There's this low grade buzz from some rheumatologists about the potential analgesic benefits of low dose naltrexone. I haven't used it. Should you?

Aside from diarrhea, colchicine use is generally well tolerated, but its metabolism via the CYP3A4 cytochrome P450 enzyme pathway poses a potential risk of medication interaction. Statins are one of the most widely prescribed medication classes also metabolized by this pathway thus positing question of additive risk when colchicine and a statin are prescribed concurrently.

Avacopan (Tavneos), the complement pathway inhibitor for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), appeared strongly effective in an Italian registry study -- a step, maybe, toward setting to rest questions about its efficacy, if not its safety.

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. 

Close to 90% of patients with rheumatoid arthritis (RA) well controlled on targeted therapies were able to take 50% dosage reductions without experiencing worsened disease activity in a randomized trial, South Korean researchers said.

A randomized clinical trial in inflammatory arthritis arthritis shows that temporarily holding biologic or Janus kinase (JAK) inhibitor therapy at the time of COVID-19 vaccination is not warranted.

van der Heijde et al have published the results of the phase 3 POETYK PsA-1 trial demonstrating that deucravacitinib was superior to placebo in clinical responses, patient-reported outcomes, and structural damage inhibition in patients with psoriatic arthritis (PsA).

The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal. 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? Feel free to use this in your own journal clubs! This edition: VALOR (brepocitinib in dermatomyositis).

The NEJM reports that retatrutide, an investigational incretin agent, was shown to yield up to 25% weight reduction, with subanalyses also showing reduced pain with knee osteoarthritis, and less apnea–hypopnea events in participants with obstructive sleep apnea.

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

At the CCR West 2026 conference in Huntington Beach, California, Dr. Michelle Petri updated her Petri Pearls. Some are derived from new data, while others are from her extensive experience caring for patients with systemic lupus erythematosus (SLE).