Infection

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Review of HLA-B27

Jack Cush, MD

HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint trafficking point to new plausible, targetable

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Dutch single center study of ANCA tests (n 5518) betw 2012-2023; 286 (5.2%) were positive: 63% did not have AAV. ANCA+ Non-AAV pts had other CTD, neoplasia, infxn, or used specific drugs. IIF and ELISA 1st test - good negative predictive values. Performing a second test increased https://t.co/0oAhOg10VL
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A Day of Infamy (9.11.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz

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Korean retrospective study compared NIDDM pts Rx w/ SGLT2 inhibitor (n 552,065) vs sulfonylurea (1,480,092) showed SGLT2 inhibitors were assoc w/ a signif 11% lower risk of incident autoimmune rheumatic disease (HR 0.89). Diff of −6.50 per 100K PYs over median ~9 mos F/U. https://t.co/uTiCjejkjL
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NME: New Molecular Entities (8.28.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com. Take this week's RheumIQ and test your knowledge!

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Japanese study of 101 864 children shows fertility treatments (ovulation induction, intrauterine insemination, invitro fertilization) increases the risk of Kawasaki Dz. Incidence rates per 100K PYs - 274 for spont conception vs 391 for assisted conception (adj HR 1.42; https://t.co/Ro0beSXAAq
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steroid prednisone lab

Glucocorticoids: Use vs.Toxicity

Jack Cush, MD

This review article addresses the recognition, prevention and management of glucocorticoid toxicity in rheumatic patients.

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Retrospective Medicare comparison 450 paired #PMR cohorts Rx w/ IL-6 inhib or csDMARDs. At 1 yr, IL-6i pts (vs csDMARD) had signif more GC D/C (adj HR 1.28) or minimal GC use (<3mg/d) (aHR 1.28). Hosp. infxn 2X higher in IL-6i (12.2 vs 5.7 per 100 PY) in year 1, but not year 2 https://t.co/G4eIusHDPa
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Retrospective Medicare comparison 450 paired #PMR cohorts Rx w/ IL-6 inhib or csDMARDs. At 1 yr, IL-6i pts (vs csDMARD) had signif more GC D/C (adj HR 1.28) or minimal GC use (<3mg/d) (aHR 1.28). Hosp. infxn 2X higher in IL-6i (12.2 vs 5.7 per 100 PY) in year 1, but not year 2 https://t.co/YgqLjD9nvM
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Doubting RS3PE (8.14.2026) 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. https://t.co/gmcrjb5bDu https://t.co/LiLl7XcZQS

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US TriNetX EHR study of of seropositive RA:  31,932 without ILD; 115 RA-ILD on antifibrotic Rx & 1885 RA-ILD not Rx w/ antifibrotics. MTX was used more in RA w/o ILD (52%) vs RA-ILD (12%) on antifibrotics. RA-ILD was assoc w/ heterogeneous antifibrotic use. https://t.co/eBJBXbnQLN
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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/7eMoNgWbB4
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What's New in Lyme Disease JAMA has published an overview of new considerations on Lyme disease, focusing on Diagnostics, Vaccines, and Prevention. https://t.co/jG09wc6gI8 https://t.co/rQBW6RIz5U

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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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Mentshlichkeit* (8.7.2026)

Jack Cush, MD

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

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British Dermatology Biologics registry (BADBIR) 18976 #PSO pts had incidence serious infxns (SIE) 28 SEI/1000 Pt-Yrs; higher if they had prior infxn (79/1000 PYs). SIE signif lower w/ RIZankizumab (HR 0.74-.80) vs BROAD, ETN, other standards Rxs. SIE deaths rare (1.81/1000 PYs) https://t.co/GTr3DLCVXs
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JAMA Case Quiz - A 57 yoF w/ #RA has a new vesicular rash. 9mos prior ETN change to ADA. Rash (painful, pruritic) started 2 wks ago. Exam: PIP swelling, & ulcerated plaques on neck, chest, & erythroderma on hands, CRP 15.0 mg/L , ESR 111 mm/h. What would you do? order?

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British Dermatology Biologics registry (BADBIR) 18976 #PSO pts had incidence serious infxns (SIE) 28 SEI/1000 Pt-Yrs; higher if they had prior infxn (79/1000 PYs). SIE signif lower w/ RIZankizumab (HR 0.74-.80) vs BROAD, ETN, other standards Rxs. SIE deaths rare (1.81/1000 PYs) https://t.co/5HqJ3zpO0g
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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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STOP-HZ trial - 30 #RA pts going on tofacitinib given Shingrix (RZV) on day 1 & wk 8 & started Tofa on d1 or wk8. @wk 12 VZV responses incr in both (2.66 & 2.91 fold incr). @wk 4, d1 Tofa had fewer ≥1.5-fold VZV vs wk8 (44.8% vs 80%); BUT can you wait 8wks to start JAKi? https://t.co/tH0zPgBbHQ
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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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QD Clinic: Gout, Sepsis… or Both? Dr. Mrinalini Dey, London, discusses a complex case. https://t.co/UtncfZgZyL https://t.co/xVTA0LnPpN

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Genetic study of 16 pts w/ Allopurinol-induced severe cutaneous adverse Rxn (SJS/TEN) shows 2 class I alleles to be associated: HLA-B*58:01 (OR, 28.0 [95% CI, 8.6-100.6]) and HLA-A*34:02 (OR, 20.6 [95% CI, 3.3-131.1]). Both explain 80% risk in US pts https://t.co/OxDXuWCbup https://t.co/oky61JImQV

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#THA revisions in 3657 RA vs 446428 OA pts (mean F/U ~7y) find RA has signif incr risk of revision (HR 1.35); espec due to infx (HR 1.48), dislocation (1.87), aseptic loosening (0–3m; 2.81). No diff w/ cemented, cementless, hybrid THA. Age > 65 was main risk factor. https://t.co/iK6pL3QF1W
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Risk Option Decision

The Hidden Cost of Gout

Mrinalini Dey, MBBChir, MA(Hons) Cantab., MRCP, FHEA

For many people, gout is viewed as an episodic disease: a painful flare, a short course of treatment, and then life returns to normal. However, as rheumatologists, we know that recurrent attacks can lead to joint damage and tophi if left untreated. Furthermore, the true burden of gout extends

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Recent Blogs

Advanced Practice Rheum

Safety of Biologics and Novel Agents

Jack Cush, MD
APR Safety Video Cover
Dr. Jack Cush reviews safety of biologics and novel agents.
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Advanced Practice Rheum

Steroids

Jack Cush, MD
STEROIDS COVER
In this Advanced Practice Rheum, Dr. Jack Cush reviews steroids.
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A Brief History of Rheumatoid Arthritis Mimics

Robert Schoen, MD, MBA
books history
Imagine that 100 years from now, your great granddaughter, an eminent rheumatologist, reviews the history of rheumatoid arthritis mimics.
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