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Guidelines for Adult-Onset IgA Vasculitis

Jack Cush, MD

A EUVAS-sponsored expert panel of 37 specialists across rheumatology, nephrology, dermatology and pathology has published evidence-based guidelines for adult-onset IgA vasculitis (IgAV), which behaves very differently in adults compared to usually self-limited childhood form.

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Glucocorticoids: Use vs.Toxicity

Jack Cush, MD

This review article addresses the recognition, prevention and management of glucocorticoid toxicity in rheumatic patients.

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Misdiagnosis of Still's Disease

Jack Cush, MD

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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ZEUS Trial: IL-6 Inhibition Fails to Cut Cardiovascular Events

Jack Cush, MD

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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DMARD Efficacy in RA-ILD

Jack Cush, MD

A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional, low-certainty recommendations.

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Do You Zoster Vaccinate? (6.19.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and best ways to review EULAR 2026.

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EULAR 2026 Rheumatology RoundUp

Jack Cush, MD

It’s time for Rheumatology RoundUp from EULAR 2026 from London, UK. Drs. Artie Kavanaugh and Jack Cush review their choice presentations from the meeting, offering their perspectives on impact and applicability.

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True or False: A meta-analysis of 61 studies found that exercise showed anti-inflammatory trends, including reductions in CRP, IL-6, and TNF-α, in most chronic diseases. Test your knowledge in this week's RheumIQ at https://t.co/TBlB4pmnKa. https://t.co/7MxkveOuZE

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Dr. John Cush RheumNow ( View Tweet)
Does exercise affect inflammatory biomarkers? Metanalysis of 61 studies shows mostly low certainty evidence of inflammation-modulating effects of exercise. In most chronic diseases, exercise showed anti-inflammatory trends w/ reductions in CRP, IL-6, TNF-α https://t.co/EP74b3mVAT https://t.co/WBTHjsCzKL

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Dr. John Cush RheumNow ( View Tweet)
Retrospective Medicare comparison 450 paired #PMR cohorts Rx w/ IL-6 inhib or csDMARDs. At 1 yr, IL-6i pts (vs csDMARD) had signif more GC D/C (adj HR 1.28) or minimal GC use (<3mg/d) (aHR 1.28). Hosp. infxn 2X higher in IL-6i (12.2 vs 5.7 per 100 PY) in year 1, but not year 2 https://t.co/G4eIusHDPa
Dr. John Cush RheumNow ( View Tweet)
Retrospective Medicare comparison 450 paired #PMR cohorts Rx w/ IL-6 inhib or csDMARDs. At 1 yr, IL-6i pts (vs csDMARD) had signif more GC D/C (adj HR 1.28) or minimal GC use (<3mg/d) (aHR 1.28). Hosp. infxn 2X higher in IL-6i (12.2 vs 5.7 per 100 PY) in year 1, but not year 2 https://t.co/YgqLjD9nvM
Dr. John Cush RheumNow ( View Tweet)
ZEUS Trial: IL-6 Inhibition Fails to Cut Cardiovascular Events The phase 3 ZEUS trial tested the IL-6 ligand inhibitor ZVK in over 6,000 patients with ASCVD, CKD, and elevated hsCRP. Although ZVK significantly lowered IL-6 and CRP levels, it did not improved outcomes (HR 0.99 https://t.co/jf2gAtvmpZ
Dr. John Cush RheumNow ( View Tweet)
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

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Dr. John Cush RheumNow ( View Tweet)
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

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Dr. John Cush RheumNow ( View Tweet)
From Cytokine Endotypes to Clinical Reality in Still’s Disease Recent EULAR 2026 data highlight a paradigm shift in Still’s disease from syndromic management to biologically informed precision therapy. https://t.co/fBtkDLPJNE https://t.co/y8NBW6VHHa

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Dr. John Cush RheumNow ( View Tweet)
From Cytokine Endotypes to Clinical Reality in Still’s Disease Recent EULAR 2026 data highlight a paradigm shift in Still’s disease from syndromic management to biologically informed precision therapy. https://t.co/FrghBJdlXj https://t.co/CbHYDKbnK9

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Dr. John Cush RheumNow ( View Tweet)
Kyoto U. cohort study of 55 relapsing polychondritis pts (503 Pt-yrs) Rx w/ TNFi, IL-6i or none -- Crude relapse rates were 46.9/100PYs NoBio, 22.4 TNFi, & 12.5 IL-6Ri. Adjusted relapses signif lower w/ TNFi (IRR 0.4) & IL-6Ri (IRR 0.2) vs no biologic. Estimates for hospitalised https://t.co/h6IcVWjqfp
Dr. John Cush RheumNow ( View Tweet)
#OP0209 #EULAR2026 SPECIFI-RA Balinatunfib, oral selective TNFR1 inhibitor designed to preserve TNFR2 signalling in RA. Phase 2b trial missed primary ACR20 endpoint, but 200mg QD arm showed signals for higher ACR50, ACR70 and DAS28 low disease activity & reduced IL-6. @RheumNow https://t.co/emxNQy0cPx

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Mrinalini Dey DrMiniDey ( View Tweet)
#EULAR2026 Recommendations: Vasculitis -Confirm diagnosis with imaging and biopsy - Start GC early but with taper plan - For major flare again confirm dx and restart GC - Consider IL-6 or UPA - MTX may be option if biologics not available @RheumNow https://t.co/DqLZtW630y

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Jiha Lee JihaRheum ( View Tweet)
Emapalumab in MAS secondary to stills disease 39 pts, median age 12, 2 pooled prospective, open label, single arm studies. Endpoint complete resolution at week 8-. Around 60% and partial resolution nearly 100% 67% had concomitant anakinra @RheumNow ##EULAR2026 #EULARBest https://t.co/sGm43C3LfH

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Bella Mehta bella_mehta ( View Tweet)
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