Anti-Rheumatic Rx

STOP-RA: Hydroxychloroquine Fails in ACPA+ Arthralgia Deane et al has published the results of the STOP-RA trial, demonstrating that 12 months of hydroxychloroquine (HCQ) did not prevent the development of clinical RA at 36 months. https://t.co/HLLhwgcVrS https://t.co/MKpeXhVdoe

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Dr. John Cush @RheumNow( View Tweet )
GLP-1.injx

GLP-1 drugs cost-effective for knee osteoarthritis and obesity

EurekAlert!

A new study led by investigators at Mass General Brigham finds that adding novel weight loss GLP-1 drugs semaglutide and tirzepatide to usual care represents a cost-effective treatment strategy for people with knee osteoarthritis and obesity, with tirzepatide providing greater health benefits at

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Study of 43 PsA pts starting bDMARD shows Calprotectin was elevated in PsA, decreased w/ biologics, but had no signif correlation w/ US synovitis. Baseline calprotectin, S100A12, IL-6, IL-17A, IL-23, CXCL10 were high. Calprotectin, S100A12, IL-6 decreased w/ Rx (p < 0.05).

Dr. John Cush @RheumNow( View Tweet )

GCs have potent anti-inflammatory effects but it’s long term complications can be catastrophic. In SLE pts, it shows a 3-fold increased risk of organ damage for each addtl 1mg of Pred/day. 📌Aim for short duration of use with lowest effective dose @RheumNow #APLAR25 https://t.co/UugrcX073Z

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sheila @RHEUMarampa( View Tweet )
JAK Janus

Equal Safety of JAK Inhibitors and TNF Inhibitors

Jack Cush, MD

JAMA has published a systematic review and meta-analysis of head-to-head studies showing there was no meaningful difference in safety events observed when taking either JAK inhibitor (JAKi) vs TNF antagonist (TNFi) therapies for the treatment of immune-

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Target trial emulation looked at CV (MACE) events in 18,120 propensity score–matched adults with gout starting allopurinol who were given NSAIDs or colchicine for prophylaxis. MACE & CV death were signif. higher w/ NSAIDs vs Colchicine (HRs of 1.56 and 2.50), respectively. https://t.co/0T8slmPBng
Dr. John Cush @RheumNow( View Tweet )
SMART study - Single vs. Split Dose Methotrexate in RA Split dose weekly, oral methotrexate (MTX) was shown to be superior to single dose MTX in treating active rheumatoid arthritis (RA) patients. https://t.co/JN5wPGNjao https://t.co/lizsrtVHwf

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Dr. John Cush @RheumNow( View Tweet )
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STOP-RA: Hydroxychloroquine Fails in ACPA+ Arthralgia

Jack Cush, MD

Deane et al has published the results of the STOP-RA trial, demonstrating that 12 months of hydroxychloroquine (HCQ) did not prevent the development of clinical RA at 36 months. 

The fate of Individuals elevated anti-cyclic citrullinated peptide (anti-CCP) antibodies and

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Different B cells depletion strategies in SARDs highlighted by Georg Schett From low and short lived depletion achieved w/ drugs to sustained deep tissular depletion with CAR T cells leading to potential immune reset @RheumNow #APLAR25 https://t.co/t35lrzEomF

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Aurelie Najm @AurelieRheumo( View Tweet )
STOP-RA results published in A&R. 144 at risk, CCP+ pts were enrolled to received HCQ vs PBO for 12 mos, w/ 24 mos F/U. Progression to RA seen in 30.4% on HCQ vs 32.9% on PBO (NS; P=0.52). Also IA, Jt Sxs, severity & adverse events were similar between groups.

Dr. John Cush @RheumNow( View Tweet )

AbbVie's US patent protection for Rinvoq (upadacitinib) will run till April 2037. SEC filing shows AbbVie has reached an agreement with generic manufacturers challenging Rinvoq patents. UPA is their 2nd leading product with nearly $3.75 billion worldwide sales in 1st 1/2 of

Dr. John Cush @RheumNow( View Tweet )

Target

Hitting the Target: T2T Therapy in SLE

Sheila Reyes, MD

Treat-to-target strategies are not a new concept in rheumatology. It has shown to improve patient outcomes and quality of life in RA and PsA, and is now being increasingly adopted not only in SLE research but also in clinical practice. This article reviews key highlights from Dr. Eric Morand’s

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Antifibrotics - A New Class of Therapies in Rheumatology? Rheumatologists typically manage systemic autoimmune rheumatic diseases (SARD) and associated interstitial lung disease (ILD) with immunosuppressants. However, evidence increasingly supports also the use of antifibrotic https://t.co/IobQagC0ZE
Dr. John Cush @RheumNow( View Tweet )
RheumNow Podcast square

RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are there benefits to diet or vegan diets? What's the effect of menopause on CTD?  Ro52 makes a big entrance with all our ILD coverage this month.

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MTX.box

SMART study - Single vs. Split Dose Methotrexate in RA

Jack Cush, MD

Split dose weekly, oral methotrexate (MTX) was shown to be superior to single dose MTX in treating active rheumatoid arthritis (RA) patients.

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Regional Disparities in DMARD Management for RA Treatment Dr. Aurelie Najm, Glasgow, reports on a session on "Updates on DMARDs treatment: global standards and regional adaptations" from the APLAR 2025 Congress in Fukuoka, Japan. https://t.co/zDo5NxKtbE https://t.co/kF9FxyWkIQ

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Dr. John Cush @RheumNow( View Tweet )
COLCHICORT Trial The COLCHICORT trial in acute calcium pyrophosphate (CPP) crystal arthritis patients showed that colchicine was inferior to prednisone treatment and that responses were also influenced by other factors. https://t.co/CC2yVRXbD5 https://t.co/ebLa3FUbGR

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Dr. John Cush @RheumNow( View Tweet )
This slide reflects the rheumatologist’s goals for treating #lupus Prof. Mosca also highlights the fact that achieving targets is as important as maintaining these treatment targets. @RheumNow #APLAR25 https://t.co/u8fw3fThXI

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sheila @RHEUMarampa( View Tweet )
Optimizing outcomes of pregnancy in #lupus: 📌 all patients should undergo preconception counselling 📌 close monitoring by a multidisciplinary team - a ⬇️ cerebroplacental ratio reflects placental dysfunction #APLAR25 @RheumNow @rheumarhyme https://t.co/RSyqgpRTG5

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sheila @RHEUMarampa( View Tweet )
Study of 111 TAKayasu arteritis pts Rx w/ 74 MMF+MTX vs 37 CYC/AZA. Response rates at 28 & 52 weeks were 58.1% and 55.4% in the MMF+MTX group, respectively, higher than 32.4% at both time points in the CYC/AZA group. https://t.co/wqlOLH0VEA https://t.co/nbLvcyYkbn

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Dr. John Cush @RheumNow( View Tweet )
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ERS/EULAR guidelines for CTD-related interstitial lung disease

Jack Cush, MD

The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in

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KNee.calcinosis.inflammatin

COLCHICORT Trial

Jack Cush, MD

The COLCHICORT trial in acute calcium pyrophosphate (CPP) crystal arthritis patients showed that colchicine was inferior to prednisone treatment and that responses were also influenced by other factors.

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Prof Takeuchi on DMARDs treatment and regional disparities For similar dose, serum concentration of the polyglutamate (active) form of MTX is much higher in Japanese than US patients And also high levels achieved much quicker in Japanese than US patients This is strong https://t.co/ikp63wWifj

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Aurelie Najm @AurelieRheumo( View Tweet )
Abatacept and Methotrexate may Lower Risk of Interstitial Lung Disease in RA A post hoc, pooled analysis of of rheumatoid arthritis (RA) clinical trials shows those received abatacept had a lower rate of Interstitial lung disease (ILD). https://t.co/3AISriCUeC https://t.co/nN03e4ZBDU

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Dr. John Cush @RheumNow( View Tweet )
One of the most impt updates recommended to add a bDMARD if tx target is not achieved by the 1st csDMARD (no more prognostic stratification) But, accdg to Dr. Smolen, adding a 2nd csDMARD should still be considered especially in resource-limited countries. @RheumNow #APLAR25 https://t.co/ZQiviGcrYp

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sheila @RHEUMarampa( View Tweet )

Recent Blogs

CNS Lupus (NPSLE)

Jack Cush, MD
Cush RhTh CNS
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose? Read Post

Hydroxychloroquine for Everyone

Jack Cush, MD
ra.hands2_.JPG
Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit. Read Post
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