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
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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
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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
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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
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Hip Replacement Advances
Hip replacement surgery has been a major advance in the management of patients with hip damage and diminishing quality of life. While this review provides new information regarding a new type of hardware (end of article), lets begin with a general overview.
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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
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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
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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
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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
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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%. This https://t.co/OoLh0HUUH2
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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
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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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Whats the BEST FIRST Rx in DMARD-Naive #RA - Tofacitinib or MTX. RCTs (ORAL Start, RA-BEGIN, SELECT-EARLY, FINCH 3) prove JAKi > MTX. A recent 116 RCT from China also shows Tofa > MTX by SDAI50 (94% v 75%) @3 mos & Tofa was more cost effective. https://t.co/KL2qlDgF6D https://t.co/wNVBgQkaMI
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NEJM Retracts Pivotal ADVOCATE Trial of FDA-Approved Avacopan
MedPage Today
The New England Journal of Medicine (NEJM) retracted the pivotal study supporting FDA's approval of avacopan (Tavneos) for severe forms of anti-neutrophil
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Long term F/U of Gout (CARES) trial (febuxostat vs allopurinol) shows remission increased from 37% (1,593/4,259) 1st Yr to 63% (322/510) at year 6. Over the 6 years, ~60 achieved remission at least once; more likely based on age, race, dz severity, comorbidities, & febuxostat
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DMARD Efficacy in RA-ILD
A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional, low-certainty recommendations.
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The Power of Self-Management with Chronic Low Back Pain
EurekAlert!
Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the workforce
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RHEUM SURVEY>> Which Gout drugs lower the risk of cardiovascular death? Answer here: https://t.co/1OY1B3ET7B https://t.co/MRJP5OOtXb
Links:
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Uric Acid: Is Lower Better?
Lowering serum urate and urate crystals in the body is indispensable for long-term management of gout. The pathophysiology is simple and powerful: no urate crystals, no gout flares. However, this simplicity in goal belies a nuanced consideration in management: how low should serum
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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
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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Dr. Jack Cush reviews Gout in this continuing series for Advanced Practice Rheum. Review the companion slide deck here.
Podcasts
RA Topic Podcast compilation
PsA Topic Podcast compilation
EULAR 2026 Daily Podcast Day 4a
