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Anti-Rheumatic Rx

Opioids Down, Gabapentins Up The number of U.S. patients prescribed long-term opioid therapy declined from 2015 to 2023, but co-prescribing of opioids with gabapentinoids increased, prescription data showed. https://t.co/iXEUfR18Is https://t.co/6DCUvGAW6N
Dr. John Cush @RheumNow( View Tweet )
Potential new mechanism of MTX Effx - MTX polyglutamates accumulates in monocytes by D5, modulates transcriptional signature “non-classical monocyte”-assoc genes by Wk4, & predicts MTX responses https://t.co/g14GONKgvq https://t.co/oyoua9xAN4
Dr. John Cush @RheumNow( View Tweet )

Litifilimab in Cutaneous Lupus Erythematosus

Biogen has announced positive results of their Phase 2 study, evaluating litifilimab in patients with active cutaneous lupus erythematosus (CLE), presented at the recent American Academy of Dermatology (AAD) Annual Meeting.

Litifilimab is an investigational monoclonal antibody that

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Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/0JRd1k0R2R
Dr. John Cush @RheumNow( View Tweet )
Couldn’t attend https://t.co/4UQlqwujiR 2026? You can now watch the entire meeting On Demand. This high-impact program features leading experts discussing: • RA outcomes and pathogenesis • Obesity, inflammation, and rheumatic disease • Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3
Dr. John Cush @RheumNow( View Tweet )
Danish real-world study anifrolumab use in 36 #SLE pts. SLEDAI-2K decreased from 8 (baseline) to 2 @ mos 3; @6 mos 52% had SLEDAI-2K=0. 87% had PGA ≤0.5 w/ LLDAS, & 70% DORIS remission. Pred use declined by >50%. Herpes infx were most freq AE https://t.co/gNIAoXplMt https://t.co/D6xhQrY8ep
Dr. John Cush @RheumNow( View Tweet )
Advanced Practice Rheum: Methotrexate In this session, we're going to review methotrexate. It is the most popular of disease-modifying drugs used in rheumatology. While it may be indicated for a few disorders, it's widely used in many inflammatory and autoimmune disorders. https://t.co/RKh3mQv7Hx
Dr. John Cush @RheumNow( View Tweet )

Top Four and More (4.10.2026)

Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.

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Opioids Down, Gabapentins Up

The number of U.S. patients prescribed long-term opioid therapy declined from 2015 to 2023, but co-prescribing of opioids with gabapentinoids increased, prescription data showed.

In 2023, 4.2 million people had an active long-term opioid therapy episode, defined as a period of opioid

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Malignancies Not Increased with Biologic Therapies

The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo

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Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/Ljr5maHZcr
Dr. John Cush @RheumNow( View Tweet )

JAMA Guideline on the Management of Crohn Disease

JAMA has published a current Clinical Guidelines Synopsis on the Management of Crohn Disease (CD) in Adults.

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COMMON - Incidental Rotator Cuff Abnormalities on MRI

In this cross-sectional study of 602 Finnish adults undergoing bilateral shoulder magnetic resonance imaging (MRI) and clinical assessment, found abnormalities in nearly everyone over age 40yrs, regardless if asymptomatic or symptomatic.

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Predictors of Calcinosis Cutis in Systemic Sclerosis

Calcinosis cutis (CaC) is a common and disabling non-lethal manifestations in systemic sclerosis (SSc). This study used SSc patients from the EUSTAR database to clinically characterize patients and identify risk factors for CaC development.

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Danish real-world study anifrolumab use in 36 #SLE pts. SLEDAI-2K decreased from 8 (baseline) to 2 @ mos 3; @6 mos 52% had SLEDAI-2K=0. 87% had PGA ≤0.5 w/ LLDAS, & 70% DORIS remission. Pred use declined by >50%. Herpes infx were most freq AE https://t.co/tbMOyOioeU https://t.co/jDJgImjgQt
Dr. John Cush @RheumNow( View Tweet )
Open label RCT in 116 DMARD-naïve #RA pts Rx w/ tofacitinib or MTX (after 1 IM steroid injx). @3 mos, TOFA signif better than MTX for >50% SDAI improv(94 v 75%), CDAI[14.5 v 7.3), DAS28-CRP[1.7 v 1.2] https://t.co/smOuLlVFyX https://t.co/xGvbiu62OB
Dr. John Cush @RheumNow( View Tweet )
Japanese ANSWER study Rx 7268 RA pts initiating bDMARDs or JAKi by orthos or Rheums. Vs Rheums, Ortho Rx RA had longer Dz duration, more seropositivity, functional impairment, less comorbidity, more MTX/GC/TNFi, less AE D/Cs - responses & outcomes were similar https://t.co/1ryA8C2p1b
Dr. John Cush @RheumNow( View Tweet )

Updated CRA/SPARCC Recommendations for Axial Spondyloarthritis

In 2024, the Canadian Rheumatology Association (CMA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) published a comprehensive set of 56 treatment recommendations for the management of axial spondyloarthritis. This first update is focused on the reassessment of IL-17i

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FDA has issued a drug safety warning for avacopan (Tavneos), dentifying 76 cases of drug-induced liver injury, including 7 cases of rare vanishing bile duct syndrome (VBDS). There were 8 deaths https://t.co/2GkYNg1Apn https://t.co/fW2qafKCew
Dr. John Cush @RheumNow( View Tweet )
A new review of the GLP-1 receptor drugs @NEJM https://t.co/PK03jApZWB surprisingly, the word inflammation only appears once, in this diagram https://t.co/1PeBakBAQb
Eric Topol @EricTopol( View Tweet )

What’s New PsA? (4.3.2026)

Dr. Jack Cush reviews the news and major articles from this week, including FDA safety warnings, reports from AAD, PsA trials.

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Update on Primary CNS Angiitis

The Journal of Neurology has posted a review and update of Primary CNS vasculitis (PCNSV),  also termed primary angiitis of the CNS (PACNS). PCNSV is rare, potentially fatal, and highly treatable, making timely recognition and accurate diagnosis critical. 

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FDA has issued a drug safety warning for avacopan (Tavneos), dentifying 76 cases of drug-induced liver injury, including 7 cases of rare vanishing bile duct syndrome (VBDS). There were 8 deaths https://t.co/WkBhs1rNpf https://t.co/ZXdHsAJUOQ
Dr. John Cush @RheumNow( View Tweet )

FDA Safety Warning: Avacopan and Serious Liver Injury

Yesterday the FDA issued a Drug Safety Communication alerting patients and health care professionals about postmarketing identification of serious (drug induced) liver injury, including fatal cases, associated with the use of avacopan (Tavneos) in patients with ANCA- associated vasculitis.

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Review: Rheumatoid Arthritis–Associated Interstitial Lung Disease

RA-ILD represents the most severe extra-articular manifestation of rheumatoid arthritis, affecting an estimated 1% of the adult population in the US and Northern Europe. Prevalence estimates vary widely  (up to 58%), reflecting different diagnostic criteria, imaging modalities, and study

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