Methotrexate Safety Tips (7.31.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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COLIPSO prospective study of psoriasis or psoriatic arthritis adults starting ts/bDMARDs; MRI done serially. 35 pts f/u for ~29 wks - MASLD. Only Rx w/ IL-17 inhibitors improved liver fat and inflammation in psoriatic disease as well as clinical outcomes. https://t.co/uHO8ldjLKJ https://t.co/RqKK5JCANt
Dr. John Cush @RheumNow( View Tweet )
New Avacopan Analysis Sent to FDA
MedPage Today
After data manipulation allegations, the FDA has been calling for the vasculitis drug to be pulled from the market since January.
Amgen has submitted a third-party review of avacopan's (Tavneos) pivotal trial data and other analyses to the FDA in a bid to keep the embattled drug for
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GI dz & malnutrition in scleroderma (SSc) is common, assessed by BMI. Among 450 SSc (F/U 5.3 yrs), lower BMI were significantly assoc w/ pseudoobstruction, smaller oral aperture, higher Medsger vascular severity scores. Defines those at risk https://t.co/JY9YFOWE5C https://t.co/xFZ0rCXjQv
Dr. John Cush @RheumNow( View Tweet )
Gout Cavalcade (7.10.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week. July is Gout: More than Flares month.
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NEJM Retracts Pivotal ADVOCATE Trial of FDA-Approved Avacopan
MedPage Today
The New England Journal of Medicine (NEJM) retracted the pivotal study supporting FDA's approval of avacopan (Tavneos) for severe forms of anti-neutrophil
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NEW FROM EULAR: A real-world analysis of predictors of IBD in PsA. 🔎 In patients with PsA, signs and symptoms of IBD may appear before diagnosis, but do we know what to look for? Explore the poster: https://t.co/x2pM0T9LWg Sponsored by AbbVie Medical Affairs + Health Impact.
Dr. John Cush @RheumNow( View Tweet )
Spotlight on Comorbidities from EULAR 2026
EurekAlert!
Systemic autoimmune diseases are associated with increased cardiovascular morbidity and mortality – possibly through autonomic imbalance, myocardial inflammation, or fibrotic infiltration of the conduction system. A team in Colombia have been looking into the
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2026 Guidelines for the Treatment of Axial Spondyloarthritis
ACR
New and updated clinical guidelines released today provide comprehensive, evidence-based recommendations for the management of axial spondyloarthritis (axSpA) for both adults and children. The effort includes an update to the 2019 ACR/SAA/SPARTAN treatment guidelines focusing on adults,
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Do You Zoster Vaccinate? (6.19.2026)
Dr. Jack Cush reviews the news, journal reports and best ways to review EULAR 2026.
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Prevalence of GI involvement in dermatomyositis (DM) was assessed in 2 cohorts (n = 167). Severe GI involvement seen in 18% NXP2+ & 6% MDA5+; more common w/ NXP2 than other DM (HR 8.85). NXP2 w/ severe GI dz were younger, facial edema @dx w/ both skin & muscle dz activity. https://t.co/5kNvAkTLc0
Dr. John Cush @RheumNow( View Tweet )
How many patients with IBD have axSpA?
POS1338 #EULAR2026 @RheumNow
⬇️⬇️⬇️ https://t.co/29qkrCnDYz
Nelly ZIADE 🍀 @Nellziade( View Tweet )
RD in #IBD: 18.6% of 650 IBD pts affected, most commonly peripheral arthritis and AxSpa. Key finding: 14% of rheumatic manifestations preceded IBD diagnosis. Rheumatologists may see these pts first. GI-rheum collaboration is essential. @RheumNow #EULAR2026 POS0807 https://t.co/028yzOxJ2R
Jiha Lee @JihaRheum( View Tweet )
Early GI Involvement Predictive of Scleroderma Outcomes
Rheumatology has published a cohort study showing that earlyGI symptoms and overall symptom burden predict both GI progression and mortality in Systemic Sclerosis (SSc).
https://t.co/ftz6TeZv5Z https://t.co/Nw3wQ06VTq
Dr. John Cush @RheumNow( View Tweet )
Early GI Involvement Predictive of Scleroderma Outcomes
Rheumatology has published a cohort study showing that earlyGI symptoms and overall symptom burden predict both GI progression and mortality in Systemic Sclerosis (SSc).
Immune-Mediated Inflammatory Diseases Following Uveitis
A Korean insurance claims data study showed children and adolescents diagnosed with uveitis have a 7-fold increased risk of developing an immune-mediated inflammatory disorder (IMID).
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JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/SgVyk9fSCd
Links:
Dr. John Cush @RheumNow( View Tweet )
JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/cq3CuIuMKX
Links:
Dr. John Cush @RheumNow( View Tweet )
NSAIDs in Inflammatory Bowel Disease?
At least some patients with inflammatory bowel disease (IBD) can safely use common drugs for musculoskeletal aches and pains, a large study of insurance claims data suggested, contradicting a widespread concern that these products can https://t.co/JeINgTWTK0
Dr. John Cush @RheumNow( View Tweet )
GI involvement occurs in 37-65% of adult IgA (IgAV) cases, w/ Sxs of abdominal pain, hematochezia, severe complications of perforation & ischemia. Dx w/ CRP, NLR, D-dimer, imaging (CT, endoscopy). Steroids w/ Mod-to-severe Dz. MMF or IVIG for refractory cases. https://t.co/vgvZnYXIOI
Dr. John Cush @RheumNow( View Tweet )
Chinese study of 371 pts w/ Autoimmune hepatitis (AIH) - extrahepatic autoimmune diseases (EADs) seen in 24% -Sjogren’s & autoimmune thyroid dz (9% each). ANA+ independently assoc w/ EADs (OR 2) https://t.co/NVz8MWbJch https://t.co/tjCzaDcUFI
Dr. John Cush @RheumNow( View Tweet )
NSAIDs in Inflammatory Bowel Disease?
MedPage Today
At least some patients with inflammatory bowel disease (IBD) can safely use common drugs for musculoskeletal aches and pains, a large study of insurance claims data suggested, contradicting a widespread concern that these products can trigger IBD flares.
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Aspirin Cardiovascular Prevention in Giant Cell Arteritis
A retrospective target trial emulations has shown that low-dose aspirin (ASA) given with a giant cell arteritis (GCA) diagnosis is associated with a lower risk of major adverse cardiovascular events (MACE), but a higher risk of GI bleeding.
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Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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JAMA Guideline on the Management of Crohn Disease
https://t.co/GV0lICS8Sn https://t.co/aFWH5Tl4Jv
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
Interactions of the gut microbiota in humans promote the release of a variety of metabolites with profound effects on human health and immune regulation.
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Until the publication of the SEAM trial, evidence in the medical literature for the efficacy of the most commonly used drug for psoriatic arthritis worldwide, methotrexate, has been lukewarm at best. Yet we all employ it commonly, either as monotherapy or in combination with biologic or targeted synthetic DMARD treatment. It is inexpensive and widely available, and only modestly toxic.
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With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.
Podcasts
ACR2022 - Day 1.100:29:38
