Anti-Rheumatic Rx

Allopurinol - severe allergic reactions are estimated at 0.4%-2%, rising to 8–18% in patients with chronic kidney disease. Being HLA-B*58:01 (+) dramatically increases risk (OR 117). For more gout content, follow our Gout: More than Flares campaign at https://t.co/lQoiFjubZJ, https://t.co/fTuc4lYvJz

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Dr. John Cush @RheumNow( View Tweet )
Gout master class @RheumNow Upgrading & Maximizing the Classics (Colchicine, Allopurinol, etc.) https://t.co/yvSkULQlyR via @YouTube

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Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )

2 Still's dz cohorts (96 Shanghai, 28 Erlangen0 compared response to biolgics vs DMARDs (MTX, CNI,JAKi). in 124 AOSD pts, biologic had more sustained event-free remission and event-free state (P 0.0065, P 0.0096) & more steroid D/C vs MTX/CNI (p < 0.05). https://t.co/lJaI9nhPYr

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Dr. John Cush @RheumNow( View Tweet )

From 2015-2024, 148 inflam arthritis pts (43 SpA, 35 PsA, 50 RA) w/ a prior cancer were followed 58.1 mos. 24 (19%) had CA recurrence/progression. Post-CA exposure to b/ts-DMARDs did not incr. recurrence risk after adjusting for age & comorbidity burden. https://t.co/MHKIqwyjNN https://t.co/uhOdq1cCPW

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Dr. John Cush @RheumNow( View Tweet )
RHEUM SURVEY Q: Which gout drug has the greatest toxicity risk? Answer here>> https://t.co/EQrEjD9237

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Dr. John Cush @RheumNow( View Tweet )

SGLT2i use in gout reduces use of gout meds. Study of 26,739 gout pts w/ NIDDM (mean 66 yrs), 67% w/ polypharmacy. SGLT2i (vs DPP-4i) user had less Allopurinol starts (HR 0.62;0.52–0.73), also lower use of steroids (,78), NSAID (.85), colchicine (.87) & diuretics (.87) https://t.co/1dW27YzSvg
Dr. John Cush @RheumNow( View Tweet )
Chondrocalcinosis

Expert Perspective on Calcium Pyrophosphate Deposition Disease

Jack Cush, MD

A recent perspective by Tedeschi tackles many unresolved issues around CPPD diagnosis, classification, and management, including the lack of clinical trials or FDA approved treatments.

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Gout pills injection

Pragmatism in Gout: How therapeutic choices can have multiple benefits

Michael Toprover, MD

William James famously wrote in Pragmatism, “There can be no difference anywhere that doesn’t make a difference elsewhere.” Gout treatment offers a striking medical example of that idea. Drugs prescribed to calm flares or lower uric acid are designed with one primary goal in

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Tomorrow! Registration is still open! Time-tested gout therapies remain the cornerstone of care, optimizing their use requires thoughtful, patient-specific decision making. Join our expert faculty for Upgrading & Maximizing the Classics where they'll explore practical https://t.co/ZN0vcVjUex
Dr. John Cush @RheumNow( View Tweet )
Fatigue, FM, fibromyalgia

Fibromyalgia: Diagnosis and Management

Jack Cush, MD

Fibromyalgia (FM) affects 4–6% of the U.S. population, with nearly a 2 fold female predominance. Nociplastic pain underlies the pathophysiology of FM. CNS hypersensitization to both painful and non-painful stimuli occurs with little or no tissue pathology. Framing FM as a disorder of CNS

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QD Clinic: Allopurinol for All Gout? Not Quite Dr. Brian Jaros, Chicago, discusses the use of allopurinol. https://t.co/XENBDqZ2Z6 https://t.co/KFTZwuYVLI

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Dr. John Cush @RheumNow( View Tweet )
EULAR meeting room

Psoriatic Arthritis: EULAR 2026 Recap

Jack Cush, MD

Years of IL-17 vs. IL-23 debate in PsA finally got tested head-to-head: bimekizumab outperformed risankizumab on joint outcomes in the BE BOLD trial, while a GLP-1 combination study suggests weight and metabolic status are active drivers of PsA — not just comorbidities. This recap also digs into

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Seronegative RA Disease Activity (7.17.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and Gout features from this past week on RheumNow.com.

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Four Things About Allopurinol Hypersensitivity Syndrome Dr. Robert Terkeltaub discusses allopurinol hypersensitivity syndrome in gout patients. https://t.co/5seiyfVLW1 https://t.co/0A1Rtk9hzS

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Dr. John Cush @RheumNow( View Tweet )
ARTIC trial enrolled 234 DMARD naive RA (<2yrs) pts; 15.4% (36) were seronegative (SNRA). @enrollment SNRA worse than SPRA(+) w/ higher SJC (17 vs 8, p<0.001), DAS28 (3.9 vs 3.4, p=0.03), US scores (55 vs 25, p<0.001), MD global (49 vs 39, p=0.006). No diff in Sharp score, https://t.co/xDxQKY8ZG2
Dr. John Cush @RheumNow( View Tweet )
Intl consortium (10 EU countries) of 3952 RA pts, 184 MACE events seen 1985-2012. MACE risk signif assoc w/ DAS28 (HR 1.18;1.03-1.35), but NOT RF (HR 1.26; 0.82 to 1.94) or ACPA (HR 1.25; 0.85 to 1.83). RA activity assoc w/ MACE seen in seronegative and double positive https://t.co/RGO5IAM5oL
Dr. John Cush @RheumNow( View Tweet )
Glucocorticoid use in 1st yr of 574 newly DX RA cases-- 75% recv GC in 1st yr; 313 (55%) Rx at 1st visit. (m GC dose =9.3 mg/day. 1/2 (47%) recv IA GC injx. 20% had 1st yr infx. Risk of infx was NS (RR 1.13; 0.77 to 1.67) for 0-10 mg/d vs no GC https://t.co/s9YaGZsUjr https://t.co/ESHvVK1Egx

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Dr. John Cush @RheumNow( View Tweet )
vitamins.png

ACP Position Paper on Dietary Supplements

Jack Cush, MD

More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives. The paper notes that under DSHEA, dietary

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In 2010 Colchicine fell under patent protection and price increased 16 fold, & out-of-pocket price increased 4.4-fold, colchicine use decreased 27%, while allopurinol, steroid & gout visits (ER, Rheum) increased. https://t.co/xyOxsnoM5z https://t.co/yoXehV0mPa

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Dr. John Cush @RheumNow( View Tweet )
Premenopausal women can get gout, if they are post-transplant, taking cyclosporin or tacrolimus. For more gout content, follow our Gout: More than Flares campaign at https://t.co/lQoiFjubZJ, https://t.co/kawSlJ2tb6

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Dr. John Cush @RheumNow( View Tweet )
RZV (Shingrix) response in 76 immunosuppressed SSc & 304 controls (CG) recv two RZV doses. High seroconversion seen in SSc but signif lower than CG (92.6% vs 99.7%, P 0.001), w/ lower concentration but comparable CMI, lower AE (74% vs 86%) https://t.co/ALlnVEZIAt https://t.co/kYYy2JIo2J

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Dr. John Cush @RheumNow( View Tweet )
20 yr. Tx trends in 6583 #SSc pts. 2005 to 2025 endothelin receptor antagonists & prostanoids/prostacyclins from 3% to 28%. CCB & PDE-5 inh stable. CTX shifted to mycophenolate, RTX, & nintedanib. Steriods decr from 50% to 18% https://t.co/nrm1Ov285f https://t.co/ftLn3bGH72

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Dr. John Cush @RheumNow( View Tweet )
DMARD Efficacy in RA-ILD A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional,

Dr. John Cush @RheumNow( View Tweet )

FDA Delays Gout Drug NASP with Complete Response Letter On June 26, 2026, SOBI received a Complete Response Letter (CRL) from the U.S. Food and Drug Administration (FDA) that will delay a decision on NASP, pending the company's answer to questions regarding the drugs https://t.co/NmPbWmYd0p
Dr. John Cush @RheumNow( View Tweet )
Non-gout drugs that may lower uric acid – losartan, amlodipine, ACE inhibitors, fenofibrate, atorvastatin, leflunomide, vitamin C, estrogen, and high-dose ASA. For more gout content, follow our Gout: More than Flares campaign at https://t.co/xnBVBN5IXZ, https://t.co/vmNvqojAcS

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Dr. John Cush @RheumNow( View Tweet )

Therapeutic Updates

Lupus Nephritis

Sponsored by RheumNow
Management of CKD in Lupus Nephritis Patients
View our six video perspectives on lupus nephritis, including Management of CKD in Lupus Nephritis.
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EXXELERATE: New Thoughts on High RF Titer

UCB RX Update MARCH
Two leading rheumatologists share insights into why RF levels are important to consider when identifying treatment options for patients with RA.
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Recent Blogs

ICYMI: Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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Advanced Practice Rheum

Gout

Jack Cush, MD
APR video gout cover

Dr. Jack Cush reviews Gout in this continuing series for Advanced Practice Rheum. Review the companion slide deck here.

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Advanced Practice Rheum

Systemic Lupus Erythematosus

Jack Cush, MD
APR SLE VIDEO COVER
Dr. Cush reviews systemic lupus erythematosus.
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Podcasts

  • RA Topic Podcast compilation
  • PsA Topic Podcast compilation
  • EULAR 2026 Daily Podcast Day 4a
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