What's New in Lyme Disease
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)
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)
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)
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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The Hidden Cost of Gout
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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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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Seronegative RA Disease Activity (7.17.2026)
Dr. Jack Cush reviews the news, journal articles and Gout features from this past week on RheumNow.com.
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Four Things About Allopurinol Hypersensitivity Syndrome
Dr. Robert Terkeltaub discusses allopurinol hypersensitivity syndrome in gout patients.
https://t.co/5seiyfVLW1 https://t.co/0A1Rtk9hzS
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Glucocorticoid use in 1st yr of 574 newly DX RA cases-- 75% recv GC in 1st yr; 313 (55%) Rx at 1st visit. (m GC dose =9.3 mg/day. 1/2 (47%) recv IA GC injx. 20% had 1st yr infx. Risk of infx was NS (RR 1.13; 0.77 to 1.67) for 0-10 mg/d vs no GC https://t.co/s9YaGZsUjr https://t.co/ESHvVK1Egx
Dr. John Cush @RheumNow( View Tweet )
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/Go51MUOQlG
Dr. John Cush @RheumNow( View Tweet )
Retrospective study 1420 newly Dx non-tuberculous mycobacterial (NTM) infx (2012-2024) - 66 (4.6%) Dx w/ RA (55 after RA dx). Having RA + NTM incr risk of Resp. death (HR 4.3) w/ lower 5yr survival (75% vs 93%) partly explained by ILD and sytemic inflamm. https://t.co/6sdR7XwwD7
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RZV (Shingrix) response in 76 immunosuppressed SSc & 304 controls (CG) recv two RZV doses. High seroconversion seen in SSc but signif lower than CG (92.6% vs 99.7%, P 0.001), w/ lower concentration but comparable CMI, lower AE (74% vs 86%) https://t.co/ALlnVEZIAt https://t.co/kYYy2JIo2J
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DMARD Efficacy in RA-ILD
A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional,
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QD Clinic: Cellulitis Paradoxes
Dr. Richard Conway, Dublin, discusses a case of cellulitis and gout. Presented as part of RheumNow's "Gout: More than Flares" campaign during the month of July 2026.
https://t.co/ZeYyISJrrE https://t.co/2Ih4QRa7FK
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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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JAMA HBV review - Worldwide, HBV affects ~254 million, causing 1.1 million deaths. In 2022, 14k new HBV infx in the US. HBsAg = ongoing infxn; HBsAb indicates immunity; HBcAg=ongoing or past infection. Do HBV DNA for virus-replication activity https://t.co/Yvdx09DrQ5 https://t.co/88VsTEgFev
Links:
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#TB Infection or reactivation is Psoriasis or Psoriatic Arthritis pts taking IL-23 inhibitors is rare, rare. Literature review showed 34 studies of IL-23i in PsO had no new TB, but 1 case of LTBI reactivation. In 8 IL-23i PsA studies there were NO new TB or LTBI reactivations https://t.co/h0oe3WksK1
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Generic Tofacitinib (6.26.2026)
Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Updates on tofacitinib, CAR-T therapy and AI.
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Imagine that 100 years from now, your great granddaughter, an eminent rheumatologist, reviews the history of rheumatoid arthritis mimics.
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