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IL-23

IL-23 Blockade Goes Oral A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the interleukin-23 receptor (IL-23R), is showing encouraging efficacy and safety across a range of psoriasis (PSO) and https://t.co/7awBk16ZrQ
Dr. John Cush @RheumNow( View Tweet )

ACR 2025 Rheumatology Round Up

Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.

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ACR25 Best Abstracts - Day 4

Here's the last installment of our "ACR Best" abstracts as chosen by the RheumNow faculty.  Most of these were from the final, day 4, but a few were noteworthy holdovers from day 3. Enjoy!

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IL-23 Blockade Goes Oral

A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the interleukin-23 receptor (IL-23R), is showing encouraging efficacy and safety across a range of psoriasis (PSO) and psoriatic disease (PsD) studies.

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What's the latest in PsA? https://t.co/I8ZgRQpVy6 Great review for whats new in PsA by @drpnash Looking forward for Large IL23-Axial study results. @RheumNow #ACR25

Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )

Heydari-Kamjani et al. TriNetX study. 28973 PsA patients. IL-17i and IL-23i lower rates stroke, MI, DVT/PE than TNFi. IL-12/23i higher rate of stroke vs TNFi. @RheumNow #ACR25 Abstr#2363 https://t.co/fNHaxyYPCP
Richard Conway @RichardPAConway( View Tweet )
Icotrokinra, the new kid on the bloc! Targeted oral peptide IL-23R-inhibitor Effective in Ph2 and Ph3 in PSO Adults Data in Adolescents (12-18yo) with PSO ICO 200mg QD 44pts vs. PBO 22pts 16wks All pts received ICO wk16-wk24 Clear/Almost clear skin IGA 0/1 84% vs. 24% PASI 90 https://t.co/77YvXtdLi1
Aurelie Najm @AurelieRheumo( View Tweet )
Effect of BioDMARDs on Diabetes risk in 6400+ Psoriasis pts IL-23i and IL-17Ai associated w/ -lower risks of diabetes -Diabetic nephropathy -Stage 3–5 CKD and reduced risk compared to TNFi treated and bionaive pts Adjustment on several variables, but not disease severity https://t.co/TDIHXJOC2T
Aurelie Najm @AurelieRheumo( View Tweet )

Eating Crow (10.10.2025)

Dr. Jack Cush reviews the news, FDA approvals, and journal articles. In this episode: HMGCR Abs, FDA approvals and Cush eats crow.

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Guselkumab FDA Approved for Pediatric Psoriasis and Psoriatic Arthritis

FDA announced yesterday that guselkumab (Tremfya) is approved for use in pediatric patients moderate to severe plaque psoriasis (PsO) or active psoriatic arthritis (PsA) in children six years and older (weighing at least 40 kg).  

This is the first IL-23 inhibitor approved for use

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Malignancies Not Increased with Biologic Therapies

The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo

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Guselkumab (Tremfya) 1st IL-23 inhibitor to be FDA approved for subcutaneous induction in adults with ulcerative colitis https://t.co/KaZVzyomeY

Dr. John Cush @RheumNow( View Tweet )

Safety of Combination Targeted Therapies in Psoriatic Arthritis

MedPage Today

Treating psoriatic arthritis (PsA) patients with more than one targeted therapy appears to be just fine, with no increased risk of serious infections, insurance claims data indicate.

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Biologic Switching in Psoriasis

A systematic review and meta-analysis found that biologic switching was effective in a significant number of psoriasis patients; but there may be a price to pay. 

Patients with psoriasis may be required to switch therapies, for a variet of reasons (

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Options for Refractory axSpA or PsA

MedPage Today

Although most patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) didn't respond adequately to the interleukin-17 (IL-17) inhibitor ixekizumab (Taltz), enough did that it should still be considered in such cases, a Danish registry study indicated.

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Biologic survival study of British Assoc. of Dermatologists Biologics Register (11/07-6/23) looked at 19,034 Rx courses (median F/U 2.3 yrs), of TNFi, IL-12/23i, IL-17i, & IL-23i. IL-23i (GUS & RIS) had best survival (~1.93yrs) for efficacy & safety (broadalumab the least) https://t.co/uhomYmiUZy
Dr. John Cush @RheumNow( View Tweet )
GALAXI-2 and GALAXI-3 published showing the efficacy of IL-23 inhibitor, Guselkumab in a 48 week study in adults with moderately to severely active Crohn's disease. https://t.co/pWolec25cX https://t.co/e2fdcMxEro
Dr. John Cush @RheumNow( View Tweet )
Biologic survival study of British Assoc. of Dermatologists Biologics Register (11/07-6/23) looked at 19,034 Rx courses (median F/U 2.3 yrs), of TNFi, IL-12/23i, IL-17i, & IL-23i. IL-23i (GUS & RIS) had best survival (~1.93yrs) for efficacy & safety (broadalumab the least) https://t.co/aAULb0e3o9
Dr. John Cush @RheumNow( View Tweet )

Cancer Survival Outcomes in Autoimmune Skin Disease Patients

Patients with autoimmune skin diseases (ASDs) with cancer had significantly better cancer survival outcomes than those without ASD, suggesting coexistant autoimmune or inflammatory disease does not adversely affect a cancer prognosis.

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Early DMARD Initiation Benefits in Psoriatic Arthritis

Mease et al has published the results of a cohort study showing early initiation of disease-modifying antirheumatic drugs (DMARDs) in patients with psoriatic arthritis (PsA) resulted in better outcomes compared to late initiation.

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ICYMI: Axial Involvement in Psoriatic Arthritis

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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PCR: Prevalence, Cost, & Risk (6.27.2025)

Dr. Jack Cush reviews the news and journal reports from last week on RheumNow.com

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APEX study showed significant inhibition of structural damage progression with both dosing regimens (Q4W and Q8W) of GUS (IL-23i) in biologic-naïve pts with active PsA. Abstract #LB0010 #EULAR2025 @RheumNow https://t.co/QxYAPGB67v
Adela Castro @AdelaCastro222( View Tweet )
In the APEX Phase 3b RCT (N=1020), guselkumab (IL-23p19 inhibitor) significantly reduced radiographic progression (ΔvdH-S 0.55 & 0.54 vs 1.35 PBO; p≤0.002) and improved ACR20 (67–68% vs 47%) at W24 in biologic-naïve PsA. Safety consistent with prior data. Abstract LB0010 https://t.co/mFDsBsCg6m
Antoni Chan MD (Prof) @synovialjoints( View Tweet )

Imaging and Early Detection in Psoriatic Arthritis

At EULAR 2025, there have been new developments in imaging in PsA. Two key poster presentations (POS0104 and 

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