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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Lancet viewpoint on early imaging in axial SpA. Over-reliance on BM edema = incr in misDx. Newer tech (high-res sequences, quantitative MRI, radiomics, artificial intelligence) may improve Dx precision. Remember the SI is susceptible to mechanical stress https://t.co/E80GyQGIM0 https://t.co/csQrBPHAlM
Dr. John Cush @RheumNow( View Tweet )
Pitfalls in sacroiliitis imaging: Bone marrow edema may also be seen in young-middle-aged postpartum women, & athletes & kids (ongoing bone growth) & w/ advancing age (DJD) https://t.co/bwS047wlmI https://t.co/pqI3xTYtCz
Dr. John Cush @RheumNow( View Tweet )
Pitfalls in sacroiliitis imaging: Bone marrow edema may also be seen in young-middle-aged postpartum women, & athletes & kids (ongoing bone growth) & w/ advancing age (DJD) https://t.co/bwS047wlmI https://t.co/FvWlEcZ5JP
Dr. John Cush @RheumNow( View Tweet )
Norwegian RevNatus Pregnancy study on 417 births in 350 women w/ axSpA: 86% (347) were breastfeeding @6wks, 70% @6mos, & 38% @12 mos. Non-breastfeeders more likely to have C-section (41 vs 20%), higher ASDAS-CRP (2.6 vs 2.2), CRP (5.3 vs 3.3), & VAS pain (41 vs 32) https://t.co/DI6owL5dof
Dr. John Cush @RheumNow( View Tweet )
Norwegian RevNatus Pregnancy study on 417 births in 350 women w/ axSpA: 86% (347) were breastfeeding @6wks, 70% @6mos, & 38% @12 mos. Non-breastfeeders more likely to have C-section (41 vs 20%), higher ASDAS-CRP (2.6 vs 2.2), CRP (5.3 vs 3.3), & VAS pain (41 vs 32) https://t.co/GhLtLqT0iS
Dr. John Cush @RheumNow( View Tweet )
2025 BSR Guideline for Treatment of Axial Spondyloarthritis
The British Society of Rheumatology has published its 2025 Guidelines for the Treatment of Axial Spondyloarthritis (axSpA); addressing axial and extra-musculoskeletal manifestations including acute anterior uveitis, https://t.co/IRdxsZTFdC
Dr. John Cush @RheumNow( View Tweet )
IL-17 inhibitors increase risk of IBD. TriNetX database study of PsO & AS pts starting IL-17i vs apremilast. 13,216 matched pts per group, 142 developed IBD w/ IL-17i vs. 60 with apremilast (aHR = 2.50, 95% CI: 1.85–3.39). https://t.co/sSPqKsfbZ4 https://t.co/YCqDUzX9xq
Dr. John Cush @RheumNow( View Tweet )
2025 BSR Guideline for Treatment of Axial Spondyloarthritis
The British Society of Rheumatology has published its 2025 Guidelines for the Treatment of Axial Spondyloarthritis (axSpA); addressing axial and extra-musculoskeletal manifestations including acute anterior uveitis, psoriasis and IBD. They address the effectiveness and safety of
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Osteoarthritis Risky Business (4.18.2025)
Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com. Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.
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Full read state of the art review of treatments for Axial Spondyloarthritis
Concluding unmet needs:
-Suboptimal Tx Response
- Limited Drug Options
- No Biomarkers
- Extra-Axial Dz
- Non-Inflammatory Pain https://t.co/K3oqRCgTCP https://t.co/rkX2givwF8
Dr. John Cush @RheumNow( View Tweet )
🚨 New publication alert!
We review the latest advances in imaging for axial spondyloarthritis—from high-res MRI and synthetic CT to deep learning algorithms improving lesion detection.
🔗 https://t.co/oddjoFOGzM
#AxSpA #AIinMedicine
@XBaraliakos @WalterMaks @krystelaouad https://t.co/VwuUwYL1Xs
Links:
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Full read state of the art review of treatments for Axial Spondyloarthritis
Concluding unmet needs:
-Suboptimal Tx Response
- Limited Drug Options
- No Biomarkers
- Extra-Axial Dz
- Non-Inflammatory Pain https://t.co/K3oqRCgTCP https://t.co/IPn09jMFM2
Dr. John Cush @RheumNow( View Tweet )
2nd Opinions in Rheumatology
https://t.co/R4CjJHEaL4 https://t.co/0quDwdANyU
Dr. John Cush @RheumNow( View Tweet )
Summary of the updated BSR Axial Spondyloarthritis for biological and targeted synthetic DMARD guidelines 2025 @RheumatologyUK #axialspondyloarthritis
Full paper available at:
https://t.co/LytDiHjawi https://t.co/iaHzD1BQRe
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
In our latest episode, @deodhara takes us behind the scenes of his research on IV secukinumab in #AxSpA. Discover key findings from the INVIGORATE-1 study, how it’s shaping treatment options, & what’s next in AxSpA research. LISTEN NOW → https://t.co/2IBixQSdpO @ACR_Journals https://t.co/HzcJw0pzWI
Links:
American College of Rheumatology @ACRheum( View Tweet )
Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis
A prospective French study of rheumatoid arthritis (RA) or spondyloarthritis (SpA) patients showed that most maintained stable disease activity during pregnancy, but over one-third flared and https://t.co/MaWx6AZ0JF
Dr. John Cush @RheumNow( View Tweet )
Rheums! Have a rheumatology question or case for Dr.Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/VkPL7thzo8 https://t.co/h85iF6tIVk
Dr. John Cush @RheumNow( View Tweet )
Cancer Survival with TNF Inhibitors (3.28.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com
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Treating chronic inflammatory diseases with JAK inhibitors
Science Daily
Janus kinase inhibitors (JAKis) are an important treatment option for people with chronic inflammatory diseases such as rheumatoid arthritis, psoriasis, Crohn's disease or ulcerative colitis. Since their approval, the indications for these medical
Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis
A prospective French study of rheumatoid arthritis (RA) or spondyloarthritis (SpA) patients showed that most maintained stable disease activity during pregnancy, but over one-third flared and https://t.co/3k6ZJTybAb
Dr. John Cush @RheumNow( View Tweet )
Post hoc analysis of 5 ph III Belimumab RCTs (BLISS, etc, N=3086) on skin outcomes BILAG & SLEDAI-2K), BEL was superior to PBO (mcBILAG OR: 1.29; mcSLEDAI-2K OR: 1.37). Also if SLEDAI ≥10 & dsDNA+ pts. BEL prevented skin flares (HR 0.70) https://t.co/p1MVVf97Go https://t.co/qwWUyegpyi
Dr. John Cush @RheumNow( View Tweet )
Autoimmune Disease Impact Report
Integrated Benefit Institute, a nonprofit independent research organization, has published its 2025 Autoimmune Disease Impact Report, which examines the health and productivity impacts of five prevalent and costly autoimmune conditions: rheumatoid arthritis, multiple sclerosis,
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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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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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