Methotrexate Safety Tips (7.31.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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British Dermatology Biologics registry (BADBIR) 18976 #PSO pts had incidence serious infxns (SIE) 28 SEI/1000 Pt-Yrs; higher if they had prior infxn (79/1000 PYs). SIE signif lower w/ RIZankizumab (HR 0.74-.80) vs BROAD, ETN, other standards Rxs. SIE deaths rare (1.81/1000 PYs) https://t.co/5HqJ3zpO0g
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Uricase-Targeted Therapies in Gout
https://t.co/RB6Yj4oY9a https://t.co/NrWq6Y93Hg
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Four Decades of Gout Management
During this month-long campaign on Gout, we have documented many significant changes in our approach to gout, as well as many unmet needs and deficiencies that merit our continued, primary attention. We are all familiar with the famous 1905 quote, “Those who cannot remember the past
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2 T2T RCTs of 383 gout pts starting allopurinol - 31% had tophi. At 12 mos achieving target uric acid (<0.36mmol/L) was same in pts with and without tophi (70.3 vs 73.6), as was the %gout flares in month 11 (71.4% vs 79.7%; p=0.21). Allopurinol T2T success not influenced by https://t.co/zr7K8Y2Bqz
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Treatment goals in gout: aim for remission!
Rheumatologists are used to the concept of disease remission as this is a treatment goal we use for many chronic rheumatic diseases in our clinical practice. Recently, G-CAN (the Gout and Crystal Arthritis Network), endorsed a
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New Avacopan Analysis Sent to FDA
MedPage Today
After data manipulation allegations, the FDA has been calling for the vasculitis drug to be pulled from the market since January.
Amgen has submitted a third-party review of avacopan's (Tavneos) pivotal trial data and other analyses to the FDA in a bid to keep the embattled drug for
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3 Rx are FDA approved for hidradenitis supprativa (secukinumab, adalimumab, bimekizumab). New JAK1i Povorcitinib in STOP-HS1 and STOP-HS2 ph 3 PCTs (608/619 pts). Povo showed HiSCR50 ~42% vs PBO 29% @wk12. AE: acne, pharyngitis https://t.co/n3FJUOjNuo https://t.co/9YAmPqW44z
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Tips for safe use of allopurinol
These are tips and hopefully the patients are abstaining from moderate alcohol and are not tipsy! Here are 5 tips that may not be totally obvious.
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$2 Million in Research Grants for Juvenile Arthritis
July is Juvenile Arthritis Awareness Month, and while many people think of arthritis as a disease of aging, nearly 300,000 children in the U.S. are living with a rheumatic disease.
Equally important is that 2026 marks a 50 year anniversary for Pediatric
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Pragmatism in Gout: How therapeutic choices can have multiple benefits
Drugs prescribed to calm flares or lower uric acid are designed with one primary goal in mind, yet many also produce meaningful effects beyond the joints. Some of those secondary effects are unwelcome; such https://t.co/QvXAwFM7LJ
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Retrospective study of 2187 RA pts initiating menopausal hormone Tx (MHT) vs 8,205 unexposed controls. VTE incidence higher among MHT users (6.49 vs 3.3/1000PY). MHT use was associated with a 92% signif increased risk of VTE in RA (adj HR: 1.92), mostly DVT risk (aHR: 2.26)
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Genetic Risk Loci in Fibromyalgia
Researchers examined genetic data drawn from 11 different worldwide cohorts, that included from more than 2.5 million adults, of which 55,000 had been diagnosed with fibromyalgia. They identified DNA sequence variants in 26 regions of the genome that affect the risk of developing fibromyalgia.
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Uricase-Targeted Therapies in Gout
In most mammals, uricase catalyzes the oxidation of uric acid to allantoin, a highly soluble compound easily excreted by the kidneys. But humans lack functional uricase, leaving xanthine oxidase inhibitors (allopurinol/febuxostat) as first-line urate-lowering therapy (ULT). Uricase-based
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The Wider Implications of Dactylitis
Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis. This review article discusses the wider implications of dactylitis in rheumatology and medicine underscores the
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UTSW observational study of labs (n 14,199) changes w/ MTX use in 2,439 pts (13% RA, 11% PsO/PsA, 15% inflam arthritis) - found no difference in labs q3 vs q6 mos. No signif correlation betw monitoring intervals & changes in ALT, AST,WBC, HCT, MCV, PLT, FIB-4. Small https://t.co/gKwA7juexG
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When Gout Flares, So Does the Cardiovascular System
We have spent decades teaching that a gout flare is a joint problem: a hot, swollen, painful joint that we treat with anti-inflammatory drugs and move on from (i.e., the treat to avoid symptoms strategy). The campaign title says it well — gout is more than flares. I would add
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Expert Perspective on Calcium Pyrophosphate Deposition Disease
A current perspective article by Dr. Sara Tedeschi tackles many unresolved issues around CPPD diagnosis, classification, and management, including the lack of clinical trials or FDA approved treatments. https://t.co/zxJ9aQweNl
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Chikungunya Club Meeting (7.24.2026)
Dr. Jack Cush reviews the news, journal reports from the past week on RheumNow.com.
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Swimming Reduces Disability from Low Back Pain
EurekAlert!
Swimming is commonly recommended for patients with chronic low back pain. Yet, there is little trial data investigating swimming. An Australian study has shown for the first time that a program of swimming can be clinically effective in reducing disability from chronic low back pain
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EUSTAR scleroderma substudy propensity matched pts Rx w/ JAKi (n 38) vs 180 pts ea Rx w/ MMF, MTX, RTX. 1/3 had dcSSc. 23 AEs in 997 Pt-yrs. JAKi outcomes similar to comparators. JAKi Tx D/C in 39%, FVC stable, skin fibrosis improved (mRSS −1.8) & SJC decreased. No new
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The Lancet Rheumatology has a good editorial about the avacopan bad news reports with EMA, FDA and Japan issuing negative opinions that threaten the drugs future. Yet, since approval real world data on avacopan has been favorable w/ less steroid toxicity & most hepatotoxicity https://t.co/k6ebVeWv2K
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Psoriatic Arthritis: EULAR 2026 Recap
https://t.co/tBMu4CEn0o https://t.co/iztShOHxOf
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2 Still's dz cohorts (96 Shanghai, 28 Erlangen0 compared response to biolgics vs DMARDs (MTX, CNI,JAKi). in 124 AOSD pts, biologic had more sustained event-free remission and event-free state (P 0.0065, P 0.0096) & more steroid D/C vs MTX/CNI (p < 0.05). https://t.co/lJaI9nhPYr
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Therapeutic Updates
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
Systemic Burden of Gout Part 1
Better Gout Management-
Gout Advice & Tips
