From Cytokine Endotypes to Clinical Reality in Still’s Disease
Recent EULAR 2026 data highlight a paradigm shift in Still’s disease from syndromic management to biologically informed precision therapy.
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From Cytokine Endotypes to Clinical Reality in Still’s Disease
Recent EULAR 2026 data highlight a paradigm shift in Still’s disease from syndromic management to biologically informed precision therapy.
https://t.co/FrghBJdlXj https://t.co/CbHYDKbnK9
Dr. John Cush @RheumNow( View Tweet )
What’s New in Macrophage Activation Syndrome Therapeutics
MAS, the most severe complication of Still’s disease, is increasingly recognized as a cytokine-driven hyperinflammatory state centered on interferon gamma (IFNγ). Therapeutic advances presented at EULAR 2026 demonstrate both consolidation of established pathways and expansion into novel biologic
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Emapalumab in MAS secondary to stills disease
39 pts, median age 12, 2 pooled prospective, open label, single arm studies.
Endpoint complete resolution at week 8-. Around 60% and partial resolution nearly 100%
67% had concomitant anakinra
@RheumNow ##EULAR2026 #EULARBest https://t.co/sGm43C3LfH
Links:
Bella Mehta @bella_mehta( View Tweet )
Window of opportunity in stills disease is early. With IL1 / IL6 agents
#sJIA and #AOSD are the same disease. - may need a standard new crieteria
IL18 measuremnet should be encouraged.
@RheumNow #EULAR2026 plenary https://t.co/EQbs9mDYjS
Links:
Bella Mehta @bella_mehta( View Tweet )
Transitioning from pediatrics to adult rheumatology for patients with autoinflammatory disease such as #AOSD should be done with administrative support and the right hand off.
@RheumNow #EULAR2026 plenary talk https://t.co/N8qB7jrZfM
Links:
Bella Mehta @bella_mehta( View Tweet )
Sad to see this but important to be aware. Increasing risk of suicide using colchicine in Familial Mediterranean Fever. #POS0768 #EULAR2026 @rheumnow.
Average age 28! 87%female, only 7 % with psychiatric referral!
Retrospective 15 pts. https://t.co/241SE6O395
Links:
Bella Mehta @bella_mehta( View Tweet )
#EULAR2026 OP028 In 16 patients with AID (SSc,IIM, RA, IgG4,SjD, Grave’s), CD3xBCMA BiTE, Teclistamab was effective in 15/16. Duration of GC & DMARD-free was 11 mths. 2/16 need retreatment. All had low IgG and needed IVIG. Need long-term safety data & comparative study @RheumNow https://t.co/97MUPnXRua
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Multisystem inflammatory syndrome in children (MIS-C) - analysis of cases 2023-2024 shows 99% were undervaccinated against COVID-19. OVer 2 yrs, 141 MIS-C 78%had no COVID-19 vaccine. All 4 children who died were unvaccinated https://t.co/iBcA4GIdDe https://t.co/IQLLaG55gm
Dr. John Cush @RheumNow( View Tweet )
Review of Ruxolitinib in 7 pts w/ refractory systemic JIA complicated by macrophage activation (MAS) (ages 1.6-11 yrs; 3M: 4F). 5 achieved complete remission; 2 partial remission. 2 relapsed w/ GC tapering (remission after adding canakinumab). No deaths https://t.co/j4Cm3UYB9c https://t.co/pKoDwpSKII
Dr. John Cush @RheumNow( View Tweet )
Review of Ruxolitinib in 7 pts w/ refractory systemic JIA complicated by macrophage activation (MAS) (ages 1.6-11 yrs; 3M: 4F). 5 achieved complete remission; 2 partial remission. 2 relapsed w/ GC tapering (remission after adding canakinumab). No deaths https://t.co/j4Cm3UYB9c https://t.co/YIupsBank5
Dr. John Cush @RheumNow( View Tweet )
Quiz Talk (5.22.2026)
Dr. Jack Cush talks of birthdays, Quizzes and journal articles this week on the podcast.
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FDA has approved benralizumab (Fasenra) for the treatment of adult and pediatric patients w/ hypereosinophilic syndrome (HES); based on the NATRON Phase III trial https://t.co/qqPsjhUClP https://t.co/lCZNoTh9fv
Dr. John Cush @RheumNow( View Tweet )
10yr retrosp. study of 110 Still’s dz pts. MAS occurred in 37% (1/2 @onset; assoc w/ serositis) and ILD observed in 82% (also assoc w/ MAS, polycyclic course) https://t.co/SNa0KiWfgY https://t.co/xbpCuHdJka
Dr. John Cush @RheumNow( View Tweet )
APR: Still's Disease
Companion slide deck for the Advanced Practice Rheum: Still's Disease and Fever video, featuring Dr. Jack Cush.
https://t.co/wsUP2zEulC https://t.co/AWSNt9Uzlg
Dr. John Cush @RheumNow( View Tweet )
In Still's disease, what is the primary life-threatening complication clinicians must monitor for? If you think you know the answer, prove it in this week's RheumIQ quiz at https://t.co/KVK8J2iaFQ https://t.co/O62ZpIciWW
Dr. John Cush @RheumNow( View Tweet )
Review of Toll-like Receptor Research
EurekAlert!
A new review on Toll-like receptors (TLRs) systematically summarizes forty years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding
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Follow the Money (4.23.2026)
Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week.
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Mevalonate kinase deficiency (AKA hyper-IgD syndr-HIDS) is a rare autosomal recessive autoinflammatory dz of the MVK gene w/ exaggerated innate immunity & incr IL-1β production. Usually Dx in kids, milder forms of periodic fever syndrome have been seen in adults. https://t.co/0hAIz4JgY3
Dr. John Cush @RheumNow( View Tweet )
Still's Disease Update
Arthritis Research & Therapy has published an overarching review of Still's disease, claiming it is a single acquired, complex autoinflammatory disease in which both pediatric and adult forms share core pathogenic mechanisms, genetic associations, and https://t.co/8ctddvIq7k
Dr. John Cush @RheumNow( View Tweet )
Still's Disease Update
Arthritis Research & Therapy has published an overarching review of Still's disease - claiming it to be a single acquired and complex autoinflammatory disease in which both pediatric and adult forms share core pathogenic mechanisms, genetic associations and clinical presentations, with minor
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Top Four and More (4.10.2026)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.
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VEXAS Syndrome - A Review
Beck et al has published a review of the VEXAS syndrome in The Lancet, focusing on the pathogenesis, spectrum, and treatment strategies.
https://t.co/Nik0TJm6Qu https://t.co/WS35PRnbBv
Dr. John Cush @RheumNow( View Tweet )
Machine learning predicts macrophage activation syndrome in adult Still's disease - 312 AOSD - XGBoost model had 5 predictors: ferritin, splenomegaly, Plt#, cholesterol, & ESR (AUC 0.839, sensit 0.824, specificity 0.710. https://t.co/QrogaCYPCT https://t.co/Z6WgCnFTfx
Dr. John Cush @RheumNow( View Tweet )
19 yr old male is Dx w/ Stills Dz (Fever 104F, pleuritis, organomegaly, WBC 24k, ESR 98, CRP 11 mg/L) - what drug do you prescribe first?
Dr. John Cush @RheumNow( View Tweet )
Therapeutic Updates
Dr. Jack Cush reviews the history, manifestations, diagnosis and treatment of Still's disease.
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Recent Blogs
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.
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Podcasts
ACR 2025 Daily Podcasts Day2d
AOSD - Adult - Onset Still's Disease00:33:08 
ACR Fireside Chats - Still's disease Abstracts00:22:48
