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Anti-Rheumatic Rx

Methotrexate Safety Tips (7.31.2026) Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow. And if you're ready to test your knowledge, take this week's RheumIQ quiz! https://t.co/3iE9ZAH7q4 https://t.co/y3ir6j6XIP
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U Alberta Rheumatology study of GCAPS score in 62 new onset, suspected GCA referrals. GCA Dx in 39 pts excluded in 23. 50% had a High risk GCAPS (screening) score, 38% Intermediate & 13% had Low risk GCAPs. Intermediate or High risk GCAPS sensitivity 97%, specificity 30%, PPV 70% https://t.co/HxHL60VAuO
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In a Cohort of 410 #SLE pts, there were 37 MALES who demonstrated a high prevalence of renal (IV/V lupus nephritis 49%) and a notable incidence of Plaquenil-related retinal toxicity. 62% on HCQ, but 22% D/C HCQ due to retinal toxicity or drug intolerance. https://t.co/FcIFxRoZ6O https://t.co/7OgexLYWge
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Keep HCQ Blood Levels Up to Avoid Cardiovascular Disease in Lupus

MedPage Today

People taking hydroxychloroquine (HCQ) for systemic lupus erythematosus (SLE) showed markedly increased risk for atherosclerotic cardiovascular disease when blood levels of the drug were low and when long-term adherence was poor, a prospective study showed.

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New Avacopan Analysis Sent to FDA 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 https://t.co/TdLWRMPvnR
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Tips for safe use of allopurinol https://t.co/Yn1u1bEj4F https://t.co/lMWPI9OsVe
Dr. John Cush @RheumNow( View Tweet )

Arrhythmias in Autoimmune Rheumatic Disease

A new review in the Journal of Cardiovascular Development and Disease (Tamirisa et al) synthesizes how systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis have an increased risk of arrhythmias and sudden cardiac death attributable to shared immune pathways.

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JAMA Review of Hip Fracture

The July 16th edition of JAMA reviews the highly prevalent problem of hip fractures - a major global health burden: 14.2 million occur worldwide annually (280,000 in the US), with global incidence higher in women (833.9/100,000) than men (510.0/100,000). Lifetime risk at age 50 is 22.9% for

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Future therapies (in development) for gout - the goal is durable crystal depletion. Created by: Dr. Aravind Palraj @rheumat_aravind for RheumNow. https://t.co/yeCSAnHiY2 https://t.co/nH8f2Y3hNP
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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
Dr. John Cush @RheumNow( View Tweet )

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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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

Read Article
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
Dr. John Cush @RheumNow( View Tweet )

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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