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Anti-Rheumatic Rx

Adela Castro
@AdelaCastro222
Treatment for ICI-IrAEs: •Early immunosuppression/high doses of steroids (first 2 months) associated with worse survival. •ICI-IA: TNFi and IL-6Ri mostly used •ICI-PMR: steroids/IL6Ri •ICI-myositis: steroids/IVIG mostly used. •Little data on effects of long-term
Adela Castro
@AdelaCastro222
-Biologic DMARDs are generally safe for pregnancy: ETA and CZP safer compared to others. -B cell depletion can be used in pregnancy but caution about neonatal cytopenias for first 6m if dosed in 2nd half og pregnancy. -Counsel on vaccination for biologic exposed babies. #ACR26 https://t.co/byQgPpAveT
Dr. John Cush
@RheumNow
Tocilizumab is effective in glucocorticoid-resistant adult-onset Still’s dz. 40 AOSD pts rx w/ TCZ (4-8 mg/kg q4wks). @12 mos clin remission 55%, 6 mos CID 62%, signif drops in CRP, ESR, ferritin & daily pred decr 91% (50 to 4.4 mg; p<0.001). TCZ retention 65%; MAS 7.5% & https://t.co/Olynr7VfhE

3 x IL-23 = IL do Better (11.6.2026)

Jack Cush, MD

Dr. Jack Cush reviews the FDA approvals and news reports from this past week on RheumNow.com. This week we discuss playing the numbers in rheumatology, playing the long game with stem cell transplants, and a=the Positive spin on seronegative RA. 

ACR Responds to Final Medicare Payment Rule from CMS

ACR

The American College of Rheumatology (ACR) today issued the following statement in response to the final Medicare Physician Fee Schedule (MPFS) for calendar year 2027 (CY27) from the Centers for Medicare & Medicaid Services (CMS).

Autologous HCT in Severe Systemic Sclerosis

Jack Cush, MD

An international study reports 60% progression-free survival at 10 years after autologous bone marrow transplantation, adding important evidence on sustained positive clinical outcomes and long-term safety in patients treated for early severe systemic sclerosis.

The Concern about Seronegative RA

Jack Cush, MD

A current review of seronegative RA (SNRA) by D’Onofrio, et al in npj Autoimmunity shows the diverse fate of seronegative RA - which can resolve, persist or become refractory. Clearly dedicated trials of SNRA are needed to better predict.

Jiha Lee
@JihaRheum
Same molecule, different route, different persistence: golimumab IV persisted 4.44 yrs vs 2.07 for SC in biologic-naive RA (n=9,464, Korean claims). Is it the route, or differenntial out of pocket cost, or supervised dosing and better adherence? P#240 #APLAR26 @RheumNow
Dr. John Cush
@RheumNow
Does IVIG have a Role in Scleroderma? A recent systemic review and meta-analysis by Jozelio Freire de Carvalho and colleagues analyzed the available literature on this therapy. This study, published in Frontiers in Immunology in October 2026, evaluated the available evidence https://t.co/a8J2UT2I7Y

FDA Approves Tildrakizumab for Psoriatic Arthritis

Jack Cush, MD

Sun Pharmaceuticals announced Friday that the FDA has approved its IL-23 inhibitor, tildrakizumab  (Ilumya) for use in patients with active psoriatic arthritis. This agent is already FDA approved for plaque psoriasis, and joins guselkumab and risankizumab as the third IL-23 inhibitor

Dr. John Cush
@RheumNow
Tocilizumab is effective in glucocorticoid-resistant adult-onset Still’s dz. 40 AOSD pts rx w/ TCZ (4-8 mg/kg q4wks). @12 mos clin remission 55%, 6 mos CID 62%, signif drops in CRP, ESR, ferritin & daily pred decr 91% (50 to 4.4 mg; p<0.001). TCZ retention 65%; MAS 7.5% & https://t.co/jtAxrz6ETd
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