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Early RA Referral Clinics Work!

Jack Cush, MD

An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals.

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Weight Loss Improves Psoriatic Disease Substantially!

Jack Cush, MD

Even before the introduction of incretin therapy and bariatric surgery, many randomized and interventional studies (2019–2026) have consistently showed that weight loss produces clinically meaningful, dose-dependent improvement in both psoriasis and psoriatic arthritis.

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A Day of Infamy (9.11.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz!

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JAMA: Review of Adult Rheumatoid Arthritis

Jack Cush, MD

Smolen, Kerschbaumer, Aletaha, and Robinson have published a comprehensive review article of rheumatoid arthritis (RA) in JAMA, noting significant changes to our understanding and treatment guidelines.

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Obesity in Axial Spondyloarthritis: what are we missing beyond the scale?

Antoni Chan, MD, PhD

Obesity in axial spondyloarthritis (axSpA) is not a minor comorbidity. Beyond the scale, there are several factors that need to be considered with obesity in axSpA.

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Treating Obesity is Disease-Modifying (9.4.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  New drugs approved, new drugs halted and some drugs out of control. Ready to test your knowlege? Take this week's quiz!

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BMI Affects JAK Inhibitor Responses in Rheumatoid Arthritis

Jack Cush, MD

A meta-analysis of Janus kinase (JAKi) inhibitors clinical trials in rheumatoid arthritis (RA) has shown higher BMI was associated with poorer responses and a reduced treatment benefit with JAK inhibitors in RA patients.

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Music and Pain Relief

Jack Cush, MD

If laughter is the best medicine, then music has to be second best. A new scoping review in Pain Reports by Bradt et al., examines the effect of music-based interventions (MBIs) on pain management. While its efficacy is well established, how or why music relieves pain has never been fully explained.

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EBR Journal Club: Dapirolizumab Pegol in SLE (PHOENYCS GO)

Michael Putman, MD, MSCI

The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal to an important RCT in rheumatology. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How great are the benefits and harms? And what didn’t they show me? This edition: PHOENYCS GO (dapirolizumab pegol in SLE).

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“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis

Jack Cush, MD

The proposed approach to difficult-to-treat rheumatoid arthritis is based on the EULAR definition (having failed 2 or more b/tsDMARDs). The authors provide guidance in the form of an easy acronym, A B C D E, which covers both diagnostic and therapeutic considerations.

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Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/JDvVZ1KEIY
Dr. John Cush RheumNow ( View Tweet)
EBR Journal Club: Dapirolizumab Pegol in SLE (PHOENYCS GO) The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal to an important RCT in rheumatology. Each review covers four domains: Does this apply to my patients? What is the risk https://t.co/Pi45T99oJm
Dr. John Cush RheumNow ( View Tweet)
Dr John Stone grand rounds Kroc lecture #wustlRheum. Pearls: -IgG4RD can manifest as a variable vasculitis -Men have worse disease -Histology will not show necrosis or neutrophils -IgG4 levels will rise as the disease progress (>5X) -Rx with B cell therapy @alhkim @RheumNow https://t.co/GUw348OrrA

Links:

TheDaoIndex KDAO2011 ( View Tweet)
ACP Clinical Guideline on Treatments of Overweight or Obese Adults In July 2026, ACP published its first living clinical guideline addressing pharmacologic management of overweight and obesity in nonpregnant adults in outpatient settings. As this therapeutic area is rapidly https://t.co/5oQIY7J2Aw
Dr. John Cush RheumNow ( View Tweet)
Necrotizing arteritis is rare w/ IgA Vasculitis (IgAV). Review compared 30 IgAV-NA to 257 adult IgAV & 196 PAN pts. Overall IgAV-NA is a severe IgAV phenotype with life-threatening complications & should prompt vascular imaging and intensified immunosuppression. IgAV-NA had more https://t.co/GRVcqRPKTL
Dr. John Cush RheumNow ( View Tweet)
Small series of 5 Idiopathic inflammatory myopathy (IIM) pts Rx w/ obinutuzumab for refractory myositis (2 antisynthetase syndr, 1 DM, 2 overlap myositis). 4/5 patients achieved complete response. Lung improved/stabilized in ILD patients. Two required second obinutuzumab cycle. https://t.co/ev9qlEO04l
Dr. John Cush RheumNow ( View Tweet)
“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis The proposed approach to D2T-RA is based on the EULAR definition (having failed 2 or more b/tsDMARDs). It is estimated that up to 20% of RA patients meet this D2T-RA definition and can be plagued by active or https://t.co/o39IREvjI4
Dr. John Cush RheumNow ( View Tweet)
Cochrane systematic review of LBP Rx (8 RCTs, 501 cLBP pts) show that Lumbar supports may result in a small reduction in pain intensity if given w/ NSAIDs, but may offer little to no benefit for pain intensity & disability if used alone. Insufficient evidence to support their https://t.co/6Vq4CPXLvE
Dr. John Cush RheumNow ( View Tweet)
VA (VARA) registry study of 2723 RA pts showed frailty was independently associated with increased cancer incidence. Age-adjusted CA incidence rates (per 1,000PYs) were 12.3 (robust), 15.5 (pre-frail), and 19.9 (frail). CA mortality rates were 7.8, 10.6, & 9.8/1,000PYs https://t.co/Ex52R56oT1
Dr. John Cush RheumNow ( View Tweet)
Necrotizing arteritis is rare w/ IgA Vasculitis (IgAV). Review compared 30 IgAV-NA to 257 adult IgAV & 196 PAN pts. Overall IgAV-NA is a severe IgAV phenotype with life-threatening complications & should prompt vascular imaging and intensified immunosuppression. IgAV-NA had more https://t.co/XdPbGX770D
Dr. John Cush RheumNow ( View Tweet)
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