Lupus

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Antibiotics are not linked to Autoimmune disease in kids

EurekAlert!

The global incidence of autoimmune diseases among children has increased over the past few decades. A study published August 21st in the open-access journal PLOS Medicine by Ju-Young Shin at Sungkyunkwan University, Republic of Korea, and colleagues suggests that early

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Rheumatic Dz & HIV - Arthralgia: self limiting - HIV-assoc arthritis: mimics RA - Occurs w/ HIV: SpA, ReA, PsA - Less : IIM, vasculitis, opportunistic infxn https://t.co/Yf7jZ0icZw https://t.co/6FuJgvDYRF

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Dr. John Cush @RheumNow( View Tweet )
Anifrolumab appears effective & safe in refractory Cutaneous LE. OL Study of 15 CLE, on HCQ, topical steroids, failed multiple DMARDs. All Rx w/ ANIF 300 mg IV q4wks. ALL improved, CLASI-A decr from 16 to 1 (p<0.001); CLASI-D decreased from 5 to 4 (p<0.001). DBPCT needed! https://t.co/umEYz0XDyt
Dr. John Cush @RheumNow( View Tweet )
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Teaching You How to Think… (8.15.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and  aphorisms to live by.

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Systematic review of 47 studies covering 1.5 million cases found that Dx of Crohns, SLE, Type I DM positively associated w/ incr risk of pancreatic, esophageal, colon, liver, and hepatobiliary cancers. MS assoc w/ lower risk of pancreatic, esophageal, rectal, & colorectal CA https://t.co/g0N5eHhJYj
Dr. John Cush @RheumNow( View Tweet )
Prospective study 1,237 pregnant women (APS excluded) - finding LA-RVVT, anti-β2GPI IgG, predicted preeclampsia & intrauterine fetal death (IUFDR) and were were in identifying obstetric antiphospholipid syndrome (APS) https://t.co/5zKpR9NTcw https://t.co/6HXID7gtwR

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Dr. John Cush @RheumNow( View Tweet )
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The Patient Journey with Rheumatic Disease

Jack Cush, MD

Oton and colleagues have reviewed the "patient journey" - from symptoms to specialty referral in those diagnosed with rheumatic and musculoskeletal diseases (RMDs).
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Aging Quiets Lupus UCSF researchers have found that epigentic changes in interferon genes over time may lead to lupus being less active as they age. https://t.co/MLBFLXnXOQ https://t.co/9aacdZPoED

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Dr. John Cush @RheumNow( View Tweet )
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Inefficiencies of ANA Testing

Jack Cush, MD

The Journal of Rheumatology has published an analysis of antinuclear antibody (ANA) multiplex testing showing its nonspecific utility and poor rate of return in identifying ANA-associated autoimmune rheumatic disease (ARDs).

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Study of 110 #SLE pts found 41% w/ osteoporosis, 35% of whom had Lupus nephritis (LN). SLE w/ lower BMD assoc w/ LN classes III & IV, U1-RNP Abs, high CRP, & longer Dz duration, also w/ higher age, HAQ, C3 levels. 86% were on glucocorticoids, mean age 48 yrs. https://t.co/dqutqbvnjB
Dr. John Cush @RheumNow( View Tweet )
lupus SLE

Aging Quiets Lupus

EurekAlert!

UCSF researchers have found that epigentic changes in interferon genes over time may lead to lupus being less active as they age. Lupus is a “classic” autoimmune disease. It causes the immune system’s first-line viral defenses — known as interferons — to attack the body. Nearly every organ is at

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HCQ Preserves Renal Function in Lupus Nephritis Lupus nephritis (LN) patients on long-term therapy with hydroxychloroquine (HCQ) showed significantly less decline in renal function, compared with patients treated otherwise, a 10-year retrospective study indicated. https://t.co/YpJGpAysUQ
Dr. John Cush @RheumNow( View Tweet )
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A New RA Approval (8.1.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and a new treatment for RA from the FDA.

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HCQ Preserves Renal Function in Lupus Nephritis Lupus nephritis (LN) patients on long-term therapy with hydroxychloroquine (HCQ) showed significantly less decline in renal function, compared with patients treated otherwise, a 10-year retrospective study indicated. https://t.co/dB6G34c6Mw
Dr. John Cush @RheumNow( View Tweet )
"FLAME" - machine learning model developed to predict SLE flares. Data from 28,433 SLE pts (2011-2022) looked at clinical & social determinants of health (SDoH) to predict 3 mo flare risk. AUROC = 0.67; SHAP analysis identified HA, OBS, & pyuria as predictors. Is this the https://t.co/6Eqqc9w2oV
Dr. John Cush @RheumNow( View Tweet )
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HCQ Preserves Renal Function in Lupus Nephritis

MedPage Today

Lupus nephritis patients on long-term therapy with hydroxychloroquine showed significantly less decline in renal function, compared with patients treated otherwise, a 10-year retrospective study indicated.

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Systemic immune-inflammation index (SII), as a potential biomarker -- computed as platelet count × neutrophil count/lymphocyte count. SII has been shown to be useful in RA, PsA, SpA, SLE and vasculitis, reflecting disease activity, drug responses & supplements ESR & CRP levels https://t.co/LuFaYbWiWN
Dr. John Cush @RheumNow( View Tweet )
If severe refractory SLE is defined as SLEDAI-2K≥10 despite steroids & immunosuppressives; Cohort of 3,744 SLE - 14% (578) had srSLE. Median SLEDAI-2K = 12, & decreased to 6 at 6m & 12m> < 25% achieved LLDAS & only 1% attained GC-free remission @ 12 mos https://t.co/7tehA27gyT https://t.co/yef4wCpqNf

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Dr. John Cush @RheumNow( View Tweet )
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Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors

Jack Cush, MD

Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer.
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NHANES, Numbers, & Risk (7.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".

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Stroke in patients with SLE is associated with a poorer outcome than matched controls in terms of functional recovery, recurrence, and mortality - study of 40 SLE vs 120 controls w/ CVA https://t.co/spBT1u6bfj https://t.co/eVNYBogJWz

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Dr. John Cush @RheumNow( View Tweet )
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1 in 5 Patients are Unaware of their Arthritis Diagnosis

Jack Cush, MD

Current CDC numbers suggest that arthritis (any type) affects an estimated 67.1 million (27.9% ) adults in the USA.  Interestingly, 1 in 5 do not know their arthritis subtype (21.6%, 14.4 million).

This most recent analysis of the prevalence and distribution of arthritis subtypes

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Rheums! Question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. https://t.co/HsqM9xLNtP https://t.co/voONsOLeSK

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Dr. John Cush @RheumNow( View Tweet )
🎩REGENCY: Obinutuzumab + standard therapy improved renal outcomes in #lupus nephritis across all tested response definitions (REGENCY, BLISS-LN, AURORA-1). Week 76 CRR consistently 13–16% higher vs placebo. Results hold despite variable thresholds. @RheumNow #EULAR2025 #OP0006

Dr. John Cush @RheumNow( View Tweet )

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ICYMI: SLE: advances to achieve deep B-cell depletion

Md Yuzaiful Md Yusof, MRCP(UK), PhD

The race is on for the first chimeric antigen receptor (CAR)-based therapy to be approved for the treatment of systemic lupus erythematosus. Its main principle is to induce deep B-cell depletion, with the hope to reset the B-cell aberrant immunity for a sustained clinical remission. At EULAR

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Recent Blogs

CNS Lupus (NPSLE)

Jack Cush, MD
Cush RhTh CNS
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose? Read Post

Hydroxychloroquine for Everyone

Jack Cush, MD
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Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit. Read Post
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