Outcomes

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/JX0Y0AQ07N Sponsored by AbbVie Medical Affairs + Health Impact. https://t.co/zx9kjsiZfZ

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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/TA4gSnZax1 https://t.co/riYs5YJwQV

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Dr. John Cush @RheumNow( View Tweet )
QD Clinic: The Weight Behind Delay in Diagnosis Dr. Antoni Chan, London, discusses a case of a patient with ankylosing spondylitis whose weight delayed the diagnosis and treatment of AS. This QD Clinic is presented as part of RheumNow's "The Obesity Imperative" campaign, https://t.co/fDozAaX64j
Dr. John Cush @RheumNow( View Tweet )
“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis The proposed approach to D2T-RA is based on the EULAR definition (having failed 2 or more b/tsDMARDs). It is estimated that up to 20% of RA patients meet this D2T-RA definition and can be plagued by active or https://t.co/o39IREvjI4
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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Cochrane systematic review of LBP Rx (8 RCTs, 501 cLBP pts) show that Lumbar supports may result in a small reduction in pain intensity if given w/ NSAIDs, but may offer little to no benefit for pain intensity & disability if used alone. Insufficient evidence to support their https://t.co/6Vq4CPXLvE
Dr. John Cush @RheumNow( View Tweet )
NY Times reports Gallop poll: 15% Americans have used a wt-loss drug (11% currently taking) - up from 3% in 2024. These have been approved for use in NIDDM, weight loss, liver Dz, CV risk reduct. & sleep apnea. Also obesity in USA is fell to 36.4%, after peak of 39.9% in 2022. https://t.co/ghxUEcuoGr
Dr. John Cush @RheumNow( View Tweet )
Lupus Research Alliance has awarded >$2 million in 2026 awards to studying innovative lifestyle interventions for people living with lupus. This includes studies on ginger supplementation, physical activity, and a whole health online programs https://t.co/C45y9laeHN https://t.co/6ifbPMWNt9

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Dr. John Cush @RheumNow( View Tweet )
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BMI Affects JAK Inhibitor Responses in Rheumatoid Arthritis

Jack Cush, MD

A meta-analysis of Janus kinase (JAKi) inhibitors clinical trials in rheumatoid arthritis (RA) has shown higher BMI was associated with poorer responses and a reduced treatment benefit with JAK inhibitors in RA patients.

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Music and Pain Relief

Jack Cush, MD

If laughter is the best medicine, then music has to be second best. A new scoping review in Pain Reports by Bradt et al., examines the effect of music-based interventions (MBIs) on pain management. While its efficacy is well established, how or why music relieves pain has never been fully

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MSK problems w/ Mobile gaming addiction (MGA)? Study of 364 Jordanian med students showed 9% had MGA- these has signif more UE MSK pain (71% vs 48%; p 0.012) vs nonaddicts. Elbow pain (41%) best predictor of MGA, but also neck (85%), upper back (65%), wrists (41%). https://t.co/51AWgHjrGC
Dr. John Cush @RheumNow( View Tweet )
VA (VARA) registry study of 2723 RA pts showed frailty was independently associated with increased cancer incidence. Age-adjusted CA incidence rates (per 1,000PYs) were 12.3 (robust), 15.5 (pre-frail), and 19.9 (frail). CA mortality rates were 7.8, 10.6, & 9.8/1,000PYs https://t.co/Ex52R56oT1
Dr. John Cush @RheumNow( View Tweet )
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EBR Journal Club: Dapirolizumab Pegol in SLE (PHOENYCS GO)

Michael Putman, MD, MSCI

The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal to an important RCT in rheumatology. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How great are the benefits and harms? And what didn’t they show me

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Necrotizing arteritis is rare w/ IgA Vasculitis (IgAV). Review compared 30 IgAV-NA to 257 adult IgAV & 196 PAN pts. Overall IgAV-NA is a severe IgAV phenotype with life-threatening complications & should prompt vascular imaging and intensified immunosuppression. IgAV-NA had more https://t.co/XdPbGX770D
Dr. John Cush @RheumNow( View Tweet )
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“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis

Jack Cush, MD

The proposed approach to difficult-to-treat rheumatoid arthritis is based on the EULAR definition (having failed 2 or more b/tsDMARDs). The authors provide guidance in the form of an easy acronym, A B C D E, which covers both diagnostic and therapeutic considerations.

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The global inflammatory myopathies market size was valued at USD 1.81 billion in 2025 and is expected to reach USD 2.67 billion by 2033 (CAGR of 5.00%). This applies to: Polymyositis, Dermatomyositis, Inclusion Body Myositis, Juvenile Myositis, Corticosteroids, https://t.co/vb7zfM76pO
Dr. John Cush @RheumNow( View Tweet )
Korean National Health Insurance claims study of 4,107 newly Dx gout on allopurinol x 24 mos (vs non-gout controls). Gout significantly higher risk of fractures (aHR 5.52_; 95% CI 4.19–7.26), highest in those with low-adherence to allopurinol (aHR 5.91). Consistent trends seen https://t.co/cTO4lGtYAy
Dr. John Cush @RheumNow( View Tweet )
Rheum Survey> What effect does obesity have on #Lupus pts?

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/ROG5L4nfo2 https://t.co/9mqqId45lG

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Dr. John Cush @RheumNow( View Tweet )
CART.Safety

Novartis & BMS CAR-T Cell Trials on Hold

Jack Cush, MD

Reuters and the Wall Street Journal report that both Novartis and Bristol Myers Squibb (BMS) have paused their autoimmune disease CAR-

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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/may6ZTJkvt https://t.co/EuinNbZUm7

Links:

Dr. John Cush @RheumNow( View Tweet )
Secukinumab in Polymyalgia Rheumatica PMR is a common disorder of the elderly that responds well to GC, but is plagued by an inability to wean off of GCs. The NEJM has published the results of the REPLENISH trial demonstrating that secukinumab (an interleukin-17A inhibitor) is https://t.co/ijkHKC7IWJ
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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FDA Approves Brepocitinib to Treat Dermatomyositis

Jack Cush, MD

The FDA and Priovant recently annouced approval of brepocitinib (Lisraya), a JAK1/TYK2 inhibitor, for the indication of adults with dermatomyositis (DM). This is the first oral (once daily) agent approved for DM.

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True or False: Compared to adult systemic sclerosis, juvenile systemic sclerosis is more commonly associated with diffuse cutaneous disease and renal crisis. Test your knowledge in this week's RheumIQ at https://t.co/TBlB4pmnKa. https://t.co/q4wlnCQsny

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

rheumthought

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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Hydroxychloroquine for Everyone

Jack Cush, MD
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Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit.
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Choice Overload (and the Way Out)

Jack Cush, MD
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I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”.
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Podcasts

  • EULAR 2026 Daily Podcast Day 2c
  • Are your patients with moderate to severe RA getting the appropriate dose? Sponsored by Genentech, Inc
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