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Anti-Rheumatic Rx

RHEUM SURVEY Q: Which gout drug has the greatest toxicity risk? Answer here>> https://t.co/EQrEjD9237

Dr. John Cush @RheumNow( View Tweet )

SGLT2i use in gout reduces use of gout meds. Study of 26,739 gout pts w/ NIDDM (mean 66 yrs), 67% w/ polypharmacy. SGLT2i (vs DPP-4i) user had less Allopurinol starts (HR 0.62;0.52–0.73), also lower use of steroids (,78), NSAID (.85), colchicine (.87) & diuretics (.87) https://t.co/1dW27YzSvg
Dr. John Cush @RheumNow( View Tweet )

Expert Perspective on Calcium Pyrophosphate Deposition Disease

A recent perspective by Tedeschi tackles many unresolved issues around CPPD diagnosis, classification, and management, including the lack of clinical trials or FDA approved treatments.

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Pragmatism in Gout: How therapeutic choices can have multiple benefits

William James famously wrote in Pragmatism, “There can be no difference anywhere that doesn’t make a difference elsewhere.” Gout treatment offers a striking medical example of that idea. Drugs prescribed to calm flares or lower uric acid are designed with one primary goal in

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Tomorrow! Registration is still open! Time-tested gout therapies remain the cornerstone of care, optimizing their use requires thoughtful, patient-specific decision making. Join our expert faculty for Upgrading & Maximizing the Classics where they'll explore practical https://t.co/ZN0vcVjUex
Dr. John Cush @RheumNow( View Tweet )

Fibromyalgia: Diagnosis and Management

Fibromyalgia (FM) affects 4–6% of the U.S. population, with nearly a 2 fold female predominance. Nociplastic pain underlies the pathophysiology of FM. CNS hypersensitization to both painful and non-painful stimuli occurs with little or no tissue pathology. Framing FM as a disorder of CNS

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QD Clinic: Allopurinol for All Gout? Not Quite Dr. Brian Jaros, Chicago, discusses the use of allopurinol. https://t.co/XENBDqZ2Z6 https://t.co/KFTZwuYVLI
Dr. John Cush @RheumNow( View Tweet )

Psoriatic Arthritis: EULAR 2026 Recap

Years of IL-17 vs. IL-23 debate in PsA finally got tested head-to-head: bimekizumab outperformed risankizumab on joint outcomes in the BE BOLD trial, while a GLP-1 combination study suggests weight and metabolic status are active drivers of PsA — not just comorbidities. This recap also digs into

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Seronegative RA Disease Activity (7.17.2026)

Dr. Jack Cush reviews the news, journal articles and Gout features from this past week on RheumNow.com.

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Four Things About Allopurinol Hypersensitivity Syndrome Dr. Robert Terkeltaub discusses allopurinol hypersensitivity syndrome in gout patients. https://t.co/5seiyfVLW1 https://t.co/0A1Rtk9hzS
Dr. John Cush @RheumNow( View Tweet )
Intl consortium (10 EU countries) of 3952 RA pts, 184 MACE events seen 1985-2012. MACE risk signif assoc w/ DAS28 (HR 1.18;1.03-1.35), but NOT RF (HR 1.26; 0.82 to 1.94) or ACPA (HR 1.25; 0.85 to 1.83). RA activity assoc w/ MACE seen in seronegative and double positive https://t.co/RGO5IAM5oL
Dr. John Cush @RheumNow( View Tweet )
Glucocorticoid use in 1st yr of 574 newly DX RA cases-- 75% recv GC in 1st yr; 313 (55%) Rx at 1st visit. (m GC dose =9.3 mg/day. 1/2 (47%) recv IA GC injx. 20% had 1st yr infx. Risk of infx was NS (RR 1.13; 0.77 to 1.67) for 0-10 mg/d vs no GC https://t.co/s9YaGZsUjr https://t.co/ESHvVK1Egx
Dr. John Cush @RheumNow( View Tweet )

ACP Position Paper on Dietary Supplements

More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives. The paper notes that under DSHEA, dietary

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In 2010 Colchicine fell under patent protection and price increased 16 fold, & out-of-pocket price increased 4.4-fold, colchicine use decreased 27%, while allopurinol, steroid & gout visits (ER, Rheum) increased. https://t.co/xyOxsnoM5z https://t.co/yoXehV0mPa
Dr. John Cush @RheumNow( View Tweet )
RZV (Shingrix) response in 76 immunosuppressed SSc & 304 controls (CG) recv two RZV doses. High seroconversion seen in SSc but signif lower than CG (92.6% vs 99.7%, P 0.001), w/ lower concentration but comparable CMI, lower AE (74% vs 86%) https://t.co/ALlnVEZIAt https://t.co/kYYy2JIo2J
Dr. John Cush @RheumNow( View Tweet )
20 yr. Tx trends in 6583 #SSc pts. 2005 to 2025 endothelin receptor antagonists & prostanoids/prostacyclins from 3% to 28%. CCB & PDE-5 inh stable. CTX shifted to mycophenolate, RTX, & nintedanib. Steriods decr from 50% to 18% https://t.co/nrm1Ov285f https://t.co/ftLn3bGH72
Dr. John Cush @RheumNow( View Tweet )
FDA Delays Gout Drug NASP with Complete Response Letter On June 26, 2026, SOBI received a Complete Response Letter (CRL) from the U.S. Food and Drug Administration (FDA) that will delay a decision on NASP, pending the company's answer to questions regarding the drugs https://t.co/NmPbWmYd0p
Dr. John Cush @RheumNow( View Tweet )
Non-gout drugs that may lower uric acid – losartan, amlodipine, ACE inhibitors, fenofibrate, atorvastatin, leflunomide, vitamin C, estrogen, and high-dose ASA. For more gout content, follow our Gout: More than Flares campaign at https://t.co/xnBVBN5IXZ, https://t.co/vmNvqojAcS
Dr. John Cush @RheumNow( View Tweet )
Problems with treatment adherence in the management of gout Compared to common medical conditions such as hypertension, type 2 diabetes, hyperlipidemia or osteoporosis, where the reported drug adherence rates are between 50% to 70%, the drug adherence for gout is 37%. This https://t.co/OoLh0HUUH2
Dr. John Cush @RheumNow( View Tweet )
Netherlands pragmatic open-label RCT from 8 rheum centres tested T2T vs Sx Rx in 308 Gout pts starting ULT (87% male; 66 yrs). Remission (no flares & pain < 2) betw 18-24 mos was more in T2T pts (39% vs 24%; p=0.02), but more AE w/ Sx driven Rx (53 vs 42%) https://t.co/5g2dY5y900
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Gout Cavalcade (7.10.2026)

Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week. July is Gout: More than Flares month.

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Do we need Better Strategies to Prevent Osteoporotic Fractures?

In a recent JAMA Viewpoints article, Dr. Susan Ott addresses several controversies in preventing osteoporosis (OP) related fractures.

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NEJM Retracts Pivotal ADVOCATE Trial of FDA-Approved Avacopan The New England Journal of Medicine (NEJM) retracted the pivotal study supporting FDA's approval of avacopan (Tavneos) for severe forms of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis. https://t.co/GOVyk5poNq
Dr. John Cush @RheumNow( View Tweet )

FDA Delays Gout Drug NASP with Complete Response Letter

At the end of June, Sobi was awaiting an FDA decision on its Biologics License Application (BLA) for NASP (nanoencapsulated sirolimus plus pegadricase) for the treatment of adult patients with uncontrolled gout. On June 26, 2026, SOBI received a Complete Response Letter from the U.S. FDA that

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Problems with treatment adherence in the management of gout

Compared to common medical conditions such as hypertension, type 2 diabetes, hyperlipidemia or osteoporosis, where the reported drug adherence rates are between 50% to 70%, the drug adherence for gout is 37%.

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