Doubting RS3PE (8.14.2026)
Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.
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Survey: Upgrading & Maximizing the Classics (Urate Lowering Therapies, etc)
https://t.co/w6uzIlaeG7 https://t.co/HW09DVrMed
Dr. John Cush @RheumNow( View Tweet )
ZEUS Trial: IL-6 Inhibition Fails to Cut Cardiovascular Events
The phase 3 ZEUS trial (published in JAMA Dec. 2025) tested the IL-6 ligand inhibitor ziltivekimab in over 6,000 patients with atherosclerotic cardiovascular disease, chronic kidney disease, and elevated hsCRP—a population enriched for an inflammatory driver of risk.
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2026 BSR Pain Guideline: What Rheumatologists Need to Know
The British Society for Rheumatology has issued its first guideline dedicated solely to pain in inflammatory arthritis (IA)—covering RA, PsA, axial SpA and JIA.
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Substudy of 131 Still’s dz pts from the Autoinflammatory Dz (AIDA) registry. 38% underdosed w/ canakinumab (CAN) vs 62% appropriately dosed (300 mg q4wks or 4 mg/kg). Underdosed CAN had lower odds of long-term remission & D/C CAN (3.9% vs 19%) https://t.co/l94zB9NkKv https://t.co/D8FNUXS0nv
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CDC warns of an association betw severe CNS arboviral disease, w/ neurologic sequelae in pts receiving anti-CD20 mAbs (rituximab, ocrelizumab, ofatumumab, obinutuzumab, etc). West Nile virus was the most common arbovirus, but there are others; mortality up to 40%. Most arbovirus https://t.co/WWg41fsRgr
Dr. John Cush @RheumNow( View Tweet )
Evaluating Inflammatory Joint Pain in Older Adults
Lee, Levinson, and Makris have published an approach to evaluating inflammatory joint pain in older adults in JAMA Internal Medicine. While intended to be a practical guide for primary care clinicians, the tenets and clues ring true for all.
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Wealth and Where you Live Influences Outcomes
EurekAlert!
Patients from wealthier European countries tend to start treatment with biologics earlier but also stop or switch treatment earlier. They also experience lower disease activity at treatment start than patients in middle- and low-income countries.
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What's New in Lyme Disease
JAMA has published an overview of new considerations on Lyme disease, focusing on Diagnostics, Vaccines, and Prevention.
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POETYK PsA-1: Deucravacitinib in Biologic-Naïve PsA
POETYK PsA-1 trial tested the disease modifying efficacy of deucravacitinib, a tyrosine kinase 2 (TYK2) inhibitor, in psoriatic arthritis (PsA) patients and was shown to be superior vs to placebo for clinical responses, patient-reported outcomes, and structural damage inhibition in PsA.
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Rethinking Treatment of EGPA
Like MPA & GPA, the goals of EGPA are controlling initial organ damage and preventing relapse. But EGPA has the added challenge of chronic upper and lower respiratory tract involvement, allergic type 2 inflammations and risk of glucocorticoid https://t.co/KIVpyhsghg
Dr. John Cush @RheumNow( View Tweet )
Best proof of difference betw Seropos vs seroneg RA from TREAT-EARLIER 12 mos study 236 clinically suspect arthralgia pts w/ subclinical Jt inflammation Rx w/ MTX vs PBO. MTX prevented RA only the seroneg RA (9 v 35%); But no protection in seropos RA (58 vs 65%) https://t.co/ufY9ZJmKgf
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In a Cohort of 410 #SLE pts, there were 37 MALES who demonstrated a high prevalence of renal (IV/V lupus nephritis 49%) and a notable incidence of Plaquenil-related retinal toxicity. 62% on HCQ, but 22% D/C HCQ due to retinal toxicity or drug intolerance. https://t.co/VISwHO1wcK https://t.co/6SoD6mD5tf
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Mentshlichkeit* (8.7.2026)
Dr. Jack Cush reviews the news and recent journal reports on RheumNow.com.
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Cassi Calabrese @CCalabreseDO easy overview of vaccinating IMID pts. Vaccinating IMID pts. Stresses risk-based approach: RZV for all JAK-i/anifrolumab pts regardless of age; time COVID vax around rituximab; annual flu + PCV20/21 for all immunosuppressed; RSV ≥75 or younger w/ https://t.co/AHykuqJn2N
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Rethinking Treatment of EGPA
Eosinophilic granulomatosis with polyangiitis (EGPA) has long been managed by extrapolating results from microscopic polyangiitis and granulomatosis with polyangiitis clinical trials. But new insights into EGPA's has lead to advances in therapy and new treatment paradigms.
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U Alberta Rheumatology study of GCAPS score in 62 new onset, suspected GCA referrals. GCA Dx in 39 pts excluded in 23. 50% had a High risk GCAPS (screening) score, 38% Intermediate & 13% had Low risk GCAPs. Intermediate or High risk GCAPS sensitivity 97%, specificity 30%, PPV 70% https://t.co/HxHL60VAuO
Dr. John Cush @RheumNow( View Tweet )
In a Cohort of 410 #SLE pts, there were 37 MALES who demonstrated a high prevalence of renal (IV/V lupus nephritis 49%) and a notable incidence of Plaquenil-related retinal toxicity. 62% on HCQ, but 22% D/C HCQ due to retinal toxicity or drug intolerance. https://t.co/FcIFxRoZ6O https://t.co/7OgexLYWge
Dr. John Cush @RheumNow( View Tweet )
Keep HCQ Blood Levels Up to Avoid Cardiovascular Disease in Lupus
MedPage Today
People taking hydroxychloroquine (HCQ) for systemic lupus erythematosus (SLE) showed markedly increased risk for atherosclerotic cardiovascular disease when blood levels of the drug were low and when long-term adherence was poor, a prospective study showed.
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A Tribute to Daniel L. Kastner, MD, PhD (1951–2026)
The rheumatology, genetics and NIH communities mourn for Dr. Daniel L. Kastner, who died on July 28, 2026, in Bethesda, Maryland, at age 74. The following are declarations, tributes, and memories dedicated to this mensch of a man, titan of science, memorable mentor and humble physician.
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New Avacopan Analysis Sent to FDA
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 https://t.co/TdLWRMPvnR
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Tips for safe use of allopurinol
https://t.co/Yn1u1bEj4F https://t.co/lMWPI9OsVe
Dr. John Cush @RheumNow( View Tweet )
Arrhythmias in Autoimmune Rheumatic Disease
A new review in the Journal of Cardiovascular Development and Disease (Tamirisa et al) synthesizes how systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis have an increased risk of arrhythmias and sudden cardiac death attributable to shared immune pathways.
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JAMA Review of Hip Fracture
The July 16th edition of JAMA reviews the highly prevalent problem of hip fractures - a major global health burden: 14.2 million occur worldwide annually (280,000 in the US), with global incidence higher in women (833.9/100,000) than men (510.0/100,000). Lifetime risk at age 50 is 22.9% for
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Lupus Nephritis
Sponsored by RheumNow
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
Sponsored by: UCB
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
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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Dr. Jack Cush reviews Gout in this continuing series for Advanced Practice Rheum. Review the companion slide deck here.
Podcasts
Systemic Burden of Gout Part 1
Better Gout Management-
Gout Advice & Tips
