Seronegative RA Disease Activity (7.17.2026)

Jack Cush, MD

Jul 16, 2026 8:28 pm

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

Genicular artery embolization for knee OA does not work in a 12-mos randomized sham-controlled trial of 58 pts. Pain scores improved equally in both groups https://t.co/7wwmzpTaNL
ARTIC trial enrolled 234 DMARD naive RA (<2yrs) pts; 15.4% (36) were seronegative (SNRA). @enrollment SNRA worse than SPRA(+) w/ higher SJC (17 vs 8, p<0.001), DAS28 (3.9 vs 3.4, p=0.03), US scores (55 vs 25, p<0.001), MD global (49 vs 39, p=0.006). No diff in Sharp score, https://t.co/xDxQKY8ZG2
Intl consortium (10 EU countries) of 3952 RA pts, 184 MACE events seen 1985-2012. MACE risk signif assoc w/ DAS28 (HR 1.18;1.03-1.35), but NOT RF (HR 1.26; 0.82 to 1.94) or ACPA (HR 1.25; 0.85 to 1.83). RA activity assoc w/ MACE seen in seronegative and double positive https://t.co/RGO5IAM5oL
Glucocorticoid use in 1st yr of 574 newly DX RA cases-- 75% recv GC in 1st yr; 313 (55%) Rx at 1st visit. (m GC dose =9.3 mg/day. 1/2 (47%) recv IA GC injx. 20% had 1st yr infx. Risk of infx was NS (RR 1.13; 0.77 to 1.67) for 0-10 mg/d vs no GC https://t.co/s9YaGZsUjr
Metanalysis of 31 studies (14,548 pts) looked at infection in idiopathic inflamm myopathy (IIMs). Infection prevalence was 24%, primarily Respiratory tract. PJP, aspergillosis, H zoster most prevalent pathogens. Risk factors: older age, male, DM, HTN,MDA5+ (OR 3.41), rapidly https://t.co/Go51MUOQlG
Retrospective study 1420 newly Dx non-tuberculous mycobacterial (NTM) infx (2012-2024) - 66 (4.6%) Dx w/ RA (55 after RA dx). Having RA + NTM incr risk of Resp. death (HR 4.3) w/ lower 5yr survival (75% vs 93%) partly explained by ILD and sytemic inflamm. https://t.co/6sdR7XwwD7
RZV (Shingrix) response in 76 immunosuppressed SSc & 304 controls (CG) recv two RZV doses. High seroconversion seen in SSc but signif lower than CG (92.6% vs 99.7%, P 0.001), w/ lower concentration but comparable CMI, lower AE (74% vs 86%) https://t.co/ALlnVEZIAt
20 yr. Tx trends in 6583 #SSc pts. 2005 to 2025 endothelin receptor antagonists & prostanoids/prostacyclins from 3% to 28%. CCB & PDE-5 inh stable. CTX shifted to mycophenolate, RTX, & nintedanib. Steriods decr from 50% to 18% https://t.co/nrm1Ov285f
Systemic sclerosis metanalysis of 31 studies (32,134 pts) shows malignancy risk signif increased (SIR 1.66; CI 1.32 - 2.08). Highest: esophageal, liver, cervical, lung, & Heme (SIR 3.35 - 13.95). 7.4 yr mean from SSc to CA dx. https://t.co/IhxvfkMqkf
Updated Algorithm for the Management of Restless Legs Syndrome Diagnose: chronic vs intermittent RLS (no need for polysomnography) Test Iron levels (& Rx if) Consider: remove exacerbators; walking/massage/heat; carbidopa/ levodopa; pramipexole or ropinirole; low potency opioids; https://t.co/XdzIipw1X8
FDA - a 120Year History Protecting Americans. Nice overview. - Began 1906 (as Bureau of Chemistry) w/ Pure Food & Drugs Act - 1930 changed to Food and Drug Administration - 1938 Food, Drug, and Cosmetics Act - 1960s denied thalidomide approval https://t.co/3Ey98M9sxw My rec on hx: https://t.co/JS36EfJ19k
"People wish their enemies dead—but I do not; I say give them the gout, give them the stone!" — Mary Wortley Montagu
In 2010 Colchicine fell under patent protection and price increased 16 fold, & out-of-pocket price increased 4.4-fold, colchicine use decreased 27%, while allopurinol, steroid & gout visits (ER, Rheum) increased. https://t.co/xyOxsnoM5z
While not a validated Dx tool for gout, AI retinal scanning of digital fundus photography was tested on 107730 pts & showed high ROC - f NIDDM 0.833, Gout 0.832, OP 0.787, HTN 0.740, hyperlipidemia 0.736 & thyroid Dz 0.699 https://t.co/1yrlR04z4g
Saliva and Uric Acid Testing
Guidelines to Spot Cancer in High Risk Dermatomyositis