Early RA Referral Clinics Work (9.18.2026)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com
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Added IVIG is Effective in Myositis
A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly diagnosed idiopathic inflammatory myopathies (IIMs). https://t.co/uNNJ9sHU8M
Dr. John Cush @RheumNow( View Tweet )
Join us for Tuesday Nite Rheumatology on September 22 for:
đź”´ Obesity Treatment & Safety
Experts will tackle:
• GLP-1/GIP therapies
• Lifestyle & bariatric interventions
• Treatment selection & safety
• Cost & compounding concerns
• Sarcopenia & bone health
• The future https://t.co/v7kSZamLKF
Dr. John Cush @RheumNow( View Tweet )
Metanalysis of 87 studies shows predictors of #MTX response: early Dz, low dz activity, early MTX initiation, and absence of erosive disease. Smoking and higher BMI were linked to reduced efficacy. https://t.co/OfB09aHNOS https://t.co/4UiOgfW940
Links:
Dr. John Cush @RheumNow( View Tweet )
ACR Updates Osteoarthritis Guidance
ACR
The American College of Rheumatology (ACR) has released updated clinical guidance for the treatment and management of osteoarthritis (OA) of the knee, hip, and hand. The evidence-based recommendations update the 2019 ACR/Arthritis Foundation guideline and are designed to support individualized,
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Review of HLA-B27
HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint trafficking point to new plausible, targetable
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Indian study of 85 #RA pts in LDA or better (DAS28-ESR ≤ 3.2). W/ 6 mos F/U, 39 (46%) had 1+ RA flare (DAS28 > 3.2); time to flare 12 wks (8–18) unrelate to Dz activity. Predictors: seropositivity (HR 2-2.3) https://t.co/ifqeoPtxpx https://t.co/ltx64X55fd
Dr. John Cush @RheumNow( View Tweet )
Added IVIG is Effective in Myositis
A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly
Early RA Referral Clinics Work!
An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals.
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Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/JDvVZ1KEIY
Dr. John Cush @RheumNow( View Tweet )
EBR Journal Club: Dapirolizumab Pegol in SLE (PHOENYCS GO)
The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal to an important RCT in rheumatology. Each review covers four domains: Does this apply to my patients? What is the risk https://t.co/Pi45T99oJm
Dr. John Cush @RheumNow( View Tweet )
The 1980s quietly rewired rheumatology.
Methotrexate became the anchor DMARD.
APS emerged as a distinct clinical syndrome.
SLE classification was standardized.
Cytokine biology began pointing toward the biologic era.
A decade that moved rheumatology from symptom control toward https://t.co/9NUXorQDTG
Aravind Palraj @Rheumat_Aravind( View Tweet )
Dr John Stone grand rounds Kroc lecture #wustlRheum.
Pearls:
-IgG4RD can manifest as a variable vasculitis
-Men have worse disease
-Histology will not show necrosis or neutrophils
-IgG4 levels will rise as the disease progress (>5X)
-Rx with B cell therapy
@alhkim @RheumNow https://t.co/GUw348OrrA
TheDaoIndex @KDAO2011( View Tweet )
Weight Loss Improves Psoriatic Disease Substantially!
Even before the introduction of incretin therapy and bariatric surgery, many randomized and interventional studies (2019–2026) have consistently showed that weight loss produces clinically meaningful, dose-dependent improvement in both psoriasis and psoriatic arthritis.
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A Day of Infamy (9.11.2026)
Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz
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JAMA: Review of Adult Rheumatoid Arthritis
Smolen, Kerschbaumer, Aletaha, and Robinson have published a comprehensive review article of rheumatoid arthritis (RA) in JAMA, noting significant changes to our understanding and treatment guidelines.
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Obesity in Axial Spondyloarthritis: what are we missing beyond the scale?
Obesity in axial spondyloarthritis (axSpA) is not a minor comorbidity. Beyond the scale, there are several factors that need to be considered with obesity in axSpA.
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ACP Clinical Guideline on Treatments of Overweight or Obese Adults
In July 2026, ACP published its first living clinical guideline addressing pharmacologic management of overweight and obesity in nonpregnant adults in outpatient settings. As this therapeutic area is rapidly https://t.co/5oQIY7J2Aw
Dr. John Cush @RheumNow( View Tweet )
Necrotizing arteritis is rare w/ IgA Vasculitis (IgAV). Review compared 30 IgAV-NA to 257 adult IgAV & 196 PAN pts. Overall IgAV-NA is a severe IgAV phenotype with life-threatening complications & should prompt vascular imaging and intensified immunosuppression. IgAV-NA had more https://t.co/GRVcqRPKTL
Dr. John Cush @RheumNow( View Tweet )
Small series of 5 Idiopathic inflammatory myopathy (IIM) pts Rx w/ obinutuzumab for refractory myositis (2 antisynthetase syndr, 1 DM, 2 overlap myositis). 4/5 patients achieved complete response. Lung improved/stabilized in ILD patients. Two required second obinutuzumab cycle. https://t.co/ev9qlEO04l
Dr. John Cush @RheumNow( View Tweet )
“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis
The proposed approach to D2T-RA is based on the EULAR definition (having failed 2 or more b/tsDMARDs). It is estimated that up to 20% of RA patients meet this D2T-RA definition and can be plagued by active or https://t.co/o39IREvjI4
Dr. John Cush @RheumNow( View Tweet )
Treating Obesity is Disease-Modifying (9.4.2026)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. New drugs approved, new drugs halted and some drugs out of control. Ready to test your knowlege? Take this week's quiz!
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Cochrane systematic review of LBP Rx (8 RCTs, 501 cLBP pts) show that Lumbar supports may result in a small reduction in pain intensity if given w/ NSAIDs, but may offer little to no benefit for pain intensity & disability if used alone. Insufficient evidence to support their https://t.co/6Vq4CPXLvE
Dr. John Cush @RheumNow( View Tweet )
BMI Affects JAK Inhibitor Responses in Rheumatoid Arthritis
A meta-analysis of Janus kinase (JAKi) inhibitors clinical trials in rheumatoid arthritis (RA) has shown higher BMI was associated with poorer responses and a reduced treatment benefit with JAK inhibitors in RA patients.
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Music and Pain Relief
If laughter is the best medicine, then music has to be second best. A new scoping review in Pain Reports by Bradt et al., examines the effect of music-based interventions (MBIs) on pain management. While its efficacy is well established, how or why music relieves pain has never been fully
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Lupus Nephritis
Sponsored by RheumNow
View our six video perspectives on lupus nephritis, including Management of CKD in Lupus Nephritis.
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EXXELERATE: New Thoughts on High RF Titer
Sponsored by: UCB
Two leading rheumatologists share insights into why RF levels are important to consider when identifying treatment options for patients with RA.
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Recent Blogs
A few years ago, when I would see a patient with rheumatic disease and increased BMI, I would often document it as obesity as a comorbidity, recommend weight loss and exercise, and then move on. My approach has changed.
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Dr. Al Kim, St. Louis, discusses the effects of obesity on lupus activity, organ damage, complement levels and mTor activation.
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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Podcasts
Systemic Burden of Gout Part 1
Better Gout Management-
Gout Advice & Tips
