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Maui Potpourri (2.13.2026)
Dr. Jack Cush reviews the hot item takeaways from last week's RheumNow.Live 2026.
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Obesity, Surgery, and Optimizing Patient Care
Rheumatologic care involves multidisciplinary approaches and collaboration with specialties to treat complex, systemic diseases. While many Pods at RheumNow Live are disease specific, the Pod II focused on Advancing Practice on important and emerging areas affecting rheumatologic patients. This session focused on two major areas of need: obesity and peri-operative management.
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Screening study of lung US (LUS) vs HRCT in 73 RA pts (DAS28 3.47) Chest HRCT identified ILD in 29%. LUS identified ILD in 22% of patients. LUS sensitivity was 59%; specificity 94%. ROC. This study demonstrates the good diagnostic performance of LUS in RA- ILD detection https://t.co/E8avnbvUiw
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/Z0BXxyNrCI
Dr. John Cush RheumNow ( View Tweet)
RT @RichardPAConway
Comparative survival in incident RA-ILD 1955-1995 vs 1999-2014. We are getting better, althoug need to take into account the general survival improvement also. More work to do! #RNL26 https://t.co/VwV33tHgR8
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC Gout flares are not benign. Recent flares double MI/stroke risk and markedly increase CV mortality—making flare prevention vital.#RNL26 https://t.co/gKvqo3vFYb
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD
#RNL26
GLP on Knee OA
STEP 9 Trial - 68 wk
Mean WOMAC improved by 41.7 pts, compared to 27.5 in PBO, improved SF-36
7% stopped due to side effects https://t.co/LJzGzzlgq6 https://t.co/5ybyUdfNjZ
Links:
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD
#RNL26 Haque
Effect of GLP1 on Pts with RA
Retrospective study
Significant reduction is RA disease activity (P=0.03), VAS pain (p<0.001), weight, cholesterol and A1c
But 1/3 stopped due to side effects (mostly GI) https://t.co/SNHTcRFmAX
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAconway
We have improved RA mortality in many areas but respiratory (mainly ILD) and infectious issues remain stubbornly elevated. #RNL26 https://t.co/ViucOIOOzY https://t.co/3kIqPMeKKX
Links:
Dr. John Cush RheumNow ( View Tweet)
RT @Gibson_RheumPAC
Drug-induced SCLE remains an important mimic in biologic-treated patients. Compared with idiopathic SCLE, drug-induced disease is often more widespread and may resolve with antibody normalization after withdrawal.#RNL26 https://t.co/ICOzg3Tz4L
Dr. John Cush RheumNow ( View Tweet)
RT @Gibson_RheumPAC
Important rheumatology signal: dupilumab-associated inflammatory arthritis. Usually seronegative, imaging-supported, and sometimes persistent despite normal labs. Co-management and careful work-up are essential.#RNL26 https://t.co/r73cSZC59s
Dr. John Cush RheumNow ( View Tweet)
RT @@Gibson_RheumPAC
Eczematous eruptions with IL-17 inhibition are increasingly recognized. Registry data suggest higher adjusted incidence with IL-17 inhibitors compared with other biologic classes, especially in older patients and those with atopic history. #RNL26 https://t.co/nvwl5mNg4k
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAconway
Who to screen for RA-ILD is a tricky one. It is not feasible to screen everyone. This is from ACR/Chest 2023 ILD guidelines and is based on identified risk factors. #RNL26 https://t.co/NtAWYCVclJ
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAconway Disease activity is a strong risk factor for RA-ILD. Particularly for moderate/high disease activity but there appears to be a linear relationship (at least above a certain threshold) #RNL26 https://t.co/ot8ttdmu5G
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAconway
Lifetime risk of ILD by RA/sex/MUC5B status. We can see the synergistic effect. Also note RA>MUC5B in general. #RNL26 https://t.co/L5MOVVGIt3
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinmd
RA-ILD #RNL26
Jeff Sparks
MTX and ILD
- Rare MTX-induced pneumonitis. 7 cases in n=4786 (0.3% cases) vs <0.1 on PBO, rare diff from ILD
- No increase in incident ILD - meta-analysis of 7 studies show OR 0.49 https://t.co/k2XeAzBsYB
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinmd
#RNL26 RA-ILD Jeff Sparks
ILD pooled prevalence 0.11
Sparks: "prevalence is high but not so high that we don't screen everyone," means lots of subclinical ILD
Subtypes:
UIP 50-60%, fibrotic
NSIP 30-40%, inflammatory
Less common: LIP, DIP, RB-ILD, DAD
Dr. John Cush RheumNow ( View Tweet)
RT @richardPAconway
Dr Sparks shows risk factors for RA-ILD. Important for diagnosis (and screening?) Focus interventions on the modifiable ones! #RNL26 https://t.co/lE9Mkbq8oh
Dr. John Cush RheumNow ( View Tweet)
Advances in RA-ILD
Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26.
https://t.co/xO7hBRKeqE https://t.co/rs1MS08Svl
Links:
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinmd
Mortality risk in RA #RNL26
Myasoedova
Premature deaths in up to 1/4 of pts
Decline in mortality in RA after year 2000
Full siblings of RA also high mortality (shared genetic or environ factors affect risk?)
Risks: Seropositivity, esp ACPA, CRP, extra-artic https://t.co/ytm6odmtgR
Dr. John Cush RheumNow ( View Tweet)
