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2026 BSR Pain Guideline: What Rheumatologists Need to Know

Jack Cush, MD

The British Society for Rheumatology has issued its first guideline dedicated solely to pain in inflammatory arthritis (IA)—covering RA, PsA, axial SpA and JIA.

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Evaluating Inflammatory Joint Pain in Older Adults

Jack Cush, MD

Lee, Levinson, and Makris have published an approach to evaluating inflammatory joint pain in older adults in JAMA Internal Medicine. While intended to be a practical guide for primary care clinicians, the tenets and clues ring true for all.

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Wealth and Where you Live Influences Outcomes

EurekAlert!

Patients from wealthier European countries tend to start treatment with biologics earlier but also stop or switch treatment earlier. They also experience lower disease activity at treatment start than patients in middle- and low-income countries.

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POETYK PsA-1: Deucravacitinib in Biologic-Naïve PsA

Jack Cush, MD

POETYK PsA-1 trial tested the disease modifying efficacy of deucravacitinib, a tyrosine kinase 2 (TYK2) inhibitor, in psoriatic arthritis (PsA) patients and was shown to be superior vs to placebo for clinical responses, patient-reported outcomes, and structural damage inhibition in PsA.

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Mentshlichkeit* (8.7.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and recent journal reports on RheumNow.com.

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A Tribute to Daniel L. Kastner, MD, PhD (1951–2026)

Jack Cush, MD

The rheumatology, genetics and NIH communities mourn for Dr. Daniel L. Kastner, who died on July 28, 2026, in Bethesda, Maryland, at age 74. The following are declarations, tributes, and memories dedicated to this mensch of a man, titan of science, memorable mentor and humble physician.

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Methotrexate Safety Tips (7.31.2026)

Jack Cush, MD

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

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The Wider Implications of Dactylitis

Jack Cush, MD

Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis. This review article discusses the wider implications of dactylitis in rheumatology and medicine underscores the diagnostic and prognostic significance of this manifestation.

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POETYK PsA-1: Deucravacitinib in Biologic-Naïve PsA POETYK PsA-1 trial tested the disease modifying efficacy of deucravacitinib, a tyrosine kinase 2 (TYK2) inhibitor, in PsA patients and was shown to be superior vs to placebo for clinical responses, patient-reported outcomes, https://t.co/VjwpCVKPz0
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MoonLake announced positive phase 3 data from its IZAR-1 RCT using its dual A/F IL-17 inhibitor sonelokimab, showing significant responses at week 16: 66% ACR20, 42% ACR50, 41% minimal disease activity (MDA), & 61% PASI90 at week 16. a 2nd IZAR-2 PsA RCT is in progress https://t.co/eX0cxekRKG
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COLIPSO prospective study of psoriasis or psoriatic arthritis adults starting ts/bDMARDs; MRI done serially. 35 pts f/u for ~29 wks - MASLD. Only Rx w/ IL-17 inhibitors improved liver fat and inflammation in psoriatic disease as well as clinical outcomes. https://t.co/MFjvh5OJg2 https://t.co/k0C7RSvaaR

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British Dermatology Biologics registry (BADBIR) 18976 #PSO pts had incidence serious infxns (SIE) 28 SEI/1000 Pt-Yrs; higher if they had prior infxn (79/1000 PYs). SIE signif lower w/ RIZankizumab (HR 0.74-.80) vs BROAD, ETN, other standards Rxs. SIE deaths rare (1.81/1000 PYs) https://t.co/GTr3DLCVXs
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British Dermatology Biologics registry (BADBIR) 18976 #PSO pts had incidence serious infxns (SIE) 28 SEI/1000 Pt-Yrs; higher if they had prior infxn (79/1000 PYs). SIE signif lower w/ RIZankizumab (HR 0.74-.80) vs BROAD, ETN, other standards Rxs. SIE deaths rare (1.81/1000 PYs) https://t.co/5HqJ3zpO0g
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The Wider Implications of Dactylitis Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis. https://t.co/HRaIvMHMSV https://t.co/XOcHbFVMsS

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3 Rx are FDA approved for hidradenitis supprativa (secukinumab, adalimumab, bimekizumab). New JAK1i Povorcitinib in STOP-HS1 and STOP-HS2 ph 3 PCTs (608/619 pts). Povo showed HiSCR50 ~42% vs PBO 29% @wk12. AE: acne, pharyngitis https://t.co/n3FJUOjNuo https://t.co/9YAmPqW44z

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Psoriasis = Myocardial Dysfunction (unrelated to Cardiometabolic Risk Factors) 1010 PsO pts vs controls w/o skin dz, assessed clinically & by ECHO. PSO pts (even w/ controlled dz) had signif more myocardial dysfunction (17% vs 6%). Higher BMI & DM independently assoc w/ https://t.co/MjcRmgyCWX
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UTSW observational study of labs (n 14,199) changes w/ MTX use in 2,439 pts (13% RA, 11% PsO/PsA, 15% inflam arthritis) - found no difference in labs q3 vs q6 mos. No signif correlation betw monitoring intervals & changes in ALT, AST,WBC, HCT, MCV, PLT, FIB-4. Small https://t.co/gKwA7juexG
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Fibrosis-4 (FIB-4) Index for Liver Fibrosis is calculated from age, AST, ALT, Plts. Study of 174 RA, PsA, PsO pts on MTX find 11% w/ fibrosis (by elastography). FIB-4 AUC for fibrosis =0.68 (weak). Fibrosis was signif assoc w/ FIB-4 >1.62, DM, obesity, advanced steatosis https://t.co/GYrhs2U1s3
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Psoriatic Arthritis: EULAR 2026 Recap https://t.co/tBMu4CEn0o https://t.co/iztShOHxOf

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From 2015-2024, 148 inflam arthritis pts (43 SpA, 35 PsA, 50 RA) w/ a prior cancer were followed 58.1 mos. 24 (19%) had CA recurrence/progression. Post-CA exposure to b/ts-DMARDs did not incr. recurrence risk after adjusting for age & comorbidity burden. https://t.co/MHKIqwyjNN https://t.co/uhOdq1cCPW

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