Anti-Rheumatic Rx

Effectiveness of IL-6 Receptor Inhibitors versus Methotrexate or any Conventional Immunomodulators in Patients with Steroid Refractory Polymyalgia Rheumatica Sponsored by Sanofi https://t.co/z6tqpblbOZ https://t.co/FxsMMbCFdX

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Dr. John Cush @RheumNow( View Tweet )
renal.adrenal.pills.steroid

Adrenal Dysfunction after Steroids in PMR and GCA Patients

Jack Cush, MD

JAMA has published a study of PMR and GCA patients who stopped glucocorticoid (GC) therapy and noted a low (1.2%) risk of GC-induced adrenal insufficiency after planned cessation.

GC are widespreadly and chronically used in rheumatology, often with the

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PAFLAR Guidelines for Polyarticular Juvenile Idiopathic Arthritis

Jack Cush, MD

The Pediatric African League against Rheumatism (PAFLAR) initiative has published its guidelines for the diagnosis and treatment of polyarticular juvenile idiopathic arthritis (pJIA

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Glucocorticoid Toxicity Index Dr. John Stone has led the effort to develop the GTI - glucocorticoid toxicity index. In this review article he acknowledges the need and benefit of steroids, but details a novel means to identify and limit the untoward effects of glucorticoids… https://t.co/xR8D4Jpjfv https://t.co/LyfHrbneTO
Dr. John Cush @RheumNow( View Tweet )
Comprehensive review of the management of knee osteoarthritis - topicals, analgesics, narcotics, intraarticular, metabolic, nutraceuticals, TENS, acupuncture and biologics. https://t.co/SEyG4IQ0bh https://t.co/f6UY4hEl18

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2024 Rheumatology Year in Review 2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians. https://t.co/XuEG8Hrc9e https://t.co/ja5OoZXdWo

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Stelara Biosimilar Steqeyma Launches at 85% Discount https://t.co/2ZR7LMq1JT https://t.co/coHj1jh8JB

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Mizoribine Effective in Lupus Nephritis

Jack Cush, MD

A randomized clinical trial has shown that oral mizoribine, a common immunosuppressant in Japan, was noninferior to intravenous cyclophosphamide (CTX) as induction therapy in patients with active lupus nephritis. 

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With GLP-1 agonists, is there a risk of aspiration during gen. anesthesia. Most advise against elective surgery/anesthesia unless the GLP-1 is held for 1-2 weeks. Based on MOA of delayed gastric emptying - 7/8 studies show Incr residual gastric contents in GLP-1, but none… https://t.co/BMeYVaBmIy https://t.co/DpTqKhb1Sg
Dr. John Cush @RheumNow( View Tweet )
Are Combination Biologics Safe? Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution. https://t.co/zcmo9mTRoS https://t.co/Q1lB0LvymF

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Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/aU8j4d6pei https://t.co/Ft99jwzPB3
Dr. John Cush @RheumNow( View Tweet )
Available the first time: https://t.co/4UQlqwujiR 2025 On Demand! On Demand gives you access to all lectures, Q & A panels, and STEP talks, and all speaker slides and handouts — all packed with insights you won’t find anywhere else. Non-CME, practical, and finally here.… https://t.co/qZb8OKjPpw https://t.co/Exr8u6QkNc

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cancer.cross_.jpg

Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs

Jack Cush, MD

A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (

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Earlier ACL reconstruction and a lower risk of knee osteoarthritis

EurekAlert!

A preclinical study by HSS investigators found that earlier anterior cruciate ligament (ACL) reconstruction led to lower immune cell activity, less inflammation and fewer joint changes associated with knee osteoarthritis compared to delayed surgery. The research team shared their study

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With GLP-1 agonists, is there a risk of aspiration during gen. anesthesia. Most advise against elective surgery/anesthesia unless the GLP-1 is held for 1-2 weeks. Based on MOA of delayed gastric emptying - 7/8 studies show Incr residual gastric contents in GLP-1, but none… https://t.co/U690OmeqJm https://t.co/Q6kyv9fyVJ
Dr. John Cush @RheumNow( View Tweet )
steroids.prednisone.pills_.jpg

Glucocorticoid Toxicity Index

Jack Cush, MD

Dr. John Stone has led the effort to develop the GTI - glucocorticoid toxicity index. In this review article he acknowledges the need and benefit of steroids, but details a novel means to identify and limit the untoward effects of glucorticoids (GC).

Read Article
2024.year.review

2024 Rheumatology Year in Review

Jack Cush, MD

2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians.  While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list

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Are Combination Biologics Safe? Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution. https://t.co/IEIi6kQI4b https://t.co/KVSbqeMbyA

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Dr. John Cush @RheumNow( View Tweet )
Hydroxychloro-King (3.7.2025) Dr. Jack Cush reviews the news, journal reports and regulatory actions from the past week on RheumNow. https://t.co/83ZAyrrgg3 https://t.co/63cIdP559y

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Dr. John Cush @RheumNow( View Tweet )
heart

Cardiovascular and Fracture Risk with Denosumab Versus Bisphosphonates in Dialysis Patients

Jack Cush, MD

Annals of Internal Medicine has published a  Japanese administrative claims database study showing that, compared with oral bisphosphonates (BIS), denosumab (DEN) lowered fracture risk by 45%, but increased the risk for major adverse
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Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/3Y2cOzt3TQ https://t.co/6f8yiwMqAa
Dr. John Cush @RheumNow( View Tweet )
Polypharmacy (>=5Rx) studied in 81 RA & 30 SLE pts. Polypharmacy incr at 2 yrs ~44% to ~73%. Med adherence >85%. Polypharmacy NOT assoc w/ Dz activity in SLE, but in RA did correlate w/ better DAS28CRP score at one year https://t.co/Jw05DIrBym https://t.co/pLIoDvPj8i

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Dr. John Cush @RheumNow( View Tweet )
syringe, pill, DMARD, Treatment, therapy

Are Combination Biologics Safe?

Jack Cush, MD

Although package inserts commonly warn against combining the use of biologic or targeted therapies, there is growing interest in such combination therapy for patients with problematic immune-mediated inflammatory diseases (IMID).
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dementia.think.brain

Long-Term Use of NSAIDs Linked to Lower Dementia Risk

MedPage Today

Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) was tied to a decreased risk of dementia, data from the prospective Rotterdam Study showed.

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Early Hydroxychloroquine Slows Cutaneous Lupus Progression A prospective study of patients with limited cutaneous lupus erythematosus (CLE) shows that early introduction of hydroxychloroquine (HCQ) may prevent progression to systemic lupus erythematosus (SLE).… https://t.co/evsvf2GQiL https://t.co/J0Zl35FEHz
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Overlap Syndrome with ILD

Jack Cush, MD
Cush RheumThought ILD

How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?

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Best of 2023: New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?

Richard Conway, MBBChBAO, PhD
Lungs ILD
Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base.  Read Post
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