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On this week's podcast, Dr. Jack Cush reviews the news: Steroids are easy to start and hard to stop; hold the MTX but not the biologic or JAK, weighing in on avacopan, and age-old messages for old-age patients.
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High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be misdiagnosed or mistreated. A current case review by Zhu et al. presents six cases initially diagnosed as systemic JIA, teaching several important lessons.
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Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.
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The phase 3 ZEUS trial (published in JAMA Dec. 2025) tested the IL-6 ligand inhibitor ziltivekimab in over 6,000 patients with atherosclerotic cardiovascular disease, chronic kidney disease, and elevated hsCRP—a population enriched for an inflammatory driver of risk.
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Dr. Jack Cush reviews the news and recent journal reports on RheumNow.com.
Dr. John Cush
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Study of 64 Stills related #MAS pts (55 sJIA; 9 AOSD). All Rx GCs; 75% anakinra, 52% ciclosporin. Complete remission in 7, partial Rem in 64%; GCs tapered in 78% in median 40d. MAS recurred in 31%; 11% died; 1-year survival probability 93.75% https://t.co/HxhhpRsSMO https://t.co/WtJeFx0SGR
Dr. John Cush
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Study of 64 Stills related #MAS pts (55 sJIA; 9 AOSD). All Rx GCs; 75% anakinra, 52% ciclosporin. Complete remission in 7, partial Rem in 64%; GCs tapered in 78% in median 40d. MAS recurred in 31%; 11% died; 1-year survival probability 93.75% https://t.co/HxhhpRsSMO https://t.co/IQHLRlULcP
Dr. John Cush
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Serum Abs against IL-1 recept antagonist (aIL-1Ra) were studied in 46 adult-onset Still’s Dz (AOSD not on anakinra) pts & found signif. higher in AOSD vs controls (p=0.003); but levels did not differ between active vs inactive AOSD https://t.co/w6KvLyv1j8 https://t.co/IuQ1SHLDF8
Dr. John Cush
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52 VEXAS pts Rx w/ IL‐1i, IL‐6i, or JAKi therapy judged as compl Resp (CR), partial (PR), Failure (TF). @ 6mos: 3/19 IL‐6i had CR, 4/19 PR, 7/19 TF. JAKi had 2/17 CR, 3/17 PR, 6/17 TF. No CR w/ IL‐1i or TNFαi, only 1/5 IL‐1i patients experienced PR. Only IL‐6i & JAKi had https://t.co/wqogmfeAru
Dr. John Cush
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Retrospective review of 33 referred pts w/ Recurrent fever w/ MSK & skin Sxs, assessed by NGS. NLRP1 had FMF-like Dz; NLRP recurrent fevers w/ mucocutaneous; NLRP12 periodic fevers w/ MP/EN rash; NLRC4 episodic systemic inflammation GI Sxs & atypical skin rash https://t.co/Ll2V0Uzfio
Dr. John Cush
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Retrospective review of 33 referred pts w/ Recurrent fever w/ MSK & skin Sxs, assessed by NGS. NLRP1 had FMF-like Dz; NLRP recurrent fevers w/ mucocutaneous; NLRP12 periodic fevers w/ MP/EN rash; NLRC4 episodic systemic inflammation GI Sxs & atypical skin rash https://t.co/IWafJVFoaJ
Dr. John Cush
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Congratulations to Professor Christopher Goodnow, BVSc, MBBS, PhD (from UNSW Sydney) as he is the recipient of the German Paul Ehrlich and Ludwig Darmstaedter Prize for 2027 base on his work in autoimmunity! https://t.co/uvfYfXTrh3 https://t.co/FgyOzTI8lb
Dr. John Cush
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Sobi Receives US FDA Fast Track Designation for pacritinib in VEXAS Syndrome. Pacritinib (Vonjo) is a kinase inhibitor (JAK2, FLT3) that is approved to treat adults with intermediate or high-risk myelofibrosis https://t.co/V7duJPyJpG https://t.co/Dn5DgeaX7N
Dr. John Cush
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Sobi Receives US FDA Fast Track Designation for pacritinib in VEXAS Syndrome. Pacritinib (Vonjo) is a kinase inhibitor (JAK2, FLT3) that is approved to treat adults with intermediate or high-risk myelofibrosis https://t.co/V7duJPyJpG https://t.co/N9rg30EA4W
AiArthritis
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🔥 Still’s Disease Awareness Day 2026
🐉 I Won’t Be Still: Making Still’s Disease Visible
Show us a moment from your life with Still’s Disease. 📸 Share a photo/video + what “I Won’t Be Still” means to you.
For 47 hours, let’s make Still’s visible.
#MyStills #StillsDay https://t.co/B7VNmlIOQj
Mithu Maheswaranathan, MD
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🆕 #AutoInflammatory / Periodic Fever Syndromes
In Memory of Dr. Dan Kastner🕊️
So grateful Dr. Kastner agreed to review this graphic >1 year ago, providing thoughtful input and suggestions to improve the final version 🙏
New Board Review Series for Rheum OnePagers 📟
#RheumX https://t.co/zx8dX2yHkA
Dr. John Cush
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Misdiagnosis of Still's Disease
High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly rarer, systemic disorder that should not be https://t.co/pSfSahO5Nw
Dr. John Cush
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Misdiagnosis of Still's Disease
High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be https://t.co/mCbNBAt9T5
Dr. John Cush
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Substudy of 131 Still’s dz pts from the Autoinflammatory Dz (AIDA) registry. 38% underdosed w/ canakinumab (CAN) vs 62% appropriately dosed (300 mg q4wks or 4 mg/kg). Underdosed CAN had lower odds of long-term remission & D/C CAN (3.9% vs 19%) https://t.co/l94zB9NkKv https://t.co/FQTrCWZLQI
Dr. John Cush
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Substudy of 131 Still’s dz pts from the Autoinflammatory Dz (AIDA) registry. 38% underdosed w/ canakinumab (CAN) vs 62% appropriately dosed (300 mg q4wks or 4 mg/kg). Underdosed CAN had lower odds of long-term remission & D/C CAN (3.9% vs 19%) https://t.co/l94zB9NkKv https://t.co/D8FNUXS0nv
