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Early vs Delayed Belimumab in Lupus
An economic evaluation of early vs delayed use of the Blys inhibitor, belimumab (BEL), in systemic lupus erythematosus (SLE) has shown both cost effectiveness and clinical utility of early BEL initiation in active lupus patients.
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Referral Rules to Live By (2.20.2026)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Highlights include referral rules, combination biiologics in psoriasis and don't use JAK inhibitors in pregnancy.
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Together PSO Trial - Combination Ixekizumab and Tirzepatide
Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over IXE alone.
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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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Danish DERMBIO registry of psoriasis pts Rx w/ biologics. Among 3790 bionaive pts ustekinumab had best 1-5 yr survival vs (ADA & SEC). In 3403 bioexperienced pts, bimekizumab, guselkumab, & risankizumab had highest 2-year drug survival rate. https://t.co/TInyLPMYkb https://t.co/UTPqa9erPU
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FDA Commissioner Marty Makary is seeking to make more drugs available without a prescription; and has stated “everything should be over-the-counter” unless the drug is addictive, unsafe, or requires monitoring. https://t.co/CGurlOWO8m https://t.co/bFwkpZ3kbn
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Full read review of JAK inhibitors. JAK inhibitors have a reasonably rapid onset of action and a short half-life, which facilitates management of any adverse effects. The half-life of Tofacitinib, Baricitinib & Upadacitinib is 3 hrs, 13 hrs. & 9-14hrs. https://t.co/jKO2LL2TVC
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Population survey of 21 000 US adults, 62.3% reported recent use of any OTC or prescription meds. Past-7-day prevalence of any OTC medication was equal to RX med use (46%) and increased use with age among both male and female individuals. https://t.co/xeWBQ0DnlB https://t.co/c8lqXOmAaT
Dr. John Cush RheumNow ( View Tweet)
Together PSO Trial - Combination Ixekizumab and Tirzepatide
Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over https://t.co/YWCjN2NyGM
Dr. John Cush RheumNow ( View Tweet)
FDA has Changed labels for 6 Menopausal Hormone Therapies (HRT) removing black box warnings for CV dz, breast CA, & dementia. 1st six HRTs includes estrogen-& progestogen-only Rx:Prometrium, Divigel, Cenestin, Enjuvia, & combo Rx Bijuva, & topical Estring. https://t.co/ZpcKkzYPKn https://t.co/f9XbmlKZNo
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC
Given rising resistance, effective first-line regimens and adequate duration (14 days) are critical. PPI-based quadruple regimens remain highly effective when patients can adhere.
#RNL26 https://t.co/rQps2rls8G
Dr. John Cush RheumNow ( View Tweet)
RT @gibson_rheumPAC
Who should be tested?
Test only if you plan to treat.
Indications include:
• Active or prior ulcers
• MALT lymphoma
• Gastric cancer
• Chronic atrophic gastritis
Avoid indiscriminate testing.
#RNL26 atoid arthritis https://t.co/2KJluSAPNx
Dr. John Cush RheumNow ( View Tweet)
Genentech announced results of Phase III, MAJESTY OL study of obinutuzumab vs tacrolimus in 142 pts w/ primary membranous nephropathy & found signif more complete remissions at 2 yrs in obintuzumab Rx pts. Obintuzumab (Gazyva) if FDA approved for lupus nephritis. https://t.co/maJbvUCkBe
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD
#RNL26
Haque
TOGETHER-PsA -P3B study of IXE v IXE + Tirzepatide
BMI >27 + 1 wt related co-morbidity
-Endpts - ACR and >10% weight reduction
-ACR50 improved 33.5% compared to 20% IXE alone (p<0.05) https://t.co/KCpqbg3fHs https://t.co/zktIkdumDk
Links:
Dr. John Cush RheumNow ( View Tweet)
Incretins/GLP-1s are being investigated widely. @RWCSmtg #RWCS26 https://t.co/57JzRJfK8l
Dr. John Cush RheumNow ( View Tweet)
The hx and timeline of GLP1a development. @RWCSmtg #RWCS26 https://t.co/7tPgcRy4Ze
Dr. John Cush RheumNow ( View Tweet)
Dr. Willa Tsueh taking on hx of GLP-1 agonists. The first ones, Victoza and Tulicity go back to 2010. @RWCSmtg #RWCS26 https://t.co/cKiDCM5xw6
Dr. John Cush RheumNow ( View Tweet)
RT @ericdeinMD
#RNL26
Dx Modification of OA
@Tuhina_Neogi
Challenge in drug develop:
Models in young animal, not like human OA
Trial enrollment in pts w late, establ OA- not early interv tx
Many paths to OA - target mechanism to correct pt
Slow progress of dx, $$
Endpt? Sx or
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 @gibson_RheumPAC
Osteoarthritis affects 600 million people worldwide—yet we still have no approved disease-modifying therapies.
A powerful opening to this talk on why OA drug development keeps missing the mark. https://t.co/wBUN3lux6X
Dr. John Cush RheumNow ( View Tweet)
