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Rheumatology Pitfalls (3.20.2026)

Jack Cush, MD

Dr. Jack Cush reviews the regulatory actions, news and journal reports from this past week on RheumNow.com.

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2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management

Jack Cush, MD

The European Alliance of Associations for Rheumatology (EULAR) has updated their rheumatoid arthritis (RA) management recommendations, notably with fewer recommendations (total of 9, down from 11 in 2022 version), by merging and removing previous recommendations.

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Pitfalls of autoimmune serologic testing

Jack Cush, MD

Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of  serological autoimmune markers. 

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Rheumatic Immune-related Adverse Effects with Checkpoint Inhibitor Therapy

Jack Cush, MD

A retrospective study of patients who developed rheumatic immune-related adverse events (R-irAEs) after receiving immune checkpoint inhibitors (ICIs) at two oncology centers in Spain suggests that early recognition can lead to effective management that allows continuation of cancer therapy. 

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b/ts-DMARDs Do Not Arrest Bone Loss in RA

Jack Cush, MD

In RA, the goal is to control or arrest inflammation such that articular and bony damage is halted. While we have many effective therapies, it is not clear that biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) can prevent or improve osteoporosis outcomes in RA. A current real-world study showed that 1 year of b/tsDMARDs use did not arrest osteoporosis progression.

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UBER Rheumatology Ride (3.6.2026)

Jack Cush, MD

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

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Open-access Arthralgia Clinics

Jack Cush, MD

The early diagnosis in inflammatory arthritis (IA), particularly rheumatoid arthritis (RA), hinges on efficient referral and screening of arthralgia patients.

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Mortality in Rheumatoid Arthritis: A Story of Decline, Delay, or Plateau? Dr. Elena Myasoedova https://t.co/YoQmrXHZif https://t.co/7v82hHvvZv

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Prednisone use in Alberta primary care 546 #RA pts - 40% of PCP RA Rx w/ 1 or more prednisone Rx. 41% Rx w/ both Pred + DMARD, w/ 44% on Pred median 124 day before DMARD. 66% continued Pred >1 yr after DMARD initiation. https://t.co/wrxQRP2TWN https://t.co/XxWpjafBsk

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RA pt on 7.5 mg/d Prednisone need hip replacement. What do you advise re: pred dose before TKR?

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2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management EULAR has updated its RA management recommendations, notably with fewer recommendations (a total of 9, down from 11 in the 2022 version), by merging and removing previous recommendations. https://t.co/7SCIL2Prjw
Dr. John Cush RheumNow ( View Tweet)
https://t.co/4UQlqwujiR 2026 — On Demand Catch the sessions everyone in rheumatology is talking about: • RA advances • Psoriatic arthritis decisions • Spondyloarthritis updates • Autoimmune disease highlights • Vasculitis insights Full recordings + slides available now. https://t.co/QT6NOXakVv

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Dr. John Cush RheumNow ( View Tweet)
Annual fibromyalgia survey (FIRST) in axSpA pts in the DESIR cohort. FM was found in 22% (& assoc w/ less HLA-B27+ & XRay sacroiliitis, equal MRI SI a& ^ CRP. FM/AxSpA had less self-reported Dz activity, QOL, more disability & more likely to Rx w/ TNFi (64% vs 41%), but resp https://t.co/9rkZFUSB2M
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of calcineurin inhib. in RA - 11 RCTs, 1793 RA pts. Cyclosporin (CSA( (RR 1.6 & Tacrolimus (TAC (RR 2.1) signif improved ACR20 responses. CSA was dose dependent, less so w/ TAC. Both require serum Creat. monitoring consistent increase in s-Cr https://t.co/OxNGYbupnt https://t.co/F08vDCMYtr

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Dr. John Cush RheumNow ( View Tweet)
https://t.co/4UQlqwujiR 2026 — On Demand Catch the sessions everyone in rheumatology is talking about: • RA advances • Psoriatic arthritis decisions • Spondyloarthritis updates • Autoimmune disease highlights • Vasculitis insights Full recordings + slides available now. https://t.co/wGrptPBYNu

Links:

Dr. John Cush RheumNow ( View Tweet)
Poor sleep increases risk of #RA. English Longitudinal Study of Ageing. RA risk was signif. higher in those with moderate sleep quality (SQ) (HR 1.23) or poor SQ (HR 1.50), cmpared to good SQ. Partly mediated by depression https://t.co/kTbCUHeIGi https://t.co/6CD5tsKDdA

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Hydroxychloroquine Lowers SLE and RA Hospitalizations A population-based study from British Columbia, Canada, shows that antimalarial adherence was associated with a lower risk of hospital admission in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus https://t.co/vsJDOh09ji
Dr. John Cush RheumNow ( View Tweet)
US Epidemiologic survey data from NHANES gout prevalence is incr. in RA pts vs controls (10.3% vs. 4.8%, P < 0.001), increasing trend over time. RA is as an independent risk factor for gout (OR: 2.67), strongest in SNRA. Evidence for the converse may not be as strong. https://t.co/hhRT9NCzVG
Dr. John Cush RheumNow ( View Tweet)
Open-access Arthralgia Clinics The early diagnosis of IA, particularly RA, hinges on efficient referral and screening of arthralgia patients. Yet most rheumatology practices are ill-equipped or don't have EACs. This report describes the use of an OAC to manage primary care https://t.co/8ut6LkIUEX
Dr. John Cush RheumNow ( View Tweet)
Hydroxychloroquine Lowers SLE and RA Hospitalizations A population-based study from British Columbia, Canada, shows that antimalarial adherence was associated with a lower risk of hospital admission in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus https://t.co/YR8Zfw8pL6
Dr. John Cush RheumNow ( View Tweet)
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