Immunology

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Efgartigimod Efficacy in Idiopathic Inflammatory Myopathy

Jack Cush, MD

Today Argenx announced the results of their Phase 3 "ALKIVIA" study; demonstrating efficacy and safety of subcutaneous efgartigimod for Idiopathic Inflammatory Myopathy (IIM, AKA inflammatory myositis).

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Doubting RS3PE (8.14.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.

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CDC warns of an association betw severe CNS arboviral disease, w/ neurologic sequelae in pts receiving anti-CD20 mAbs (rituximab, ocrelizumab, ofatumumab, obinutuzumab, etc). West Nile virus was the most common arbovirus, but there are others; mortality up to 40%. Most arbovirus https://t.co/WWg41fsRgr
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Simple infographic on the MOA of deucravacitinib (Sotyktu). https://t.co/fXbxMAzvAE https://t.co/6IvA0Xz3m2

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What's New in Lyme Disease

Jack Cush, MD

JAMA has published an overview of new considerations on Lyme disease, focusing on Diagnostics, Vaccines, and Prevention.

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Air Pollution Increases RA Activity and Flares Koreans with rheumatoid arthritis (RA) showed increased disease activity and higher flare rates when exposed to relatively high levels of small atmospheric particulate matter, researchers reported. https://t.co/9dZkTzivRz https://t.co/Reic3P5U6r

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Korean study of 1070 #RA pts. assessed for Dz activity & monthly pollution exposure (SO2, NO2, ozone, CO, PM10, PM2.5). Among 6 pollutants, PM2.5 signif incr risk of flare (adj OR 1.11) & DAS28-CRP, CDAI, TJC, SJC; more so w/ in women & nonsmokers & w/ prolonged PM2.5 exposure https://t.co/HgtWMz9LMs
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Best proof of difference betw Seropos vs seroneg RA from TREAT-EARLIER 12 mos study 236 clinically suspect arthralgia pts w/ subclinical Jt inflammation Rx w/ MTX vs PBO. MTX prevented RA only the seroneg RA (9 v 35%); But no protection in seropos RA (58 vs 65%) https://t.co/ufY9ZJmKgf
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A Tribute to Daniel L. Kastner, MD, PhD (1951–2026) The rheumatology, genetics and NIH communities mourn for Dr. Daniel L. Kastner, who died on July 28, 2026, in Bethesda, Maryland, at age 74. https://t.co/Qti4Nay6NX https://t.co/gjmY7G4XAc

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Mentshlichkeit* (8.7.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and recent journal reports on RheumNow.com.

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Eosinophil

Rethinking Treatment of EGPA

Jack Cush, MD

Eosinophilic granulomatosis with polyangiitis (EGPA) has long been managed by extrapolating results from microscopic polyangiitis and granulomatosis with polyangiitis clinical trials. But new insights into EGPA's has lead to advances in therapy and new treatment paradigms.

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Retrospective study, 41 pediatric Behcets Dz pts looked at Inflam. indices (NLR, SII, PIV, CRP/albumin) vs controls. BD systemic involvement in 68%, CNS dz in 10%, Vascular Dz in 12% & major organ dz 46%. Inflamm indices significantly higher in BD w/ systemic, CNS, & Vasc https://t.co/wHiBIaOWWU
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Interferon-α as an Immunologic Driver of Sjögren's Disease Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and can be elevated a decade before diagnosis. This study assessed the role of type 1 interferon (IFNα) in its onset and https://t.co/Clj9u5COzQ
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Methotrexate Safety Tips (7.31.2026)

Jack Cush, MD

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

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Interferon-α as an Immunologic Driver of Sjögren's Disease Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and can be elevated a decade before diagnosis. This study assessed the role of type 1 interferon (IFNα) in its onset and https://t.co/0BDDvR5cUB
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Uricase-Targeted Therapies in Gout

Jack Cush, MD

In most mammals, uricase catalyzes the oxidation of uric acid to allantoin, a highly soluble compound easily excreted by the kidneys. But humans lack functional uricase, leaving xanthine oxidase inhibitors (allopurinol/febuxostat) as first-line urate-lowering therapy (ULT). Uricase-based

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Chikungunya Club Meeting (7.24.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports from the past week on RheumNow.com.

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Interferon-α as an Immunologic Driver of Sjögren's Disease

Jack Cush, MD

Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and
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51 yoM w/ 2 yrs of FUO, unintentional 32-kg wt loss, LN, diffuse myalgias, but no GI Sxs or arthralgia. Neg MRIs, CT, PET scan, EGD, colonoscopy. Abnl labs: CRP 173 mg/L, ESR 46, anemia & ^ WBC. Cell-free DNA next-generation sequencing dx Tropheryma whipplei, & Whipple disease https://t.co/nJLa4l7Ers
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2 Still's dz cohorts (96 Shanghai, 28 Erlangen0 compared response to biolgics vs DMARDs (MTX, CNI,JAKi). in 124 AOSD pts, biologic had more sustained event-free remission and event-free state (P 0.0065, P 0.0096) & more steroid D/C vs MTX/CNI (p < 0.05). https://t.co/lJaI9nhPYr

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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/GvOvAVRkRv
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RheumIQ: True or False: In an international consortium of RA patients, MACE risk was significantly associated with disease activity but not ACPA positivity. Test your knowledge here: https://t.co/LATb1P18Sh https://t.co/Bs1ReJk0OY

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CAR-T Therapy: EULAR 2026 Conference Recap https://t.co/3CUp5MTN2Y https://t.co/agk5HNUSwg

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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
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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
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Recent Blogs

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CNS Lupus (NPSLE)

Jack Cush, MD
Cush RhTh CNS
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose?
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Unpopular opinion: spinach can be bad for you

Lara El Khoury, MD
pro con unsure opinion thumbs debate
PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives. 
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What Goes Wrong with the Immune System in PMR?

Kornelis van der Geest, MD, PhD
PMR,pathogenesis.JIM2022
Polymyalgia rheumatica (PMR) is a common inflammatory rheumatic disease. The exact trigger for PMR onset remains unknown. However, immunology studies and clinical trials with biological DMARDs now shed light on the immune pathways involved in PMR.
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