3 x IL-23 = IL do Better (11.6.2026) Save

Dr. Jack Cush reviews the FDA approvals and news reports from this past week on RheumNow.com. This week we discuss playing the numbers in rheumatology, playing the long game with stem cell transplants, and a=the Positive spin on seronegative RA. 

1. FDA Approves Tildrakizumab for Psoriatic Arthritis Sun Pharmaceuticals announced Friday that the FDA has approved its IL-23 inhibitor, tildrakizumab (Ilumya) for use in patients with active psoriatic arthritis. https://t.co/9vJoJ35iso
2. Medscape overview of Fibromyalgia Therapies. Only four FDA approved FM drugs in the USA - pregabalin (2007), duloxetine (2008), milnacipran (2009) & sublingual cyclobenzaprine (2025) but none approved by the EMA in Europe. https://t.co/QHFSmcozT0
3. Exagen studies 192 established RA pts (383 controls) for Abs: CCP2, RF IgA, RF IgM, PAD4 (IgA, IgG). RA signif assoc w/ CCP2+ (OR 110), RF (>7), PAD4 (3.5-5.9). In CCP neg - only PAD4 IgG (2.87) & RF (2.2) assoc w/ RA, w/ only small Dx gain (ΔAUC 0.02–0.04). https://t.co/isf7aMf24O
4. The Concern about Seronegative RA A current review of seronegative RA (SNRA) by D’Onofrio, et al in npj Autoimmunity shows the diverse fate of seronegative RA - which can resolve, persist or become refractory. Clearly dedicated trials of SNRA are needed to better predict. https://t.co/98VDKucMgX
5. Spanish Nationwide registry study of 5120 hospitalised #GCA pts (2016-2024) found that 54 (1.1%) Dx / aortic aneurysm (AA) & 41 (0.8%) developed AA on F/U (AAf group). Median time to AA Dx 2.7 yrs. AA Risk was higher in males (RRR 2.42) & smoking w/ GCA (RRR 3.23) https://t.co/eZVGKbOfQt
6. Tocilizumab is effective in glucocorticoid-resistant adult-onset Still’s dz. 40 AOSD pts rx w/ TCZ (4-8 mg/kg q4wks). @12 mos clin remission 55%, 6 mos CID 62%, signif drops in CRP, ESR, ferritin & daily pred decr 91% (50 to 4.4 mg; p<0.001). TCZ retention 65%; SAE: MAS 7.5% & lymphoma 2.5% https://t.co/jtAxrz6ETd
7. Long term F/U of 80 systemic sclerosis pts Rx w/ autologous HSCT. W/ Med. 9.2 yrs F/U. progression-free survival = 81%, 72% @5 yrs, & 60% @10 yrs. 18 pts died; death due to HSCT in 6%, SSc progression in 11%, CA in 2 (3%), serious infx 2 (3%), 34 (43%) maintained remission without immunosuppressives https://t.co/l6RUf2Zqyw
8. Japanese retrospective cohort systemic sclerosis study shows adjunctive tofacitinib improved lower esophageal sphincter pressures (LESP). 50 SSc pts w/ esophageal Sxs Rx w/ Tofa or PBO x 24 wks. Tofa assoc w/ signif LESP increases & lower mRSS & IL-6 levels https://t.co/NNREBddiOi