Infectious Rheumatology (5.15.2026)
Dr. Jack Cush discusses his favorite journal articles from the past week on RheumNow.com.
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Vitamin D in Rheumatic Disease - Is It Good Enough?
Vitamin D in rheumatic disease — is it sufficient? Vitamin D deficiency/insufficiency is common and linked to inflammatory rheumatic diseases, raising the question of whether low vitamin D drives immune dysregulation, disease https://t.co/Xd8s8LKqKT
Dr. John Cush @RheumNow( View Tweet )
ArthritisPower Registry (now PatientSpot) survey study of 351 RA pts (age 60, F 84%); reported 439 nonserious infx. 27% total infx, 14%w/ MD visist & Abx. Infx incr w/ GC ≥10 mg/d (OR 1.94), but Biologics & JAKi not assoc. w/ greater NSIE risk vs cs DMARDs https://t.co/bHqFnoY0Ud
Dr. John Cush @RheumNow( View Tweet )
Fatigue in SLE
An NIH lupus cohort study looked at fatigue in SLE and found associations with organ damage, obesity, but does not correlate with disease activity in systemic lupus erythematosus (SLE) patients.
Another IL-17A inhibitor (Vunakizumab) for active Ankylosing Spondylitis
Vunakizumab, a novel anti–interleukin (IL) 17A monoclonal antibody, was studied in patients with active radiographic axial spondyloarthritis [r-axSpA] and found to be effective
Registry of 587 #SLE pts. 30% were RNP+ --> more dz activity than RNP- (SLEDAI-2 8.0 vs 4.0) and more Rx use (daily GC 6.8 vs 3 mg). RNP+ more renal, skin & serologic activity & less likely to LLDAS (20% vs 32%) or REM (12% vs 23%). RNP + 18-fold more likely to be Sm+ https://t.co/3J0Uew48OS
Dr. John Cush @RheumNow( View Tweet )
EGPA Review
A current review of eosinophilic granulomatosis with polyangiitis (EGPA) provides current recommendations on diagnosis and management.
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Toll-Like Receptor Drugs Effective in Cutaneous Lupus
MedPage Today
Enpatoran, an investigational oral drug that inhibits Toll-like receptors (TLR) 7 and 8, was superior to placebo in relieving lupus skin manifestations in a dose-finding phase II trial.
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Lupus Mortality Risk in Young Women
ACR
New research using death certificate data from 52,942 females, reveals that systemic lupus erythematosus (lupus) is a leading cause of years of potential life lost among young women in the United States, underscoring the disease’s significant and often underrecognized public health burden.
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Chronic Low Back Pain Disappointments in a Randomized Trial
Annals of Internal Medicine reports that patients with chronic low back pain (cLBP) may benefit from physical therapy (PT); but when that fails, other secondary measures (cognitive behavioral therapy (CBT) or mindfulness) may not be effective.
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Vitamin D in Rheumatic Disease - is it Good Enough?
Vitamin D deficiency or insufficiency of is highly prevalent and has been often associated with inflammatory rheumatic diseases, raising the question of whether inadequate vitamin D status contributes to immune dysregulation, incipient disease, increased disease activity, or poor skeletal
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CorEvitas RA registry study of 9601 RA pts starting b/tsDMARDs (52K yrs F/U) - 10.4% had eGFR<60 9CRI). Achieving CDAI remission was lower w/ CRI - 28% vs 19%(adj HR 0·76 [0·66–0·88]) https://t.co/E42N3PQHwG https://t.co/WNIGGCpCfZ
Dr. John Cush @RheumNow( View Tweet )
A Review of Hydroxychloroquine Ocular Toxicity
While HCQ is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal https://t.co/BrENoaBAVx
Dr. John Cush @RheumNow( View Tweet )
JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/SgVyk9fSCd
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Dr. John Cush @RheumNow( View Tweet )
Steroids
Corticosteroids remain a cornerstone of rheumatologic therapy — rapidly effective but chronically dangerous, as their power to suppress inflammation through inhibition of prostaglandins, lipoxygenase, pro-inflammatory cytokines, and proteases comes at the cost of a https://t.co/PKdnFi1XSr
Dr. John Cush @RheumNow( View Tweet )
Influential Rheumatoid Factors (5.8.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com
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Breaking the Rules: Dual-Advanced Combinations in Rheumatology
For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes.
https://t.co/4lyYTTwJUU https://t.co/sYpYbCjlzm
Dr. John Cush @RheumNow( View Tweet )
A Review of Hydroxychloroquine Ocular Toxicity
While hydroxychloroquine (HCQ) is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal toxicity, risk stratification, and evidence-
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Review of Toll-like Receptor Research
EurekAlert!
A new review on Toll-like receptors (TLRs) systematically summarizes forty years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding
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A Patient’s Plea for a New Paradigm in Autoimmune Disease
A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?
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Breaking the Rules: Dual-Advanced Combinations in Rheumatology
For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes.
Read Article
JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/cq3CuIuMKX
Links:
Dr. John Cush @RheumNow( View Tweet )
Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis
Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.
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More Comorbidity in Difficult to Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
U.S. spending on prescription drugs in 2025 jumped 13% to $915 billion=projected to surpass $1 trillion in 2026, according to ASHP/USA today. One major reason– the popularity of the weight-loss and diabetes drugs tirzepatide and semaglutide. https://t.co/EQ9yFCCdBp https://t.co/cig1jNp6NF
Dr. John Cush @RheumNow( View Tweet )
Therapeutic Updates
Lupus Nephritis
Sponsored by RheumNow
View our six video perspectives on lupus nephritis, including Management of CKD in Lupus Nephritis.
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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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