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Anti-Rheumatic Rx

Rheum Scholarship (8.21.2026)

Dr. Cush reviews the news and journal articles from this past week on RheumNow.com; talking about lumbar belts, scholarships and misdiagnosis.

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Systematic review of targeted Rx for lupus nephritis during pregnancy (2000-25). HCQ & AZA are cornerstone good Rx. Acceptable: tacrolimus, ASA. MMF is TERATOGENIC-AVOID! Not Enuf data; Voclosporin, obinutuzumab, Anifrolumab https://t.co/otO9nMHHuO https://t.co/1hLysZLJnG
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Retrospective Medicare comparison 450 paired #PMR cohorts Rx w/ IL-6 inhib or csDMARDs. At 1 yr, IL-6i pts (vs csDMARD) had signif more GC D/C (adj HR 1.28) or minimal GC use (<3mg/d) (aHR 1.28). Hosp. infxn 2X higher in IL-6i (12.2 vs 5.7 per 100 PY) in year 1, but not year 2 https://t.co/YgqLjD9nvM
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Efgartigimod Efficacy in Idiopathic Inflammatory Myopathy Today Argenx announced the results of their Phase 3 "ALKIVIA" study; demonstrating efficacy and safety of subcutaneous efgartigimod for Idiopathic Inflammatory Myopathy (IIM, AKA inflammatory myositis). https://t.co/TYP4KcdLoa
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Risk of Venous Thromboembolism in Rheumatoid Arthritis

RA confers a 50–100% excess risk of venous thromboembolism (VTE) compared with the general population, with adjusted hazard/odds ratios ranging from 1.3–2.2 across large cohort studies (Vojinovic, Askling, Antovic; Rheumatology, 2026).

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JAMA: Review of Shoulder Pain

Shoulder pain affects 16% of adults annually and is the third most common musculoskeletal presentation in primary care. This new review reframes the diagnostic and therapeutic approach, moving away from pathoanatomic labels (rotator cuff tendinopathy, impingement, bursitis) toward the umbrella

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Efgartigimod Efficacy in Idiopathic Inflammatory Myopathy

Today Argenx announced the results of their Phase 3 "ALKIVIA" study; demonstrating efficacy and safety of subcutaneous efgartigimod for Idiopathic Inflammatory Myopathy (IIM, AKA inflammatory myositis).

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FDA & Fresenius Kabi Issues Nationwide Recall of Tyenne® (tocilizumab biosimilar) Injection 400 mg/20 mL Vials Due to Presence of Glass Particles. Applies to NDC Number 65219-594-20, Lot Number 16UI07 , Expiration date: 08/2028 . FDA warns possible ISR or VTE. https://t.co/YMRC9FO7Mu
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US TriNetX EHR study of of seropositive RA:  31,932 without ILD; 115 RA-ILD on antifibrotic Rx & 1885 RA-ILD not Rx w/ antifibrotics. MTX was used more in RA w/o ILD (52%) vs RA-ILD (12%) on antifibrotics. RA-ILD was assoc w/ heterogeneous antifibrotic use. https://t.co/eBJBXbnQLN
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3 SLE pts w/ Bx class III/IV LN had Lg proteinuria flares (4.6–13.4 g/d) despite MMF plus belimumab & were given voclosporin (+MMF) w/ rapid, sustained proteinuria reduced (≤0.7 g/day w/in 9–12 mos) & stable/improved eGFR, & GC tapering. Creat increases Rx w/ dose adjustments https://t.co/38lcD8DPgn
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Can Effective Psoriasis Therapy Prevent Psoriatic Arthritis?

A review article assesses and integrates mechanistic, imaging, and clinical evidence to examine whether effective treatment of psoriasis may modify the future risk of psoriatic arthritis (PsA).

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Substudy of 131 Still’s dz pts from the Autoinflammatory Dz (AIDA) registry. 38% underdosed w/ canakinumab (CAN) vs 62% appropriately dosed (300 mg q4wks or 4 mg/kg). Underdosed CAN had lower odds of long-term remission & D/C CAN (3.9% vs 19%) https://t.co/l94zB9NkKv https://t.co/FQTrCWZLQI
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CDC warns of an association betw severe CNS arboviral disease, w/ neurologic sequelae in pts receiving anti-CD20 mAbs (rituximab, ocrelizumab, ofatumumab, obinutuzumab, etc). West Nile virus was the most common arbovirus, but there are others; mortality up to 40%. Most arbovirus https://t.co/7eMoNgWbB4
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Doubting RS3PE (8.14.2026)

Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.

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A Case of Sweet Syndrome

This overview appeared in JAMA Dermatology.

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Survey: Upgrading & Maximizing the Classics (Urate Lowering Therapies, etc) https://t.co/w6uzIlaeG7 https://t.co/HW09DVrMed
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ZEUS Trial: IL-6 Inhibition Fails to Cut Cardiovascular Events

The phase 3 ZEUS trial (published in JAMA Dec. 2025)  tested the IL-6 ligand inhibitor ziltivekimab in over 6,000 patients with atherosclerotic cardiovascular disease, chronic kidney disease, and elevated hsCRP—a population enriched for an inflammatory driver of risk.

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2026 BSR Pain Guideline: What Rheumatologists Need to Know

The British Society for Rheumatology has issued its first guideline dedicated solely to pain in inflammatory arthritis (IA)—covering RA, PsA, axial SpA and JIA.

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Substudy of 131 Still’s dz pts from the Autoinflammatory Dz (AIDA) registry. 38% underdosed w/ canakinumab (CAN) vs 62% appropriately dosed (300 mg q4wks or 4 mg/kg). Underdosed CAN had lower odds of long-term remission & D/C CAN (3.9% vs 19%) https://t.co/l94zB9NkKv https://t.co/D8FNUXS0nv
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CDC warns of an association betw severe CNS arboviral disease, w/ neurologic sequelae in pts receiving anti-CD20 mAbs (rituximab, ocrelizumab, ofatumumab, obinutuzumab, etc). West Nile virus was the most common arbovirus, but there are others; mortality up to 40%. Most arbovirus https://t.co/WWg41fsRgr
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Evaluating Inflammatory Joint Pain in Older Adults

Lee, Levinson, and Makris have published an approach to evaluating inflammatory joint pain in older adults in JAMA Internal Medicine. While intended to be a practical guide for primary care clinicians, the tenets and clues ring true for all.

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Wealth and Where you Live Influences Outcomes

EurekAlert!

Patients from wealthier European countries tend to start treatment with biologics earlier but also stop or switch treatment earlier. They also experience lower disease activity at treatment start than patients in middle- and low-income countries.

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What's New in Lyme Disease

JAMA has published an overview of new considerations on Lyme disease, focusing on Diagnostics, Vaccines, and Prevention.

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POETYK PsA-1: Deucravacitinib in Biologic-Naïve PsA

POETYK PsA-1 trial tested the disease modifying efficacy of deucravacitinib, a tyrosine kinase 2 (TYK2) inhibitor, in psoriatic arthritis (PsA) patients and was shown to be superior vs to placebo for clinical responses, patient-reported outcomes, and structural damage inhibition in PsA.

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Rethinking Treatment of EGPA Like MPA & GPA, the goals of EGPA are controlling initial organ damage and preventing relapse. But EGPA has the added challenge of chronic upper and lower respiratory tract involvement, allergic type 2 inflammations and risk of glucocorticoid https://t.co/KIVpyhsghg
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