IL-6

2025

The 2025 Rheumatology Year in Review

Jack Cush, MD

The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.

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Kick off with a powerhouse RA session! ⚡️ Drs. Elena Myasoedova, Kristen Demoruelle, & Jeffrey Sparks dive deep into: 📉 Mortality Trends 🧬 The Mucosal Hypothesis 🫁 Recent ILD Advances Ends with a live faculty Q&A. A can’t-miss for RA clinicians in 2026! 🩺 Registration https://t.co/Z9oOkAyWPK
Dr. John Cush @RheumNow( View Tweet )
hospital,surgery

Best of 2025: Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients

Jack Cush, MD

More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the

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Best of 2025: ERS/EULAR guidelines for CTD-related interstitial lung disease

Jack Cush, MD

The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in

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Hyperferritinemia is common in Hyperinflammatory syndromes but is a hallmark of Macrophage activation syndrome and Sepsis; and is a poor prognostic sign too. MAS is excessive activation of T-lymphocytes & macrophages leading to cytokine storm & multi-organ damage. https://t.co/PTJPhcvnzC
Dr. John Cush @RheumNow( View Tweet )
Vexas

Best of 2025: Overview of the VEXAS Syndrome

Jack Cush, MD

A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.

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Disease Activity Criteria for Adult-Onset Still's Disease: EULAR Points to Consider

Jack Cush, MD

EULAR has published a "points to consider" (PtCs) guidance on the development of criteria for the assessment of the disease activity in adult-onset Still’s disease (AOSD).

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RheumNow Podcast square

Reefer Madness (12.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com.  B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.

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Phase 1 trial of IL-6 targeting immunotherapy (PPV-06) in 24 pts w/ inflammatory knee osteoarthritis (KOA) demonstrates safety, Abs that neutralize IL-6, decreasing CRP values and improved clinical outcomes, determined by changes in KOOS scores https://t.co/urZupN62Kw https://t.co/sru1SnsOig

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Dr. John Cush @RheumNow( View Tweet )
Stills,continuum

Treating Refractory Still's Disease

Jack Cush, MD

A full read systematic review article examined treatment options for difficult to manage systemic juvenile idiopathic arthritis, or Still’s disease. It classified these refractory disease patients as those with either (1) persistent arthritis, (2) recurrent or difficult-to-treat

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Retrospective review of 113 AOSD pts, median age 45yrs, ferritin 4626 (IQR 1169–14,239). Advanced Rx (IVIG, IL-1, IL-6) required in 15 (13.3%), NOT predicted by ferritin levels, either measured continuously or by quartiles. Ferritin is not a reliable biomarker in AOSD. https://t.co/pHEPeIf9u2
Dr. John Cush @RheumNow( View Tweet )
FDG,PET,CT

PET Uptake in Large Vessel GCA – Does tocilizumab help?

Brian Jaros, MD

Giant cell arteritis (GCA) is the most common form of adult vasculitis in the United States and can be subdivided into those with cranial only symptoms, those with large vessel vasculiti/PMR, and those with mixed features. Non-invasive imaging is key in detecting large vessel

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I've always (very) simplistically considered post-CAR-T CRS and HLH/MAS in the same bucket, and there certainly are substantial similarities. It raises the obvious question - can we borrow therapies? @CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/2HkHxpl89u

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David Liew @drdavidliew( View Tweet )
Mateo Faxas et al. TriNetX study, propensity score matched. 3000 patients. Arrythmia risk is higher with IL-6i vs TNFi in diabetic RA patients. V Tachy (HR 1.4), PPM need (HR 1.4) significantly higher. AF, SVT, VF all numerically increased. @RheumNow #ACR25 Abstr#2283 https://t.co/U2Tk38Mobg

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Richard Conway @RichardPAConway( View Tweet )
#1726 IA from immune checkpoint inhibitors (ICI) is a distinct autoimmune entity: T cell-driven but not antibody-mediated irAE arthritis shows hyperactive, cytotoxic CD8+ T cells & metabolic reprogramming, unlike RA. IL-6, IL-12 & IFNα fuel this process. @RheumNow #ACR25

Mrinalini Dey @DrMiniDey( View Tweet )

Biomarkers in Stills disease and MAS. #ACR25 @RheumNow IL 6 may not be helpful compared to CRP, and IL 1 beta is difficult to measure IL-18 seems to be the best one. https://t.co/u3oBTd4eaP

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Bella Mehta @bella_mehta( View Tweet )
IL- 18 go together sometimes with glycolytic enzymes such as aldolase Also MAS may not be a switch on and off mechanism. Lastly MAS with Stills may have increased IL18 levels but not in other disease like SLE #ACR25 @RheumNow https://t.co/BW1fD7usBT

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Bella Mehta @bella_mehta( View Tweet )
What do we know about IL-18 Normal levels less than 500 Non specific 500 to 15000 Stills (quiet) 2000 to 10000 Mas/glares 20000 and more @RheumNow #ACR25 https://t.co/ZAltAD5Q8V

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Bella Mehta @bella_mehta( View Tweet )
Kuzkina et al. Efficacy of IL-6i with olokizumab on depression in RA. There appear to be some benefit but anti-depressants still needed. Group 1 is olokizumab alone, other 2 groups have anti-depressants also. @RheumNow #ACR25 Abstr#1323 https://t.co/h2ExYQgKTL

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Richard Conway @RichardPAConway( View Tweet )
#0853 Olink proteomics in anti-Ro+ pregnancies identifies macrophage-derived IL-6 & CCL3 as serum predictors of foetal AV block These pro-inflammatory proteins predicted fAVB independent of maternal diagnosis or Ab titres, pointing to new pathogenic pathways. @RheumNow #ACR25

Mrinalini Dey @DrMiniDey( View Tweet )

#1627 SLR informing the 2025 @eular_org recommendations for PMR & LVV 🔍 141 studies (30 RCTs) reviewed: new & further evidence for IL-6, JAK & B-cell-targeted therapies. Data will underpin updated management guidance. @RheumNow #ACR25

Mrinalini Dey @DrMiniDey( View Tweet )

Upadacitinib in GCA doesn't just affect IL-6, it alters IFNg, known to be important in vascular change in GCA. If UPA in GCA has some cardiovascular concerns extrapolated from RA, it also has some plausible cardiovascular benefits too that TCZ may not #ACR25 ABST0751 @RheumNow https://t.co/rMetLPP9z6

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David Liew @drdavidliew( View Tweet )
From Eye on Cytokine Storm- Decoding MAS by Dr Grant Schulert : “IL-18 is highly elevated in SJIa and other autoinflammatory disorders…can amplify innate signaling as well as induce IFN-gamma”. @RheumNow #ACR2025 https://t.co/6e5yfeDepX

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Gabriela Martinez Zayas, MD @MartinezZayasMd( View Tweet )
Muscle mass & JAKi? 15 active RA pts (+ sarcopenia risk) Rx w/ tofacitinib - signif. improved @1 mo. @6 mos muscle mass signif improved (+242 cm3, +4%, p=0·017) {less w/ NSAIDs); w/ signif creatinine incr (0.06 mg/dl) & decr in serum IL-6, IL-1 & TNF. No change in CK, myoglobin, https://t.co/taY7DisMOS
Dr. John Cush @RheumNow( View Tweet )
Review of IL-1 family cytokines in inflammation and immunity - including, IL-1, IL-18, IL-33, IL-36, IL-37, IL-38, IL-1Ra, etc. Full read -- Good Reference!! https://t.co/01o05qYPjU https://t.co/HLcfPM2cPw

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

rheumthought

Overlap Syndrome with ILD

Jack Cush, MD
Cush RheumThought ILD

How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?

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Advancing PMR

Eric L. Matteson, MD, MPH
Dr. Eric Matteson
Even though polymyalgia rheumatica is not perceived by many physicians as a severe diagnosis, its diagnosis and management actually propose significant challenges. I'd like to talk about those challenges, and what directions our path forward can include to advance our understanding and improve the treatment of patients who have PMR. Read Post
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