Hmmm Really? (7.11.2025)

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Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?

CMS to Test Prior Authorization Model in Traditional Medicare

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The Centers for Medicare & Medicaid Services (CMS) announced a new experimental model late last week to streamline some prior authorizations under the traditional Medicare program, but some politicians and experts are concerned that it could result in more delays in care.

No Increased Malignancy Risk with Ixekizumab

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A pooled analysis of 25 randomized clinical trials affirms the safety of ixekizumab (IXE) when used to treat patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA).

Overview of the VEXAS Syndrome

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A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.

Cancer Survival Outcomes in Autoimmune Skin Disease Patients

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Patients with autoimmune skin diseases (ASDs) with cancer had significantly better cancer survival outcomes than those without ASD, suggesting coexistant autoimmune or inflammatory disease does not adversely affect a cancer prognosis.

Reducing Progression of Psoriasis to Psoriatic Arthritis

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Tumor necrosis factor (TNF) inhibitor therapy was effective in reducing the likelihood that psoriasis would progress to psoriatic arthritis (PsA), a retrospective study indicated.

Early DMARD Initiation Benefits in Psoriatic Arthritis

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Mease et al has published the results of a cohort study showing early initiation of disease-modifying antirheumatic drugs (DMARDs) in patients with psoriatic arthritis (PsA) resulted in better outcomes compared to late initiation.

Immunomodulators in the Treatment of Autoimmune Hepatitis

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Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on histology.

ICYMI: SLE: advances to achieve deep B-cell depletion

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The race is on for the first chimeric antigen receptor (CAR)-based therapy to be approved for the treatment of systemic lupus erythematosus. Its main principle is to induce deep B-cell depletion, with the hope to reset the B-cell aberrant immunity for a sustained clinical remission. At EULAR 2025 in Barcelona, several advances of CAR-based therapies will be presented.

ICYMI: Should Lupus Nephritis Receive PJP Prophylaxis?

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A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and risk factors.

ICYMI: Consensus Against Interventional Injections for Chronic Spinal Pain

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BMJ has published a clinical practice guideline resulting from the work of an international, multidisciplinary panel addressing chronic spine pain (≥3 months duration) not associated with cancer or inflammatory arthropathy. This is a chronic (not acute) spine pain guideline.

ICYMI: Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD

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Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic options for patients with autoimmune ILDs.