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Influential Rheumatoid Factors (5.8.2026)

Jack Cush, MD

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

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A Review of Hydroxychloroquine Ocular Toxicity

Jack Cush, MD

While hydroxychloroquine (HCQ) is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal toxicity, risk stratification, and evidence-based screening protocols and how the drug can be used and monitored.

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A Patient’s Plea for a New Paradigm in Autoimmune Disease

Jack Cush, MD

A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?

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Breaking the Rules: Dual-Advanced Combinations in Rheumatology

Jack Cush, MD

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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Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis

Jack Cush, MD

Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.

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COVID Virus Persistence with DMARD Use

MedPage Today

Drugs commonly used to treat systemic autoimmune rheumatic diseases (SARDs) may keep the SARS-CoV-2 circulating after COVID-19 infection in patients with these conditions, with researchers documenting substantially increased viral antigen persistence compared with other post-COVID patients.

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Review of GLP-1 Receptor Agonists in Psoriasis

Jack Cush, MD

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed cardiometabolic medicine and are now attracting intense interest in inflammatory disorders.

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A Review of Hydroxychloroquine Ocular Toxicity While HCQ is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal https://t.co/BrENoaBAVx
Dr. John Cush RheumNow ( View Tweet)
JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/SgVyk9fSCd

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Dr. John Cush RheumNow ( View Tweet)
Steroids Corticosteroids remain a cornerstone of rheumatologic therapy — rapidly effective but chronically dangerous, as their power to suppress inflammation through inhibition of prostaglandins, lipoxygenase, pro-inflammatory cytokines, and proteases comes at the cost of a https://t.co/PKdnFi1XSr
Dr. John Cush RheumNow ( View Tweet)
Medicare analysis of RA pts w/ metastatic nonsmall cell lung CA (mNSCLC) looked at 663 ICI-treated pts - 46% Rx w/ glucocorticoids (median Pred 6.6 mg/d). GC use was not associated with survival outcomes https://t.co/mwQeAgyKTC https://t.co/SR2XRD5Rhx

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Dr. John Cush RheumNow ( View Tweet)
Full read review of Preclinical Rheumatoid Arthritis: - Mucosal Origin Hypothesis - Gut Microbiota - Smoking & environment - Periodontitis - Immunosenescence - T cell abnormalities - Drug prevention https://t.co/UgqNBnKLMT https://t.co/2YZEiRCKNi

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Dr. John Cush RheumNow ( View Tweet)
Taiwan, real-world study 267 RA new DMARD starts w/ tofacitinib (145) or TNFi (122). Post adjustments; no significant difference in Efficacy, AEs, Serious AE (20 v 21%), MACE (0 v 0.8%), CA (2% vs 0.8%), deaths (1.4% vs 3.3), SIE (13% vs 8.2%) or H zoster (12% v 3%) https://t.co/XLsdfKyeGx
Dr. John Cush RheumNow ( View Tweet)
JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/cq3CuIuMKX

Links:

Dr. John Cush RheumNow ( View Tweet)
Steroids Corticosteroids remain a cornerstone of rheumatologic therapy — rapidly effective but chronically dangerous, as their power to suppress inflammation through inhibition of prostaglandins, lipoxygenase, pro-inflammatory cytokines, and proteases comes at the cost of a https://t.co/fKGgYF3yWA
Dr. John Cush RheumNow ( View Tweet)
COVID Virus Persistence with DMARD Use Drugs commonly used to treat systemic autoimmune rheumatic diseases (SARDs) may prolong SARS-CoV-2 circulation after COVID-19 infection in patients with these conditions, with researchers documenting substantially increased viral antigen https://t.co/szeILIbmjF
Dr. John Cush RheumNow ( View Tweet)
FDA Targeting the Safety of Avacopan The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market. https://t.co/Otl0WQaOqo
Dr. John Cush RheumNow ( View Tweet)
Anifrolumab (Saphnelo) approved in the US for subcutaneous self-administration as a new autoinjector for the treatment of systemic lupus erythematosus based on SC-TULIP study. Presumeably, all prior CRL issues resolved to FDA satisfaction... https://t.co/ZtZmJLcGYa https://t.co/4B2YDpFaep

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Dr. John Cush RheumNow ( View Tweet)
FDA Targeting the Safety of Avacopan The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market. https://t.co/4PyIoqwNIL
Dr. John Cush RheumNow ( View Tweet)
APR: Steroids https://t.co/FxqGaijo6w https://t.co/OrybGNXsdf

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Dr. John Cush RheumNow ( View Tweet)
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