Top Four and More (4.10.2026)

Jack Cush, MD

Apr 10, 2026 2:02 pm

Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.

CDC: In 2023, age-adjusted prevalence of U.S. adults (>20 yrs) with obesity was 40.3% (9.7% with severe obesity; 31.7% overweight). BMI data from NHANES, & the National Center for Health Statistics https://t.co/kH9ajbUJ2m
UK Our Future Health study of 1,563,155 finds affective Dz (depression, bipolar, anxiety) signific higher (p<0.001)in autoimmune pts vs gen. pop. (29% vs 18%) - dx by PHQ-9, GAD-7. (OR 1.86), even after adjustments income and pain, etc. https://t.co/HoKBeAZxbS
From 2015 to 2023, long-term opioid therapy declined in the USA. Approximately 4 million to 5 million patients were prescribed long-term opioid therapy in 2023. Long term opioid use remains a challenge https://t.co/N5s7mYvXSw
Machine learning predicts macrophage activation syndrome in adult Still's disease - 312 AOSD - XGBoost model had 5 predictors: ferritin, splenomegaly, Plt#, cholesterol, & ESR (AUC 0.839, sensit 0.824, specificity 0.710. https://t.co/QrogaCYPCT
Itch is common in Scleroderma (SSc) and not related to Dz duration. Study of 2173 Pts (~20K itch assessments), 87 F; mean age 55 yrs; 40% w/ diffuse SSc. Itch (moderate 4/10) seen in ~35% at all times https://t.co/QnT8d0xA5Z
Asia-Pacific Lupus study of Mucocutaneous activity (MC-A) in 4102 SLE pts. 36% had MC-A (rash 1055; alopecia 731; m ulcers 352); 15% persistently. MC-A assoc w/ W, smoking, +serologies, vasculitis, myositis, serositis, nephritis, NP-SLE https://buff.ly/D5fXJdY
Hopkins Myositis study of 637 dermatomyositis pts - FLARES were assoc w/ DM Dz activity; manifest as rash (76%), motor weakness (58%), Pulm (19%), arthritis (12%). Only 2–5% of Flare pts had cancer Dx w/in 6–24-mos https://pmc.ncbi.nlm.nih.gov/articles/PMC13002134/
5 yr Italian study of hospitalized autoimmune pts(2018-23) 4,896 IMID pts compared to 301,126 non-IMIM. IMID had signif higher risk cancer (adj OR 1.32) highest 1st yr. Decreased from 1.83 @ yr 1 to 1.2 @5+ yrs. IMID had more lung & bladder CA, leukemia lymphoma & melanoma https://t.co/UXqDHQtzv0
Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp
Single-centre retrosp study of established 257 PMR pts. 98 referred by GPs were for Dx uncertainty (51 vs 14%), less for relapse (27%) or recurrence (11%). PMR Dx accuracy better by Rheums vs PCPs (83% v 62%, P < 0.05) https://t.co/DvTKeuGa4Q
Japanese ANSWER study Rx 7268 RA pts initiating bDMARDs or JAKi by orthos or Rheums. Vs Rheums, Ortho Rx RA had longer Dz duration, more seropositivity, functional impairment, IA injx, less comorbidity, less oral steroids, but more MTX/GC/TNFi, less AE D/Cs - responses & outcomes were similar https://t.co/1ryA8C2p1b
Open label RCT in 116 DMARD-naïve #RA pts Rx w/ tofacitinib or MTX (after 1 IM steroid injx). @3 mos, TOFA signif better than MTX for >50% SDAI improv (94 v 75%), CDAI [14.5 v 7.3), DAS28-CRP[1.7 v 1.2] https://t.co/smOuLlVFyX
VEXAS Syndrome - A Review
Predictors of Calcinosis Cutis in Systemic Sclerosis
COMMON - Incidental Rotator Cuff Abnormalities on MRI