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Vexas

VEXAS Syndrome - A Review

Jack Cush, MD

Beck et al has published a review of the VEXAS syndrome in The Lancet, focusing on the pathogenesis, spectrum, and treatment strategies.

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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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FDA Safety Warning: Avacopan and Serious Liver Injury

Jack Cush, MD

Yesterday the FDA issued a Drug Safety Communication alerting patients and health care professionals about postmarketing identification of serious (drug induced) liver injury, including fatal cases, associated with the use of avacopan (Tavneos) in patients with ANCA- associated vasculitis.

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ILD.colors

Review: Rheumatoid Arthritis–Associated Interstitial Lung Disease

Jack Cush, MD

RA-ILD represents the most severe extra-articular manifestation of rheumatoid arthritis, affecting an estimated 1% of the adult population in the US and Northern Europe.

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Ixekizumab With Tirzepatide Efficacy in Obese Psoriatic Arthritis

Jack Cush, MD

The TOGETHER-PsA trial has demonstrated the efficacy and safety of ixekizumab (IXE) administered with tirzepatide (TZP) in adult active psoriatic arthritis (PsA) patients who were overweight or obese.

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TENS

TENS Efficacy in Fibromyalgia

Jack Cush, MD

A randomized clinical trial of transcutaneous electrical nerve stimulation (TENS) in fibromyalgia showed meaningful improvement in pain for 6 months when combined with physical therapy (PT). 

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Machine learning predicts macrophage activation syndrome in adult Still's disease - 312 AOSD - XGBoost model had 5 predictors: ferritin, splenomegaly, Plt#, cholesterol, & ESR (AUC 0.839, sensit 0.824, specificity 0.710. https://t.co/QrogaCYPCT https://t.co/Z6WgCnFTfx

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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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Phase 1b trial shows transdermal Curcumin Gel (VAS-101) in was effective in Knee Osteoarthritis. Enrolled 60 KOA pts 45–75 yrs Rx w/ PBO or gel qd x 28d w/ signif improvement in pain & KOOS scores https://t.co/yNiNocZxa4 https://t.co/3W7j1bIvBc

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UK Our Future Health study of 1,563,155 finds affective Dz (depression, bipolar, anxiety) signific higher (p<0.001)in autoimmune pts vs gen. pop. (29% vs 18%) - dx by PHQ-9, GAD-7. (OR 1.86), even after adjustments income and pain, etc. https://t.co/HoKBeAZxbS https://t.co/LnC4lqqgq7

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Korean study 50600 adult RA pts (Dx 2010-2020) shows Sustained high-income was assoc w/ reduced mortality, esp in younger pts (adj HR 0.50 <65 years vs 0.74 ≥65 years). Amplifed by Rural residence https://t.co/DUZoNsPSHj https://t.co/PV3Umlrgvv

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1/3 of American adults have poor sleep. New survey from Amer. Academy Sleep Medicine shows 45% of pts never discuss sleep issues with their doctors; only 15% discussed it with a sleep specialist. https://t.co/uvlHjpuVs8 https://t.co/fDOtp9rxOn

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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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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
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TENS Efficacy in Fibromyalgia A randomized clinical trial of transcutaneous electrical nerve stimulation (TENS) in fibromyalgia showed meaningful improvement in pain for 6 months when combined with physical therapy (PT). https://t.co/Gm81FWoTQN https://t.co/2gq2cDFUh7

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Dr. John Cush RheumNow ( View Tweet)
Target trial emulation: biologics or JAK vs RTX in RA-ILD -- abatacept (n=694), JAKi (156), IL-6i (389), or TNFi (734), PS-matched =# RTX; no significant differences (HR 0.74-1.09 NS) in outcomes of resp hosp, lung transplant & death. But ABA (HR 0.84) & JAKi (HR 0.62) had less https://t.co/c9IVwQYwMN
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What's it like to have RA? LISA: "It only took me three short years to go from rock climbing to a power wheel chair and that stage of the disease was frightening and painful and you feel hopeless and as if your life plan is being stolen from you. Once I was able to start https://t.co/d49htc8k4m
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Retrospective study of 1st SLE pregnancies from LUNA Registry. Fetal loss was associated w/ aPL (OR 2.46) & pulse steroids (2.46), but not w/ SSA Abs (1.32). 247 pregs, 194 live births, 53 fetal loss. Ro+ vs Ro- no difference in live births or preterm births https://t.co/bsMMvVyffw
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AXIS is an Intl prospective study of 409 psoriatic arthritis pts - found Axial involvement in 27.4% of pts. Axial PsA signif younger (45 vs 47.6 yrs) , male (56% vs 51.5%), more B27 positivity (22% vs 11%), inflammatory back pain (75% vs 43%), & ^CRP (53% vs 37%) https://t.co/XY5pf4BNNm
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