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Top Four and More (4.10.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.

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Opioids Down, Gabapentins Up

Jack Cush, MD

The number of U.S. patients prescribed long-term opioid therapy declined from 2015 to 2023, but co-prescribing of opioids with gabapentinoids increased, prescription data showed.

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Malignancies Not Increased with Biologic Therapies

Jack Cush, MD

The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo.

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JAMA Guideline on the Management of Crohn Disease

Jack Cush, MD

JAMA has published a current Clinical Guidelines Synopsis on the Management of Crohn Disease (CD) in Adults.

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COMMON - Incidental Rotator Cuff Abnormalities on MRI

Jack Cush, MD

In this cross-sectional study of 602 Finnish adults undergoing bilateral shoulder magnetic resonance imaging (MRI) and clinical assessment, found abnormalities in nearly everyone over age 40yrs, regardless if asymptomatic or symptomatic.

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Predictors of Calcinosis Cutis in Systemic Sclerosis

Jack Cush, MD

Calcinosis cutis (CaC) is a common and disabling non-lethal manifestations in systemic sclerosis (SSc). This study used SSc patients from the EUSTAR database to clinically characterize patients and identify risk factors for CaC development.

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Updated CRA/SPARCC Recommendations for Axial Spondyloarthritis

Jack Cush, MD

In 2024, the Canadian Rheumatology Association (CMA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) published a comprehensive set of 56 treatment recommendations for the management of axial spondyloarthritis. This first update is focused on the reassessment of IL-17i recommendations.

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What’s New PsA? (4.3.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and major articles from this week, including FDA safety warnings, reports from AAD, PsA trials.

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Update on Primary CNS Angiitis

Jack Cush, MD

The Journal of Neurology has posted a review and update of Primary CNS vasculitis (PCNSV),  also termed primary angiitis of the CNS (PACNS). PCNSV is rare, potentially fatal, and highly treatable, making timely recognition and accurate diagnosis critical. 

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Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/0JRd1k0R2R

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Dr. John Cush RheumNow ( View Tweet)
Couldn’t attend https://t.co/4UQlqwujiR 2026? You can now watch the entire meeting On Demand. This high-impact program features leading experts discussing: • RA outcomes and pathogenesis • Obesity, inflammation, and rheumatic disease • Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3

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Dr. John Cush RheumNow ( View Tweet)
Danish real-world study anifrolumab use in 36 #SLE pts. SLEDAI-2K decreased from 8 (baseline) to 2 @ mos 3; @6 mos 52% had SLEDAI-2K=0. 87% had PGA ≤0.5 w/ LLDAS, & 70% DORIS remission. Pred use declined by >50%. Herpes infx were most freq AE https://t.co/gNIAoXplMt https://t.co/D6xhQrY8ep

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Dr. John Cush RheumNow ( View Tweet)
Advanced Practice Rheum: Methotrexate In this session, we're going to review methotrexate. It is the most popular of disease-modifying drugs used in rheumatology. While it may be indicated for a few disorders, it's widely used in many inflammatory and autoimmune disorders. https://t.co/RKh3mQv7Hx
Dr. John Cush RheumNow ( View Tweet)
Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/Ljr5maHZcr

Links:

Dr. John Cush RheumNow ( View Tweet)
Danish real-world study anifrolumab use in 36 #SLE pts. SLEDAI-2K decreased from 8 (baseline) to 2 @ mos 3; @6 mos 52% had SLEDAI-2K=0. 87% had PGA ≤0.5 w/ LLDAS, & 70% DORIS remission. Pred use declined by >50%. Herpes infx were most freq AE https://t.co/tbMOyOioeU https://t.co/jDJgImjgQt

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Dr. John Cush RheumNow ( View Tweet)
Open label RCT in 116 DMARD-naïve #RA pts Rx w/ tofacitinib or MTX (after 1 IM steroid injx). @3 mos, TOFA signif better than MTX for >50% SDAI improv(94 v 75%), CDAI[14.5 v 7.3), DAS28-CRP[1.7 v 1.2] https://t.co/smOuLlVFyX https://t.co/xGvbiu62OB

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Dr. John Cush RheumNow ( View Tweet)
Japanese ANSWER study Rx 7268 RA pts initiating bDMARDs or JAKi by orthos or Rheums. Vs Rheums, Ortho Rx RA had longer Dz duration, more seropositivity, functional impairment, less comorbidity, more MTX/GC/TNFi, less AE D/Cs - responses & outcomes were similar https://t.co/1ryA8C2p1b
Dr. John Cush RheumNow ( View Tweet)
FDA has issued a drug safety warning for avacopan (Tavneos), dentifying 76 cases of drug-induced liver injury, including 7 cases of rare vanishing bile duct syndrome (VBDS). There were 8 deaths https://t.co/2GkYNg1Apn https://t.co/fW2qafKCew

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Dr. John Cush RheumNow ( View Tweet)
A new review of the GLP-1 receptor drugs @NEJM https://t.co/PK03jApZWB surprisingly, the word inflammation only appears once, in this diagram https://t.co/1PeBakBAQb

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Eric Topol EricTopol ( View Tweet)
FDA has issued a drug safety warning for avacopan (Tavneos), dentifying 76 cases of drug-induced liver injury, including 7 cases of rare vanishing bile duct syndrome (VBDS). There were 8 deaths https://t.co/WkBhs1rNpf https://t.co/ZXdHsAJUOQ

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Dr. John Cush RheumNow ( View Tweet)
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