September to Remember (9.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.
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A self learning program to train non Rheumatologists to interpret pelvic X-rays and identify sacro-iliitis?
It works, but it seems the participants were already well trained as pre test scores were already reaching 60+%
Surprised to see radiologists constituting 1/4 of the test https://t.co/mRcFRSuAws
Aurelie Najm @AurelieRheumo( View Tweet )
IL-17is demonstrate efficacy in SpA tx
Comparable with TNFis & JAKis in terms of achieving ASAS40 response rates
IL-17is are generally well-tolerated w/⬇️TB risk (very important tx consideration esp in Asia)
But watch out for candidal infx, IBD exacerbation
@RheumNow #APLAR25 https://t.co/rSUJlZOhKV
Links:
sheila @RHEUMarampa( View Tweet )
An important message from Prof. @XBaraliakos on D2M-axSpA:
Re-evaluate your diagnosis & check for comorbids before labelling pts as tx-refractory or difficult-to-manage.
consider other causes: FM, other causes of pain
@RheumNow #APLAR25 @rheumarhyme @marklagacmd https://t.co/Lo0yShOK0P
Links:
sheila @RHEUMarampa( View Tweet )
Stay sharp in RA, PsA & SpA care. Get the latest breakthroughs + expert insights at RWCS 2026. Don’t miss 'Year in Review: Rheumatology Advances.' Register now: https://t.co/majEsY4tXK https://t.co/fgGniR1OGk
RWCS @RWCSmtg( View Tweet )
China study of 670 SpA pts rx w/ sulfasalazine betw 2016 to 2023 (469 pure AS; 201 w/ peripheral Sxs). SSZ Signif. reduced peripheral Sxs development (HR 0.49) and improved disease activity in both pure axial and axial-with-peripheral Sxs. https://t.co/5HdQCos9yM https://t.co/tTMScQDHBq
Dr. John Cush @RheumNow( View Tweet )
Sjögren's Graduates (8.22.2025)
Dr. Jack Cush reviews the news, journal reports, FDA approvals, drug safety, and more from this week.
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Cohort study of 1,553 Biologic or JAKi Rx IBD (Crohns; UC) pts (SpA excluded) found 106 (6.8%) w/ MSK Sxs & 30 (1.9%) later Dx w/ SpA (20: axial, 10: peripheral) after median F/U 5.2 yrs. SpA risk factors: partial Mayo UC (HR 1.57) & HLA-B27 positivity (HR 3.70) https://t.co/WgLLUjlLMk
Dr. John Cush @RheumNow( View Tweet )
Difficult to manage SpA (D2M-axSpA) defined as failure ≥ 2 b/tsDMARDs (diff MOAs). Study of 129 axSpA pts, 8.5% were D2M, & 3% were treatment refractory (more inflammation- TR). D2M had signif higher BASFI (4.2 vs. 2.9), BASDAI (5.1 vs. 3.5), ASDAS (3.7 vs. 2.8). Predictors: https://t.co/4qdHEFxr3J
Dr. John Cush @RheumNow( View Tweet )
The Patient Journey with Rheumatic Disease
Oton and colleagues have reviewed the "patient journey" - from symptoms to specialty referral in those diagnosed with rheumatic and musculoskeletal diseases (RMDs).
Mid East/N African Survey on #SpA referrals.
- 190 Rheum responded (68% consultants, 53% tertiary,95% urban)
- 89% reported delay in axSpA presenting (most: Ortho, FP, internists)
- 2/3 Dx challenges
- > 60^ Pt non-adherence (side effects or Sx improvement) https://t.co/6jBdOqp2gM
Dr. John Cush @RheumNow( View Tweet )
Repurposing & Pipeline (8.8.2025)
Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.
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Juvenile Idiopathic Arthritis - NEJM Review
Sandborg et al. has published an overview of juvenile idiopathic arthritis (JIA) - its classification, biology, genetics, , clinical presentations and treatment advances in the New England Journal of Medicine (NEJM).
JIA is the most common form of inflammatory arthritis in the pediatric
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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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Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors
Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer.
10-20% of IBD pts have IBD-assoc. spondyloarthritis, as either peripheral arthritis or axial Dz, subclinical gut inflammation w/ IL-23–IL-17–TNFα playing central roles. TNFi & JAKi Rx is effective, but IL-17i may exacerbate IBD (vedolizumab??) Review here>> https://t.co/EL0sL2M3YX
Dr. John Cush @RheumNow( View Tweet )
1 in 5 Patients are Unaware of their Arthritis Diagnosis
Current CDC numbers suggest that arthritis (any type) affects an estimated 67.1 million (27.9% ) adults in the USA. Interestingly, 1 in 5 do not know their arthritis subtype (21.6%, 14.4 million).
This most recent analysis of the prevalence and distribution of arthritis subtypes
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Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients
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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10-20% of IBD pts have IBD-assoc. spondyloarthritis, as either peripheral arthritis or axial Dz, subclinical gut inflammation w/ IL-23–IL-17–TNFα playing central roles. TNFi & JAKi Rx is effective, but IL-17i may exacerbate IBD (vedolizumab??) Review here>> https://t.co/kNIAi55Y7z
Dr. John Cush @RheumNow( View Tweet )
No Increased Malignancy Risk with Ixekizumab
A pooled analysis of 25 randomized clinical trials affirms the safety of ixekizumab (IXE) when used to treat patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA). The observed incidences of https://t.co/7dAoQyeq5x
Dr. John Cush @RheumNow( View Tweet )
No Increased Malignancy Risk with Ixekizumab
A pooled analysis of 25 randomized clinical trials affirms the safety of ixekizumab (IXE) when used to treat patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA). The observed incidences of malignant neoplasms were consistent with the US general
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Biologic experienced ankylosing spondylitis patient show better retention on TNF compared to IL-17 inhibitors. 148 AS pts (F/U 31 mos), IL-17i drug survival trended better but only signif after 3yrs. More D/C w/ higher BASDAI (HR: 1.3) & ^# prior biologics (HR 1.62) https://t.co/5HXGsV4xol
Dr. John Cush @RheumNow( View Tweet )
GLP 1 Receptor Agonists in axSpA
Dr. David Liew reviews POS1232 presented at the 2025 EULAR meeting in Barcelona, Spain.
https://t.co/88Ms7ce7XX https://t.co/tt3qZH1hJT
Dr. John Cush @RheumNow( View Tweet )
HLA-B27 Testing in Practice
A single center study shows HLA-B27 testing is often performed by both by rheumatologists and nonrheumatologists for a wide array of reasons and often along with other serologic tests. Optimal use of HLA-B27 testing has yet to be defined. https://t.co/oq7GNhzwZd
Dr. John Cush @RheumNow( View Tweet )
MRI Lesions in Early axSpA vs Non-axSpA
Dr. Adela Castro reports on abstract OP0310 presented at the 2025 EULAR meeting in Barcelona, Spain.
https://t.co/sVWpyUT1IY https://t.co/wzobROoH1K
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.
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