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Doubting RS3PE (8.14.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.

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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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Mentshlichkeit* (8.7.2026)

Jack Cush, MD

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

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Air Pollution Increases RA Activity and Flares

MedPage Today

In this study from Korea, levels of small particulate matter correlated with increased RA disease activity and risk for disease flares.

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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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Arrhythmias in Autoimmune Rheumatic Disease

Jack Cush, MD

A new review in the Journal of Cardiovascular Development and Disease (Tamirisa et al) synthesizes how systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis have an increased risk of arrhythmias and sudden cardiac death attributable to shared immune pathways.

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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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French study of 90 RA F pts w/ 100 pregnancies (steroids 46% & biologics 39% were used). Vs 359 controls, RA had signif. more preterm birth (PTB;OR 2.08) & small for gestational age. SGA assoc w/ nulliparity (adj OR 4.38), PTB assoc w/ maternal age (aOR 1.14) & GC ≥10 mg/d (aOR https://t.co/StCJW2rsZI
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US TriNetX EHR study of of seropositive RA:  31,932 without ILD; 115 RA-ILD on antifibrotic Rx & 1885 RA-ILD not Rx w/ antifibrotics. MTX was used more in RA w/o ILD (52%) vs RA-ILD (12%) on antifibrotics. RA-ILD was assoc w/ heterogeneous antifibrotic use. https://t.co/eBJBXbnQLN
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2026 BSR Pain Guideline: What Rheumatologists Need to Know 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. https://t.co/3Jtneox8Rh https://t.co/06ccLhjhMh

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Dr. John Cush RheumNow ( View Tweet)
NHANES survey (2005-2018) studied prevalence of arthritis in adults w/ depression (PHQ-9 ≥10), From 15157 depressed pts, RA was most prevalent & increased 7.8 to 17.7%; OA unchanged 11.7 to 10.7% & PsA declined 7.2 to 1.7%. Depression assoc w/ higher risk for RA (OR 1.40) & PsA https://t.co/fcROEvsHDT
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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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UK Clinical Practice Research Database study RA pts 3134 on glucocorticoids (vs not 4142 matched controls). were identified. GC use assoc w/ signif risk of SSRI initiation risk - recent GC (adj OR 1.53) & past GC (aOR 1.40). GC effect or confounding dz activity? Think depression! https://t.co/WZLkQWlURC
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Air Pollution Increases RA Activity and Flares Koreans with rheumatoid arthritis (RA) showed increased disease activity and higher flare rates when exposed to relatively high levels of small atmospheric particulate matter, researchers reported. https://t.co/9dZkTzivRz https://t.co/Reic3P5U6r

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Dr. John Cush RheumNow ( View Tweet)
Korean study of 1070 #RA pts. assessed for Dz activity & monthly pollution exposure (SO2, NO2, ozone, CO, PM10, PM2.5). Among 6 pollutants, PM2.5 signif incr risk of flare (adj OR 1.11) & DAS28-CRP, CDAI, TJC, SJC; more so w/ in women & nonsmokers & w/ prolonged PM2.5 exposure https://t.co/HgtWMz9LMs
Dr. John Cush RheumNow ( View Tweet)
Arrhythmias in Autoimmune Rheumatic Disease A new review in the Journal of Cardiovascular Development and Disease (Tamirisa et al) synthesizes how SLE, RA, and SSc have an increased risk of arrhythmias and SCD attributable to shared immune pathways. These facts substantiate the https://t.co/j9AW26LE66
Dr. John Cush RheumNow ( View Tweet)
Best proof of difference betw Seropos vs seroneg RA from TREAT-EARLIER 12 mos study 236 clinically suspect arthralgia pts w/ subclinical Jt inflammation Rx w/ MTX vs PBO. MTX prevented RA only the seroneg RA (9 v 35%); But no protection in seropos RA (58 vs 65%) https://t.co/ufY9ZJmKgf
Dr. John Cush RheumNow ( View Tweet)
Best proof of difference betw Seropos vs seroneg RA from TREAT-EARLIER 12 mos study 236 clinically suspect arthralgia pts w/ subclinical Jt inflammation Rx w/ MTX vs PBO. MTX prevented RA only the seroneg RA (9 v 35%); But no protection in seropos RA (58 vs 65%) https://t.co/A5aFUgMPQR
Dr. John Cush RheumNow ( View Tweet)
JAMA Case Quiz - A 57 yoF w/ #RA has a new vesicular rash. 9mos prior ETN change to ADA. Rash (painful, pruritic) started 2 wks ago. Exam: PIP swelling, & ulcerated plaques on neck, chest, & erythroderma on hands, CRP 15.0 mg/L , ESR 111 mm/h. What would you do? order?

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