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Lifestyle and Incretin Therapy Advice for Rheumatologists

Jack Cush, MD

As GLP-1/GIP receptor agonists become standard co-management tools for obese patients with RA, PsA, axSpA, and gout, this JAMA Insights perspective by Kushner, et al. reframes lifestyle counseling as an adjunct to pharmacotherapy - a reversal of the traditional model. This has with direct implications for how we counsel obese patients we start or co-manage on these agents.

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Early RA Referral Clinics Work (9.18.2026)

Jack Cush, MD

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

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Review of HLA-B27

Jack Cush, MD

HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint trafficking point to new plausible, targetable pathways.

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Added IVIG is Effective in Myositis

Jack Cush, MD

A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly diagn

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Bariatric Surgery in the Era of GLP-1RA

Satya Dash, MD

Weight loss with lifestyle changes alone is difficult to sustain for most people. One reason for this is the weight loss associated endocrine milieu, which can decrease energy expenditure and increase the drive to eat. Therefore, we frequently use medications and/or bariatric surgery.

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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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Rheum Survey: Do You Have to be Overweight for GLP-1s to Work Best?

Dr. John Cush RheumNow ( View Tweet)

Rheum Survey>> Which obesity treatment has the greatest safety concern(s)? Click here to respond>> https://t.co/jDpVe7u9Pu https://t.co/RNftdQlU1N

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Dr. John Cush RheumNow ( View Tweet)
Observational study of 63,215 neuropsychiatric (NP) pts showed semaglutide signif lowered NP events over 2yrs (vs metformin, SGLT2 inhibitors, DPP-4 inhib);unrelaed to wt loss. Less substance, mood anxiety, CNS atrophies, neuromuscular, eating/sleep & personality/impulse-control https://t.co/tbuvLRK3QE
Dr. John Cush RheumNow ( View Tweet)
Added IVIG is Effective in Myositis A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly diagnosed IIMs. https://t.co/XLrvLSoOic https://t.co/xhjPBXLxiC

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Dr. John Cush RheumNow ( View Tweet)
Chinese 52 wk study of XKH004, a novel, SC, humanized anti-17A/F in 323 active AS pts Rx q4 wks vs PBO. @ Wk 16, XKH004 was superior for ASAS40 (45.4% vs 19.4%; P<0.001), improved to 66% by wk 52. https://t.co/f7w41m4QZy https://t.co/LELo52zUb7

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Dr. John Cush RheumNow ( View Tweet)
Join us for Tuesday Nite Rheumatology on September 22 for: Obesity Treatment & Safety Experts will tackle: • GLP-1/GIP therapies • Lifestyle & bariatric interventions • Treatment selection & safety • Cost & compounding concerns • Sarcopenia & bone health • The future of https://t.co/BCSOUot5FL
Dr. John Cush RheumNow ( View Tweet)
Chinese 52 wk study of XKH004, a novel, SC, humanized anti-17A/F in 323 active AS pts Rx q4 wks vs PBO. @ Wk 16, XKH004 was superior for ASAS40 (45.4% vs 19.4%; P<0.001), improved to 66% by wk 52. https://t.co/f7w41m4QZy https://t.co/5MPm388kau

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Dr. John Cush RheumNow ( View Tweet)
FDA Grants Priority Review to Zasocitinib for Plaque Psoriasis. Regulatory decision expected 1st quarter 2027. Supported by phase 3 RCTs, 3000 pts -- LATITUDE PsO 3001 and 3002 clinical trials. https://t.co/o7oqxSXHSw https://t.co/evzPtaTWI4

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Dr. John Cush RheumNow ( View Tweet)
Together PsA 52 wk data (n 271): ACR50 plus >10% wt loss - 39.2% w/ Taltz & Zepbound vs 1.7% w/ Taltz alone. Together PsO trial results (n 274): PASI100 plus >10% wt loss - 30.6% w/ Taltz & Zepbound vs 4.4% w/ Taltz alone. https://t.co/27TBZyL8l1 https://t.co/VdQJALdoJt

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Dr. John Cush RheumNow ( View Tweet)
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

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Dr. John Cush RheumNow ( View Tweet)
Osteoarthritis, Obesity and GLP-1s https://t.co/SGnWksQBpT https://t.co/ILP3weScxh

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Dr. John Cush RheumNow ( View Tweet)
True or False: In a Leeds study of idiopathic inflammatory myopathy patients treated with rituximab, responders had lower memory B cells and plasmablasts at 2 weeks. See if you got it right in this week's RheumIQ quiz at https://t.co/UaXqHKWizt. https://t.co/zRJOMeLn8M

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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

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TheDaoIndex KDAO2011 ( View Tweet)
FDA Grants Fast Track Designation to treprostinil inhalation powder (Yutrepia - currently FDA approved to tx Pulm HTN) for the Treatment of Raynaud’s Phenomenon assoc w/ Systemic Sclerosis. A Phase 2a RE-WARM dose-finding study will begin October 2026. https://t.co/x4X1Ld1egZ https://t.co/GsZ9LXJjre

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Dr. John Cush RheumNow ( View Tweet)
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