Emergencies, Independence & Hemorrhage (1.23.2026)
Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com
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UCAN CAN-DU study of 181 JIA pts starting biologics. Early Rx w/in 6 mos (n=35) assoc. w/ greater odds of achieving inactive arthritis (83% vs 57% in late starters (>12 mos). For each month of delay increased the odds of future active arthritis (after 6 mos) by 9%.
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Did you know theres a Subcutaneous (SC) rituximab (Hycela)? Its same RTX but combined w/ hyaluronidase, faster 5-7 minute injection Vs hours for IV RTX. FDA approved 2017 for Follicular Lymphoma (FL) and Diffuse Large B-cell Lymphoma (DLBCL). Give 1st dose IV, then use SC RTX. https://t.co/piQ2ZhAOyf
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BIOBADASER III Registry shows No Cancer Risk with b/tsDMARDs
A large, real-world cohort study of rheumatoid arthritis (RA) finds patients treated with biologic and targeted synthetic DMARDs (b/tsDMARDs) do not have an increased risk of cancer.
Researchers used 2000–2023 data for RA patients from the BIOBADASER III registry,
APPIPRA Study - Benefits of Early Treatment
EurekAlert!
Treating people who are at high risk of rheumatoid arthritis (RA) can delay the onset of the disease for several years, with benefits also continuing well after treatment has stopped.
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Preoperative Semaglutide for 3 mos. prior to Total Knee Arthroplasty assoc w/ signif less Postoperative Adverse Events in NIDDM. Retrospective study of up to 745 T2DM needed TKR . 2-3 mos of GLP-1a reduces serious AEs by 75% (OR 0.25, P < 0.001). https://t.co/re57y9OvTN https://t.co/KNirmfdr2F
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Are JAK Inhibitors Better at Pain Relief in RA?
MedPage Today
Among rheumatoid arthritis (RA) patients responding to upadacitinib (Rinvoq) or adalimumab, those receiving the former had significantly less residual pain with treatment, according to a post-hoc analysis of phase III trial data.
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Review of Restless Legs Syndrome
JAMA has published a full read review of RLS - restless leg syndrome - a frequent, but often unrecognized, cause of poor sleep and the resultant hazards of insomnia.
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German psoriasis registry PsoBest reports on 595 Rx w/ apremilast (417 APR monotherapy). Compared to Ptx Rx w/ other DMARDs/biologic drugs, APR pts higher age, more comorbidities. Nonserious AEs: ineffectiveness (14%), diarrhea (9%), nausea (7%), HA (6%). https://t.co/TviJmM7Fr9 https://t.co/tY89oHgUgV
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Emergency Department Visits by Rheumatoid Patients
A Canadian population study shows that rheumatoid arthritis (RA) patients have 30% higher emergency department (ED) visit rates for Ambulatory Care Sensitive Conditions (ACSCs) compared to age- and sex-matched population controls.
Smartphones and Rheumatoid Flares
FORWARD Databank of Rheumatoid arthritis (RA) patients reveals that smartphone data can predict flares using PROs.
RA flares are seen in 30-60% of patients, are hard
Subcutaneous Anifrolumab in SLE
Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/ruZM3Qftxb
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Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Mu3OyA4EOD
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ADJUST trial (248 JIA pts w/ Uveitis & inactive >6mos, either continued or weaned off adalimumab. ADA weaning resulted in more flares (68% vs 14%, mostly uveitis) w/ no protection from background DMARD Rx. Restarting ADA was mostly effective. https://t.co/ZWHfPl2UNl https://t.co/Fk1HES2UIc
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The 2025 Rheumatology Year in Review
The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.
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Subcutaneous Anifrolumab in SLE
Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/3DWNEXaO2x
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Metanalysis of Tramadol included 19 PBO-RCTs, 6506 pts, showing a very modest benefit on chronic pain (low certainty of evidence), but a doubling of risk for serious adverse events (OR 2.13); including nausea (NNH 7), dizziness (NNH 8), constipation (NNH 9), somnolence (NNH 13) https://t.co/0ZEIoy1gqC
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Advanced Practitioner Biologic Prescriptions for Psoriasis
Advanced practice clinicians (APCs; nurse practitioners and physician assistants) deliver a large share of US dermatologic care, accounting for 37% of clinicians and 27% of dermatology visits by 2020. A current JAMA Dermatology reports APC drug spending trends in dermatology, with a focus on
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Spread of Psoriatic Disease from Skin to Joints
Approximately 20 to 30 percent of all people who suffer from psoriasis also develop painful inflammation in their joints over time. If left untreated, psoriatic arthritis can lead to permanent damage to bones and joints. Why the disease progresses was assessed by researchers from the
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Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Hf7HaGOLXd
Dr. John Cush @RheumNow( View Tweet )
Subcutaneous Anifrolumab in SLE
Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/yrAirr2R2Y
Dr. John Cush @RheumNow( View Tweet )
Antirheumatic drug use with rheumatoid arthritis pregnancies
A nationwide Norwegian registry study of rheumatoid arthritis (RA) pregnancies showed that while medication use increased during pregnancy, many discontinued treatment during pregnancy, only to resumed it after childbirth.
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Diffuse Alveolar Hemorrhage in Rheumatic Disease
A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk.
DAH is an uncommon but
ADJUST trial (248 JIA pts w/ Uveitis & inactive >6mos, either continued or weaned off adalimumab. ADA weaning resulted in more flares (68% vs 14%, mostly uveitis) w/ no protection from background DMARD Rx. Restarting ADA was mostly effective. https://t.co/ZWHfPl2UNl https://t.co/xodyrbaQOj
Dr. John Cush @RheumNow( View Tweet )
Subcutaneous Anifrolumab in SLE
Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab.
TULIP-SC was a
