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Anti-Rheumatic Rx

New Avacopan Analysis Sent to FDA

MedPage Today

After data manipulation allegations, the FDA has been calling for the vasculitis drug to be pulled from the market since January.

Amgen has submitted a third-party review of avacopan's (Tavneos) pivotal trial data and other analyses to the FDA in a bid to keep the embattled drug for

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3 Rx are FDA approved for hidradenitis supprativa (secukinumab, adalimumab, bimekizumab). New JAK1i Povorcitinib in STOP-HS1 and STOP-HS2 ph 3 PCTs (608/619 pts). Povo showed HiSCR50 ~42% vs PBO 29% @wk12. AE: acne, pharyngitis https://t.co/n3FJUOjNuo https://t.co/9YAmPqW44z
Dr. John Cush @RheumNow( View Tweet )

Tips for safe use of allopurinol

These are tips and hopefully the patients are abstaining from moderate alcohol and are not tipsy! Here are 5 tips that may not be totally obvious.

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$2 Million in Research Grants for Juvenile Arthritis

July is Juvenile Arthritis Awareness Month, and while many people think of arthritis as a disease of aging, nearly 300,000 children in the U.S. are living with a rheumatic disease.

Equally important is that 2026 marks a 50 year anniversary for Pediatric

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Pragmatism in Gout: How therapeutic choices can have multiple benefits Drugs prescribed to calm flares or lower uric acid are designed with one primary goal in mind, yet many also produce meaningful effects beyond the joints. Some of those secondary effects are unwelcome; such https://t.co/QvXAwFM7LJ
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Retrospective study of 2187 RA pts initiating menopausal hormone Tx (MHT) vs 8,205 unexposed controls. VTE incidence higher among MHT users (6.49 vs 3.3/1000PY). MHT use was associated with a 92% signif increased risk of VTE in RA (adj HR: 1.92), mostly DVT risk (aHR: 2.26)

Dr. John Cush @RheumNow( View Tweet )

Genetic Risk Loci in Fibromyalgia

Researchers examined genetic data drawn from 11 different worldwide cohorts, that included from more than 2.5 million adults, of which 55,000 had been diagnosed with fibromyalgia. They identified DNA sequence variants in 26 regions of the genome that affect the risk of developing fibromyalgia.

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Uricase-Targeted Therapies in Gout

In most mammals, uricase catalyzes the oxidation of uric acid to allantoin, a highly soluble compound easily excreted by the kidneys. But humans lack functional uricase, leaving xanthine oxidase inhibitors (allopurinol/febuxostat) as first-line urate-lowering therapy (ULT). Uricase-based

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The Wider Implications of Dactylitis

Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis. This review article discusses the wider implications of dactylitis in rheumatology and medicine underscores the

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UTSW observational study of labs (n 14,199) changes w/ MTX use in 2,439 pts (13% RA, 11% PsO/PsA, 15% inflam arthritis) - found no difference in labs q3 vs q6 mos. No signif correlation betw monitoring intervals & changes in ALT, AST,WBC, HCT, MCV, PLT, FIB-4. Small https://t.co/gKwA7juexG
Dr. John Cush @RheumNow( View Tweet )

When Gout Flares, So Does the Cardiovascular System

We have spent decades teaching that a gout flare is a joint problem: a hot, swollen, painful joint that we treat with anti-inflammatory drugs and move on from (i.e., the treat to avoid symptoms strategy). The campaign title says it well — gout is more than flares. I would add

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Expert Perspective on Calcium Pyrophosphate Deposition Disease A current perspective article by Dr. Sara Tedeschi tackles many unresolved issues around CPPD diagnosis, classification, and management, including the lack of clinical trials or FDA approved treatments. https://t.co/zxJ9aQweNl
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Pragmatism in Gout: How therapeutic choices can have multiple benefits 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. https://t.co/DG29pro6XE
Dr. John Cush @RheumNow( View Tweet )

Chikungunya Club Meeting (7.24.2026)

Dr. Jack Cush reviews the news, journal reports from the past week on RheumNow.com.

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Swimming Reduces Disability from Low Back Pain

EurekAlert!

Swimming is commonly recommended for patients with chronic low back pain. Yet, there is little trial data investigating swimming. An Australian study has shown for the first time that a program of swimming can be clinically effective in reducing disability from chronic low back pain

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EUSTAR scleroderma substudy propensity matched pts Rx w/ JAKi (n 38) vs 180 pts ea Rx w/ MMF, MTX, RTX. 1/3 had dcSSc. 23 AEs in 997 Pt-yrs. JAKi outcomes similar to comparators. JAKi Tx D/C in 39%, FVC stable, skin fibrosis improved (mRSS −1.8) & SJC decreased. No new

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The Lancet Rheumatology has a good editorial about the avacopan bad news reports with EMA, FDA and Japan issuing negative opinions that threaten the drugs future. Yet, since approval real world data on avacopan has been favorable w/ less steroid toxicity & most hepatotoxicity https://t.co/k6ebVeWv2K
Dr. John Cush @RheumNow( View Tweet )

Interferon-α as an Immunologic Driver of Sjögren's Disease

Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and
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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
Dr. John Cush @RheumNow( View Tweet )
Psoriatic Arthritis: EULAR 2026 Recap https://t.co/tBMu4CEn0o https://t.co/iztShOHxOf
Dr. John Cush @RheumNow( View Tweet )
Gout master class @RheumNow Upgrading & Maximizing the Classics (Colchicine, Allopurinol, etc.) https://t.co/yvSkULQlyR via @YouTube

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

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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RHEUM SURVEY Q: Which gout drug has the greatest toxicity risk? Answer here>> https://t.co/EQrEjD9237

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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 )
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