Anti-Rheumatic Rx

Rheum Survey: Do You Have to be Overweight for GLP-1s to Work Best?

Dr. John Cush @RheumNow( View Tweet )

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Endocrine Society - State of Obesity Science and Management

Jack Cush, MD

The Endocrine Society has published a scientific statement reframing obesity as a heterogeneous, chronically dysregulated fat-mass disorder, the biology of which is being tested effectively by GLP-1/GIP receptor agonists. Is this precision-medicine? We await long-term safety data, while

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Rheum Survey>> Which obesity treatment has the greatest safety concern(s)? Click here to respond>> https://t.co/jDpVe7u9Pu https://t.co/RNftdQlU1N

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Dr. John Cush @RheumNow( View Tweet )
17 Sept EMA CHMP recommended marketing authorisation for secukinumab (Cosentyx) in the treatment of polymyalgia rheumatica. BUT- not yet EMA approved in the EU. https://t.co/ZGUSbw06vX https://t.co/EqRwpT8Sxo

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Dr. John Cush @RheumNow( View Tweet )
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Lifestyle and Incretin Therapy Advice for Rheumatologists

Jack Cush, MD

As GLP-1/GIP receptor agonists become standard co-management tools for obese patients with RA, PsA, axSpA, and gout, this JAMA Insights perspective by Kushner, et al. reframes lifestyle counseling as an adjunct to pharmacotherapy - a reversal of the traditional model. This has with direct

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Added IVIG is Effective in Myositis A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly diagnosed IIMs. https://t.co/XLrvLSoOic https://t.co/xhjPBXLxiC

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Dr. John Cush @RheumNow( View Tweet )
True or False: According to a metanalysis of 87 studies, higher BMI and smoking were linked to reduced methotrexate efficacy in rheumatoid arthritis. Check your knowledge in the latest RheumIQ quiz at https://t.co/LHFv1P6XZe.

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Dr. John Cush @RheumNow( View Tweet )

Added IVIG is Effective in Myositis A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly diagnosed idiopathic inflammatory myopathies (IIMs). https://t.co/uNNJ9sHU8M
Dr. John Cush @RheumNow( View Tweet )
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Early RA Referral Clinics Work (9.18.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com

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Metanalysis of 87 studies shows predictors of #MTX response: early Dz, low dz activity, early MTX initiation, and absence of erosive disease. Smoking and higher BMI were linked to reduced efficacy. https://t.co/OfB09aHNOS https://t.co/4UiOgfW940

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Dr. John Cush @RheumNow( View Tweet )
ACR, guidance, guidelines

ACR Updates Osteoarthritis Guidance

ACR

The American College of Rheumatology (ACR) has released updated clinical guidance for the treatment and management of osteoarthritis (OA) of the knee, hip, and hand. The evidence-based recommendations update the 2019 ACR/Arthritis Foundation guideline and are designed to support individualized,

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Review of HLA-B27

Jack Cush, MD

HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint trafficking point to new plausible, targetable

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Indian study of 85 #RA pts in LDA or better (DAS28-ESR ≤ 3.2). W/ 6 mos F/U, 39 (46%) had 1+ RA flare (DAS28 > 3.2); time to flare 12 wks (8–18) unrelate to Dz activity. Predictors: seropositivity (HR 2-2.3) https://t.co/ifqeoPtxpx https://t.co/ltx64X55fd

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Dr. John Cush @RheumNow( View Tweet )
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Added IVIG is Effective in Myositis

Jack Cush, MD

A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly

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undifferentiated,arthritis,early,RA

Early RA Referral Clinics Work!

Jack Cush, MD

An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals.

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Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/JDvVZ1KEIY
Dr. John Cush @RheumNow( View Tweet )
EBR Journal Club: Dapirolizumab Pegol in SLE (PHOENYCS GO) The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal to an important RCT in rheumatology. Each review covers four domains: Does this apply to my patients? What is the risk https://t.co/Pi45T99oJm
Dr. John Cush @RheumNow( View Tweet )
The 1980s quietly rewired rheumatology. Methotrexate became the anchor DMARD. APS emerged as a distinct clinical syndrome. SLE classification was standardized. Cytokine biology began pointing toward the biologic era. A decade that moved rheumatology from symptom control toward https://t.co/9NUXorQDTG

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Aravind Palraj @Rheumat_Aravind( View Tweet )
Dr John Stone grand rounds Kroc lecture #wustlRheum. Pearls: -IgG4RD can manifest as a variable vasculitis -Men have worse disease -Histology will not show necrosis or neutrophils -IgG4 levels will rise as the disease progress (>5X) -Rx with B cell therapy @alhkim @RheumNow https://t.co/GUw348OrrA

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TheDaoIndex @KDAO2011( View Tweet )
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Weight Loss Improves Psoriatic Disease Substantially!

Jack Cush, MD

Even before the introduction of incretin therapy and bariatric surgery, many randomized and interventional studies (2019–2026) have consistently showed that weight loss produces clinically meaningful, dose-dependent improvement in both psoriasis and psoriatic arthritis.

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A Day of Infamy (9.11.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz

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JAMA: Review of Adult Rheumatoid Arthritis

Jack Cush, MD

Smolen, Kerschbaumer, Aletaha, and Robinson have published a comprehensive review article of rheumatoid arthritis (RA) in JAMA, noting significant changes to our understanding and treatment guidelines.

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Scale,weight

Obesity in Axial Spondyloarthritis: what are we missing beyond the scale?

Antoni Chan, MD, PhD

Obesity in axial spondyloarthritis (axSpA) is not a minor comorbidity. Beyond the scale, there are several factors that need to be considered with obesity in axSpA.

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ACP Clinical Guideline on Treatments of Overweight or Obese Adults In July 2026, ACP published its first living clinical guideline addressing pharmacologic management of overweight and obesity in nonpregnant adults in outpatient settings. As this therapeutic area is rapidly https://t.co/5oQIY7J2Aw
Dr. John Cush @RheumNow( View Tweet )
Necrotizing arteritis is rare w/ IgA Vasculitis (IgAV). Review compared 30 IgAV-NA to 257 adult IgAV & 196 PAN pts. Overall IgAV-NA is a severe IgAV phenotype with life-threatening complications & should prompt vascular imaging and intensified immunosuppression. IgAV-NA had more https://t.co/GRVcqRPKTL
Dr. John Cush @RheumNow( View Tweet )

Therapeutic Updates

Lupus Nephritis

Sponsored by RheumNow
Management of CKD in Lupus Nephritis Patients
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

UCB RX Update MARCH
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

rheumthought

Obesity in Rheumatic Diseases: More than just a Comorbidity

Marina Magrey, MD
Magrey RT cover image
A few years ago, when I would see a patient with rheumatic disease and increased BMI, I would often document it as obesity as a comorbidity, recommend weight loss and exercise, and then move on. My approach has changed.
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rheumthought

Obesity and Lupus: Coconspirator or Comorbidity?

Alfred Kim, MD, PhD
Dr. Al Kim

Dr. Al Kim, St. Louis, discusses the effects of obesity on lupus activity, organ damage, complement levels and mTor activation.

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ICYMI: Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
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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