Labs/Biomarkers

Pss.renal.crisis.kidney

Scleroderma-Specific Autoantibodies in Early Systemic Sclerosis

Jack Cush, MD

Prognostication is tenous in early scleroderma, especially in those with diffuse cutaneous systemic sclerosis (dcSSc). dcSSc has associated with substantial morbidity and disease-specific mortality. Analysis of an early SSc registry shows that anti-RNA

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Steroid Delusions in Giant Cell Arteritis

Jack Cush, MD

A real world analysis of drug use in giant cell arteritis (GCA) patients shows that despite intending to taper patients off glucocorticoids (GC) by 24 months, 75% remained on GCs for ≥ 48 months.

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Phenotypic cluster analysis of 134 CPPD pts from COLCHICORT & CHRONIC-CPPD European cohorts ID 4 Grps: 1) C1 monoarticular recurrent flares, older, W, ^CRP; 2) C2 monoarticular w persistent arthritis; 3) C3 polyarthritis lower CRP; 4) C4 polyarticular (spine/shoulder( & recurrent https://t.co/ghMCmDLCki
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CLOAK study: 3 mos DBRPCT of Colchicine vs PBO (no NSAID) in 120 symptomatic KOA (KL gr 2/3) shows no benefit in VAS pain index knee after 3 mos. (but COL pts had signif change in some biomarkers hsCRP, β-NGF (p < 0.05); PGE2, IL-1ra, IL-8, and VEGF (p < 0.16). https://t.co/MPgLpr7LPP
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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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undifferentiated,arthritis,early,RA

Early RA Referral Clinics Work!

Jack Cush, MD

An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals.

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Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/JDvVZ1KEIY
Dr. John Cush @RheumNow( View Tweet )
True or False: In a Leeds study of idiopathic inflammatory myopathy patients treated with rituximab, responders had lower memory B cells and plasmablasts at 2 weeks. See if you got it right in this week's RheumIQ quiz at https://t.co/UaXqHKWizt. https://t.co/zRJOMeLn8M

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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
Dr. John Cush @RheumNow( View Tweet )
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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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Difficult PsA is called ‘difficult-to-manage’ (D2M) or ‘treatment-refractory’ dz (TRD). Data from 5 Nordic PsA registries 14,362 ps, D/Cs of ≥2/≥3/≥4 b/tsDMARDs in 36%/18%/10%. Freq of D2M low 2%/3%/3%, & TRD was 1.2%/1.2%/0.8%. Female #s, depression, & opioids incr w/ # of https://t.co/FkQU5BVRn2
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RA.Xray.Hands

JAMA: Review of Adult Rheumatoid Arthritis

Jack Cush, MD

Smolen, Kerschbaumer, Aletaha, and Robinson have published a comprehensive review article of rheumatoid arthritis (RA) in JAMA, noting significant changes to our understanding and treatment guidelines.

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Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/HTxOIxkezs
Dr. John Cush @RheumNow( View Tweet )
Metanalysis looked at neutrophil to Lymph ration (NLR) in SLE - 31 studies, 4,006 SLE pts. NLR signif incr in SLE worldwide. NLR was higher in Active vs inactive SLE, and showed a significant but moderate correlation w/ SLEDAI (CC=0.354, p < 0.001). https://t.co/tA6UBb1wVo https://t.co/XoXrf6HlKL

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Ro52 Abs in idiopathic inflammatory myopathies (IIM). From 2,126 IIM China/Japan pts, Ro52 positivity was common (46%), esp in MDA5+ DM & anti-synthetase syndr (ASyS) & was assoc w/ high freq of ILD, rapidly progressive ILD, and poor prognosis. https://t.co/TA4gSnZax1 https://t.co/riYs5YJwQV

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Dr. John Cush @RheumNow( View Tweet )
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Treating Obesity is Disease-Modifying (9.4.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  New drugs approved, new drugs halted and some drugs out of control. Ready to test your knowlege? Take this week's quiz!

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Metanalysis looked at neutrophil to Lymph ration (NLR) in SLE - 31 studies, 4,006 SLE pts. NLR signif incr in SLE worldwide. NLR was higher in Active vs inactive SLE, and showed a significant but moderate correlation w/ SLEDAI (CC=0.354, p < 0.001). https://t.co/ROG5L4nfo2 https://t.co/9mqqId45lG

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Dr. John Cush @RheumNow( View Tweet )
Ro52 Abs in idiopathic inflammatory myopathies (IIM). From 2,126 IIM China/Japan pts, Ro52 positivity was common (46%), esp in MDA5+ DM & anti-synthetase syndr (ASyS) & was assoc w/ high freq of ILD, rapidly progressive ILD, and poor prognosis. https://t.co/may6ZTJkvt https://t.co/EuinNbZUm7

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Dr. John Cush @RheumNow( View Tweet )
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EUSTAR Registry - Cancer in Systemic Sclerosis

Jack Cush, MD

Cancer is a major cause of mortality in systemic sclerosis (SSc).  A nested case-control study within EUSTAR registry shows distinct patterns of cancer related temporally to SSc, serologic profiles and traditional cancer risk factors.

Cancers were

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JAK inhibitors work & have a dose dependent effect in severe alopecia areata (AA). Metanalysis of 10 Rxs, 3866 AA pts (used the SALT20 endpoint) showed the best efficacy was deuruxolitinib_12 mg, and baricitinib_4 mg (OR: 2.59, 95% CI: 1.98–3.38). https://t.co/k86f2RvCEJ https://t.co/N1fsrbbmDw

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Per adult-onset IgA vasculitis guidelines, which agent is now preferred for refractory or relapsing disease? Test your knowledge in this week's RheumIQ at https://t.co/TBlB4pmnKa. https://t.co/7tMcDkoCKH

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Dr. John Cush @RheumNow( View Tweet )
purpura

Guidelines for Adult-Onset IgA Vasculitis

Jack Cush, MD

A EUVAS-sponsored expert panel of 37 specialists across rheumatology, nephrology, dermatology and pathology has published evidence-based guidelines for adult-onset IgA vasculitis (IgAV), which behaves very differently in adults compared to usually self-limited childhood form.

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SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/DIe2OJhZIc
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Misdiagnosis of Still's Disease High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be https://t.co/mCbNBAt9T5
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QD Clinic: A Watched Tophus Never Resolves Dr. Jack Cush discusses his plan to medically manage multiple large volume tophi and a patient who has recently started urate lowering therapy with febuxostat. https://t.co/swfyYEeW0s https://t.co/wyLlcHR4Td

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Therapeutic Updates

ILD Treatment and Guidelines

Hinze title card
Watch our 11-video series on ILD Treatment and Guidelines including videos on assessing ILD, guidelines caveats and concerns, and more.
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Biomarkers in RA

Augurex Front End Image
Rheumatologist Dr. Walter Maksymowych discusses the role of biomarkers in RA care, with a focus on 14-3-3eta as a modifiable marker for diagnosis and monitoring disease progression.
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Recent Blogs

ICYMI: Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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Advanced Practice Rheum

Systemic Lupus Erythematosus

Jack Cush, MD
APR SLE VIDEO COVER
Dr. Cush reviews systemic lupus erythematosus.
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Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
Read Post
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Podcasts

  • EULAR 2021 - Day2d 00:23:12
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