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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A Review of Intracranial GCA
A comprehensive review in Rheumatology on intracranial giant cell arteritis (icGCA) stresses that GCA is both an intracranial and extracranial large vessel vasculitis, with the former having unique presentations, and outcomes.
A systematic review included 102
Pregnancy outcomes in autoinflammatory disease
EurekAlert!
To address this, a French multi-centre prospective pregnancy observational cohort was set up, to analyse disease activity, treatment, pregnancy outcomes, delivery, and neonatal health. The work – presented at the 2025 annual congress of EULAR – showcased findings from 97 women with an
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In the United States, IL-6R inhibitors have continued to help PMR patients get off steroids.
Hopefully more use and more options mean that, in the future, PMR patients get no more steroids than PsA or RA patients
#EULAR2025 POS0948 @RheumNow https://t.co/JT7gFDC5rl
David Liew @drdavidliew( View Tweet )
-Difficult to treat RA is a heterogeneous concept
-Risk fx: younger onset, high disease activity,erosive disease, comorbidities, depression.
-Study in a Spanish cohort with D2T 2/2 inefficacy showed Rituximab, JAKis, and IL-6i had longer survival (hence better tx options).
-The https://t.co/ZCZcX9FRfb
Adela Castro @AdelaCastro222( View Tweet )
FMF #Recommendations
🔺️Start Colchicine in All (& continue for confirmed pts)
🔺️Single or divided dose, depend on adherence & tolerance
🔺️Max dose 2 mg children, 3 mg adults
🔺️if failure: add IL1i (6 RCT) (2 for IL6i)
🔺️Add c or bDMARd if MSK
#EULAR2025
@RheumNow https://t.co/fPyQrLbb6S
Nelly ZIADE 🍀 @Nellziade( View Tweet )
"H Syndrome" review of 23 French pts. Autoinflammatory dz due to variants of SLC29A3 gene. Multisystem histiocytic lymphoproliferative disorder of young adults- skin 2/3, sensorineural hearing loss, fever w/ endo & autoimmune dz. Best responses w IL6 inhib. #EULAR2025 Abst https://t.co/F7NGI4TkJS
Dr. John Cush @RheumNow( View Tweet )
Total serum IL 18 can help instead of CDC42 or NLCR4 genetic testing in #MAS
Several monogentic mutations in primary HLH- these panels can be available..
#EULAR2025 @RheumNow
Bella Mehta @bella_mehta( View Tweet )
Management of HLH/MAS and modes of action of advanced therapies
Jessica Manson @RheumNow #EULAR2025 https://t.co/Op3u53ZXeK
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Hepcidin detected in synovial membrane and fluid in RA, PsA, and OA. Monocytes were the main source. IL-6, IL-10, IL-17, M-CSF induced hepcidin via JAK-STAT pathway. Hepcidin reduced osteoclastogenesis but correlated with synovial neutrophils and CXCL1 induction. Functional dual https://t.co/ZjUtTYPre8
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Extract of purple sweet potato ANTHOCYANINS (PSPA) studied in CIA animal model of #RA; Rats Rx w PBO or PSPA (10, 20, or 40 mg/kg) x14days. 40mg/kg dose reduced synovitis, altered gut microbiota (Akkermansia, Lactobacillus) decr RF & cytokines TNF-α, IL-1β, IL-6, IL-18) https://t.co/UjPFEuTU1S
Dr. John Cush @RheumNow( View Tweet )
Tocilizumab vs. Methotrexate in Rheumatoid Arthritis
A large randomized rheumatoid arthritis (RA) clinical trial compared subcutaneous tocilizumab (TCZ) vs oral methotrexate (MTX) vs. the combination of subcutaneous TCZ and MTX, and showed that TCZ was superior to MTX, either given as TCZ monotherapy or in combination with MTX.
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EULAR Guidelines on Reproductive Health
MedPage Today
Rheumatology patients considering or actually having babies can safely take most of the medications currently used to treat their conditions, according to an updated guideline from the European Alliance of Associations for Rheumatology (EULAR).
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2024 Management of Familial Mediterranean Fever Recommendations
A EULAR/PReS combined task force has developed recommendations for the management of Familial Mediterranean fever (FMF), the most common monogenic autoinflammatory disease worldwide. These evidence-based recommendations update the 2016 recommendations developed for rheumatologists and other HCPs
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Rheumatology: Believe It or Not (4/25/2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?
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Unmet Needs in Still’s disease
In February 2023, an expert consensus panel of pediatric and adult rheumatologists met to address challenges in Still’s disease (SD), including systemic juvenile idiopathic arthritis and adult-onset SD. They addressed four main topics: (1) early recognition and diagnosis of SD; (2) pathogenetic
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Does DMARD Rx affect neurocognitive function in older pts? bDMARDs targeting TNF-α & IL-6 may mitigate neuroinflammation & preserve cognitive function. But, cognitive impact of csDMARDs (MTX) is complex, w/ conflicting reports on its role in vascular dementia. https://t.co/u3kSKHRvpI
Dr. John Cush @RheumNow( View Tweet )
Does DMARD Rx affect neurocognitive function in older pts? bDMARDs targeting TNF-α & IL-6 may mitigate neuroinflammation & preserve cognitive function. But, cognitive impact of csDMARDs (MTX) is complex, w/ conflicting reports on its role in vascular dementia. https://t.co/6uMmOOdRoF
Dr. John Cush @RheumNow( View Tweet )
1st Line Biologics vs csDMARDs in Adult Still's Disease
A German multicentre, retrospective study assessed the first-line efficacy of biologics and conventional synthetic DMARD therapy in patients with adult-onset Still's disease and found biologic agents were significantly better with sustained, event-free remissions and fewer complications.
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ERA, APPs, & Alpha GAL (3.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Listen in for 2 new case questions - Ask Cush Anything.
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Adrenal Dysfunction after Steroids in PMR and GCA Patients
JAMA has published a study of PMR and GCA patients who stopped glucocorticoid (GC) therapy and noted a low (1.2%) risk of GC-induced adrenal insufficiency after planned cessation.
GC are widespreadly and chronically used in rheumatology, often with the
PAFLAR Guidelines for Polyarticular Juvenile Idiopathic Arthritis
The Pediatric African League against Rheumatism (PAFLAR) initiative has published its guidelines for the diagnosis and treatment of polyarticular juvenile idiopathic arthritis (pJIA
World Changers (3.14.2025)
Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.
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Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs
A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (
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2024 Rheumatology Year in Review
2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians. While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list
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How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?
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