyalgia,Trigger

Which Fibromyalgia Drugs are Cost-Effective?

Jack Cush, MD

A cost-effectiveness analysis compared FDA approved fibromyalgia drugs (pregabalin, duloxetine, milnacipran) with amitriptyline and found duloxetine was the preferred strategy across perspectives.

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Methotrexate intolerance in rheumatoid arthritis A current large rheumatoid arthritis (RA) cohort study from Cairo assessed methotrexate (MTX) use and found over half were MTX intolerant and a third of patients were noncompliant with MTX. https://t.co/ODiVqUXBb9 https://t.co/QwmNkrjvn6

Links:

Dr. John Cush RheumNow ( View Tweet)
Aortitis in Giant Cell Arteritis Treated with Tocilizumab The Tocilizumab in Giant Cell Arteritis Spanish Collaborative Group studied giant cell arteritis (GCA) with aortitis, comparing the efficacy of intravenous (IV) vs. subcutaneously (SC) tocilizumab (TCZ) - demonstrating https://t.co/yo7SDj5lgZ
Dr. John Cush RheumNow ( View Tweet)
DMARD Responses in Localized Scleroderma JAMA Dermatology has published the results of a juvenile localized scleroderma (JLS) trial showing that mycophenolate mofetil (MMF) and methotrexate (MTX) are equally effective in treating JLS, noting low flare rates and possibly better https://t.co/6bDtVoCgRj
Dr. John Cush RheumNow ( View Tweet)
NEJM: Aortitis Due to Large-Vessel Vasculitis 63yoM w/ Hx HTN c/o 3 mos of CP, palpitations, abdominal pain. ESR-104, CRP 85 mg/L. CT showed thickening of the thoracic & abdominal aorta. After 6wks Rx w/ AZA, HCQ, Pred, ESR/CRP still high and pt stared on SC TCZ w/ improvement. https://t.co/1TBreptAFr
Dr. John Cush RheumNow ( View Tweet)
ALTO: Long-Term Abatacept Outcomes in At-Risk RA Lancet Rheumatology has published the ALTO results - long term outcomes of the APIPPRA trial, demonstrating that treatment with abatacept (ABA) in at risk patients can delay progression to rheumatoid arthritis (RA) for up to 4 https://t.co/Lb8md9cYbG
Dr. John Cush RheumNow ( View Tweet)
Giant Cell Arteritis Outcomes in Canada A retrospective cohort study of patients with giant cell arteritis (GCA) demonstrates relapses are common and seen in nearly half of patients, were common after treatment is stopped and is not effectively averted by methotrexate (MTX). https://t.co/7hIpn6CJXg
Dr. John Cush RheumNow ( View Tweet)
Which Fibromyalgia Drugs are Cost-Effective? A cost-effectiveness analysis compared FDA approved fibromyalgia (FM) drugs (pregabalin, duloxetine, milnacipran) with amitriptyline and found duloxetine was the preferred strategy across perspectives. https://t.co/5NZeYquGxs https://t.co/rhcwH2yLEm

Links:

Dr. John Cush RheumNow ( View Tweet)
REcently published SMILE study looked at the potential of HCQ (vs PBO) to prevent SLE in at risk people. Had to be ANA+ and 1-2 SLICC criteria at entry. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/4FY0kOLdRT
Dr. John Cush RheumNow ( View Tweet)
Methotrexate intolerance in rheumatoid arthritis A current large rheumatoid arthritis (RA) cohort study from Cairo assessed methotrexate (MTX) use and found over half were MTX intolerant and a third of patients were noncompliant with MTX. https://t.co/PDUv2YRFIq https://t.co/2DuBXjNqec

Links:

Dr. John Cush RheumNow ( View Tweet)
2016 ARTIC trial tested T2T w/ MTX & "bridging" tapered Prednisolone (15 mg --> 0mg over 7wks) in 237 new DMARD naive RA pts. PRED discontinuation successful in 84% @7wks, 89% @3mos, 95% @ 24 mos. Only 5% require Pred @ every visit for 2 yrs. You can D/C pred! https://t.co/O23PHq81YP
Dr. John Cush RheumNow ( View Tweet)
DMARD Responses in Localized Scleroderma JAMA Dermatology has published the results of a juvenile localized scleroderma (JLS) trial showing that mycophenolate mofetil (MMF) and methotrexate (MTX) are equally effective in treating JLS, noting low flare rates and possibly better https://t.co/NIR0ejs1RL
Dr. John Cush RheumNow ( View Tweet)
NEJM: Aortitis Due to Large-Vessel Vasculitis 63yoM w/ Hx HTN c/o 3 mos of CP, palpitations, abdominal pain. ESR-104, CRP 85 mg/L. CT showed thickening of the thoracic & abdominal aorta. After 6wks Rx w/ AZA, HCQ, Pred, ESR/CRP still high and pt stared on SC TCZ w/ improvement. https://t.co/IWm3ZQLBUN
Dr. John Cush RheumNow ( View Tweet)
The EMA CHMP has started a review of oral complement C5 inhibitor avacopan (Tavneos) based on serious questions about amendments to the data from the pivotal ADVOCATE study. The drug was approved in 2021 for use in GPA & MPA. https://t.co/a5ggUqk1dG

Links:

Dr. John Cush RheumNow ( View Tweet)

DMARD Responses in Localized Scleroderma JAMA Dermatology has published the results of a juvenile localized scleroderma (JLS) trial showing that mycophenolate mofetil (MMF) and methotrexate (MTX) are equally effective in treating JLS, noting low flare rates and possibly better https://t.co/BbIS5rdRYU
Dr. John Cush RheumNow ( View Tweet)
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