Reefer Madness (12.12.2025)
Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com. B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.
Read Article
Roche announced that the European Commission has approved obinutuzumab (Gazyvaro in EU/UK & Gazyva in US) in combination with mycophenolate mofetil for the treatment of adult patients with active Class III or IV, with or without concomitant Class V, lupus nephritis. https://t.co/usUidNVMNY
Dr. John Cush @RheumNow( View Tweet )
The countdown is on! ⏱️
Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one.
✅ Register now at https://t.co/4UQlqwujiR
🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu
Links:
Dr. John Cush @RheumNow( View Tweet )
Medical Cannabis for Pain Management
Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients.
Chronic pain affects more than one in five American adults, yet practitioners are limited in treatment alternatives. Even if we exclude the
Read Article
INITIAL Goal is to not miss Red Flag Conditions (Fx, septic or crystal arthritis [all acute monarticular})! Then provide timely Dx & Rx by establishing acute vs chronic, inflam vs noninflam, & articular vs nonarticular.
Dr. John Cush @RheumNow( View Tweet )
British Society of Rheumatology Guideline for Monitoring DMARDs
The British Society of Rheumatology has published an update to their previous 2017 BSR/BHPR guideline regarding the use and monitoring of DMARDs (disease-modifying anti-rheumatic drugs) used to treat systemic https://t.co/7KNf6cIjfo
Dr. John Cush @RheumNow( View Tweet )
I agree that multiple assessments are needed to Dx NP-SLE; but my order of preference (for Dx yield) is: A) Hx c/w cerebritis; B) imaging to r/o other causes; C) CSF IgG index w/ Q albumin
Dr. John Cush @RheumNow( View Tweet )
B Cell Targeting in Idiopathic Thrombocytopenic Purpura
EurekAlert!
The New England Journal of Medicine has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune
Read Article
GESPIC - German SpA study of 252 SpA (139 nr- axSpA, 113 r-axSpA), followed w/ serial Xrays and mSASS Scores over 2 yrs. 80% were on NSAIDs. Higher NSAID intake, particularly COX2i, on slowing radiographic progression in axSpA https://t.co/MfmzWwvtZx https://t.co/5Fe2AQgkN2
Dr. John Cush @RheumNow( View Tweet )
British Society of Rheumatology Guideline for Monitoring DMARDs
The British Society of Rheumatology has published an update to their previous 2017 BSR/BHPR guideline regarding the use and monitoring of DMARDs (disease-modifying anti-rheumatic drugs) used to treat systemic autoimmune rheumatic diseases (SARDs).
Read Article
APPs in the News (12.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.
Read Article
Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it?
Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) the data supporting its use is limited.
Read Article
DMARD Treatment Lags for Minority Groups with Rheumatoid Arthritis
MedPage Today
Use of disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) was markedly lower among all major racial-ethnic minority groups in the U.S. compared with white patients, analysis of federal survey data indicated, even after adjusting for income, education, and other factors
Read Article
High Cost of Cancelling Knee Replacement Surgery
Thousands of NHS knee replacement operations are cancelled at short notice every year, many for avoidable reasons, according to a new study published December 1st. This costs the NHS millions of pounds and increases waiting times for patients, many of whom are in severe pain.
Read Article
Taiwan Health Insurance study of 5749 #RA pts Rx w/ b/tsDMARD, followed >2.5 yrs - 268 (4.7%) had serious infx (1.3 SIE/100PYs); 51% pneumonia, 25% UTI, 10% TB). 60% had b/tsDMARDs dose reduction- not assoc w/ increase SIE (3.4% v 4.2%), but D/C increased SIE (35% v 26%) https://t.co/6J8rB3IyFR
Dr. John Cush @RheumNow( View Tweet )
Consensus Definitions on Difficult to Treat Psoriatic Arthritis
A substantial number of patients with psoriatic arthritis (PsA), have difficult, persistent and hard-to-treat disease. A GRAPPA task force has developed a consensus terminology for two distinct states: complex-to-manage PsA and treatment-refractory PsA.
Read Article
Hematologic Malignancies Increased in Systemic Sclerosis
Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.
Read Article
Taiwans insurance claims, Maternal Database, & BirthRegistry examined 42,493 births to fathers w/ autoimmune Dz, 14.3% exposed to immunosuppressants or biologics. MTX posed no risk, but Cyclosporin, AZA, JAKi may be assoc w/ adverse preg outcomes, but event #s small. https://t.co/6JXaZ2HdAF
Dr. John Cush @RheumNow( View Tweet )
Zantac is Back! Ranitidine has been off the market for 5yrs, withdrawn over concerns about N-nitrosodimethylamine (NDMA) impurity affecting shelf-life. The FDA has approved reformulated ranitidine tablets - the drug has the same prior efficacy and safety label. https://t.co/ktTz5EO2Ja
Dr. John Cush @RheumNow( View Tweet )
A New Disease Activity Score for Antiphospholipid Syndrome?
APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and https://t.co/G2xGtOPmwb
Dr. John Cush @RheumNow( View Tweet )
Turkey Tryptophan (11.28.2025)
Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
Read Article
Treating Refractory Still's Disease
A full read systematic review article examined treatment options for difficult to manage systemic juvenile idiopathic arthritis, or Still’s disease. It classified these refractory disease patients as those with either (1) persistent arthritis, (2) recurrent or difficult-to-treat
JAMA review of Peripheral Neuropathy - affects ~ 1% of adults worldwide and may cause sensory, motor, and autonomic Sxs. Diabetes is the most common cause. 1st line Rxs include gabapentin, pregabalin, duloxetine, amitriptyline. (FOR AMA MEMBERS) https://t.co/sof15I1GpU https://t.co/PN0KMeUsGA
Dr. John Cush @RheumNow( View Tweet )
Zantac is Back! Ranitidine has been off the market for 5yrs, withdrawn over concerns about N-nitrosodimethylamine (NDMA) impurity affecting shelf-life. The FDA has approved reformulated ranitidine tablets - the drug has the same prior efficacy and safety label. https://t.co/j655eiCvgf
Dr. John Cush @RheumNow( View Tweet )
Managing Perioperative DMARDs with Arthroplasty
Postoperative complications with arthroplasty may be related to chronic inflammation and immunosuppressive therapy. Yet a recent retrospective study total ankle arthroplasty in end-stage RA patients shows that early postoperative wound complications are unaffected by the continued use of their
Read ArticleRecent Blogs
