Lupus

True or False: Compared to adult systemic sclerosis, juvenile systemic sclerosis is more commonly associated with diffuse cutaneous disease and renal crisis. Test your knowledge in this week's RheumIQ at https://t.co/TBlB4pmnKa. https://t.co/q4wlnCQsny

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Dr. John Cush @RheumNow( View Tweet )
Resolved HBV infx (HBsAg-neg/anti-HBc+) retrospective study of HBc seroclearance in 230 pts Rx w/ anti-CD20 mAb. anti-HBc seroclearance seen in 16.5% (assoc w/ Younger age, less CD20 Rx, MMF Rx). HBV reactivation seen 5/230 (2.2%), including two w/ HBc seroclearance. HBc https://t.co/T0gfxftOgu
Dr. John Cush @RheumNow( View Tweet )
The Scleroderma Research Foundation (SRF) will konor John Stamos with the Bob Saget Legacy Award at this year's "Cool Comedy • Hot Cuisine" ceremony that will take place Tuesday, October 13, 2026, at the Beverly Wilshire in Los Angeles. Proceeds will support the SRF https://t.co/VHIpBJrXd4
Dr. John Cush @RheumNow( View Tweet )
Age-specific Incidence of Systemic Lupus Erythematosus Epidemiologic estimates on SLE diagnosis are limited. The CDC National Lupus Registry network of population-based SLE registries has assessed and reported age-specific incidence of SLE by sex, race, and ethnicity. https://t.co/g5A7DMQIyp
Dr. John Cush @RheumNow( View Tweet )
Aortic inflammation (Aortopathies) occurs in autoimmune rheumatic diseases (ARD) including Takayasus, #GCA, SLE, RA, AS, SSc, relapsing polychondritis, Cogan’s syndr, Behçet’s, & IgG4-related disease). Dx imaging options: CTA, MRI, & PET/CT. Underlying path may be granulomatous, https://t.co/lKBhEnTcKB
Dr. John Cush @RheumNow( View Tweet )
39 studies compared Juvenile systemic sclerosis (jSSc) & adult SSc. 935 jSSc vs 15,451 aSSc pts; jSSc had more diffuse cutaneous dz (70% vs 41%), more overlap myositis (33% vs. 5%), arthritis (33% vs 18%), digital ulcers (51% vs 20%), less renal crisis (0% vs 6%) & lower https://t.co/vflarmwSyv
Dr. John Cush @RheumNow( View Tweet )
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Age-specific Incidence of Systemic Lupus Erythematosus

Jack Cush, MD

Epidemiologic estimates on systemic lupus erythematosus (SLE) diagnosis are limited. The Centers for Disease Control and Prevention (CDC) National Lupus Registry network of population-based SLE registries has assessed and reported age-specific incidence of SLE

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402 RA pts w. symptomatic Extra-articular manifestations (eg, neuropathy, KCS) had significant impairment in quality of life and work productivity, independent of disease activity. They had lower HAQ (0.92 vs 0.68) & more Absenteeism https://t.co/1FH9gyxoxK https://t.co/faToGXpdSQ

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Dr. John Cush @RheumNow( View Tweet )
steroid prednisone lab

Glucocorticoids: Use vs.Toxicity

Jack Cush, MD

This review article addresses the recognition, prevention and management of glucocorticoid toxicity in rheumatic patients.

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e-cigarette use assoc w/ a 1.5-fold incr risk of RA & SLE. All of Us Research prg matched 15,909 e-cig users vs nonusers. 66 new RA or SLE among current e-cig (IR 1.43/1,000PYs) vs nonusers (0.93/1,000PYs; IRR 1.54); applies to past or current smokers https://t.co/xYRezwQFYC https://t.co/pnNANfui4Y

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Dr. John Cush @RheumNow( View Tweet )
VA study of 4108 RA-ILD (2006-21). PRED use was 65-77%, A& 1st line Rx (MMF, AZA, RTX, CTX) incr after ILD, use was low (1.2-12%). MTX decr (47 to 30%), but LEF, TNFi, ABA incr. Predictors of ILD Rx: FVC, CCP+, ILD Dx after 2012. https://t.co/GT3Vwo11w1 https://t.co/KFDKsjkN0k

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Dr. John Cush @RheumNow( View Tweet )
SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/DIe2OJhZIc
Dr. John Cush @RheumNow( View Tweet )
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Rheum Scholarship (8.21.2026)

Jack Cush, MD

Dr. Cush reviews the news and journal articles from this past week on RheumNow.com; talking about lumbar belts, scholarships and misdiagnosis.

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Childhood vs Adult onset SLE? Retro Australian Lupus Registry study of 519 SLE pts (68/13% w/ cSLE) found childhood onset had signif more damage (SDI≥1 53 vs 40%; renal Dz 62 vs 37%), more Dz activity, less LLDAS-50 (36% vs 51%) https://t.co/ttBRtSVl5n https://t.co/hoN1t16Za3

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Dr. John Cush @RheumNow( View Tweet )
Systematic review of targeted Rx for lupus nephritis during pregnancy (2000-25). HCQ & AZA are cornerstone good Rx. Acceptable: tacrolimus, ASA. MMF is TERATOGENIC-AVOID! Not Enuf data; Voclosporin, obinutuzumab, Anifrolumab https://t.co/otO9nMHHuO https://t.co/1hLysZLJnG

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Dr. John Cush @RheumNow( View Tweet )
Rheum Survey >> What therapy do you most commonly use to treat Sjogrens disease? Answer here: https://t.co/XJEsqoSlbn

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Dr. John Cush @RheumNow( View Tweet )

Multiple chronic conditions (MCCs; AKA multimorbidity) is highly prevalent in AIRDs; complicates Rx & increases adverse outcomes & all-cause mortality. MMCs 86% in RA, 81.5% in SLE, w/ a notable patterns of cardiopulmonary and mental health disorders https://t.co/AOWCsEodXR https://t.co/NyAR0TUQkE

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Dr. John Cush @RheumNow( View Tweet )
SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/Savx5IOTcG
Dr. John Cush @RheumNow( View Tweet )
Rheum Survey >> What therapy do you most commonly use to treat Sjogrens disease? Answer here: https://t.co/XJEsqoSlbn

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Dr. John Cush @RheumNow( View Tweet )

3 SLE pts w/ Bx class III/IV LN had Lg proteinuria flares (4.6–13.4 g/d) despite MMF plus belimumab & were given voclosporin (+MMF) w/ rapid, sustained proteinuria reduced (≤0.7 g/day w/in 9–12 mos) & stable/improved eGFR, & GC tapering. Creat increases Rx w/ dose adjustments https://t.co/38lcD8DPgn
Dr. John Cush @RheumNow( View Tweet )
Study of 154 anti-Ku Ab+ pts (51 IMMM, 46 SLE, 30 Sjögrens, 27 Sc) = 60 (39%) had ILD - 75% progressed; more rapidly in males. BUT Ku+ is rare <4%, not specific, without clear clinical implications. Ku is a myositis-assoc Ab (like Ro52/Ro60, U1-RNP, PM/Scl) https://t.co/s1VFhaOYgn
Dr. John Cush @RheumNow( View Tweet )
NHANES survey (2005-2018) studied prevalence of arthritis in adults w/ depression (PHQ-9 ≥10), From 15157 depressed pts, RA was most prevalent & increased 7.8 to 17.7%; OA unchanged 11.7 to 10.7% & PsA declined 7.2 to 1.7%. Depression assoc w/ higher risk for RA (OR 1.40) & PsA https://t.co/fcROEvsHDT
Dr. John Cush @RheumNow( View Tweet )
Biomarker substudy from SENSCIS trial of nintedanib in SSc-ILD shows higher baseline KL-6 levels >1000 U/mL was assoc w/ greater FVC worsening; & decrease in CA-125 was assoc. w/ nintedanib responses. Epithelial cells are primary source of CA-125 in the lung https://t.co/7VJ2UDOKin
Dr. John Cush @RheumNow( View Tweet )
CDC warns of an association betw severe CNS arboviral disease, w/ neurologic sequelae in pts receiving anti-CD20 mAbs (rituximab, ocrelizumab, ofatumumab, obinutuzumab, etc). West Nile virus was the most common arbovirus, but there are others; mortality up to 40%. Most arbovirus https://t.co/WWg41fsRgr
Dr. John Cush @RheumNow( View Tweet )
Study of 154 anti-Ku Ab+ pts (51 IMMM, 46 SLE, 30 Sjögrens, 27 Sc) = 60 (39%) had ILD - 75% progressed; more rapidly in males. BUT Ku+ is rare <4%, not specific, without clear clinical implications. Ku is a myositis-assoc Ab (like Ro52/Ro60, U1-RNP, PM/Scl) https://t.co/MHz8mdqDqi
Dr. John Cush @RheumNow( View Tweet )

Therapeutic Updates

Expert insights on the 2024 ACR Guideline recommendations for lupus nephritis

Sponsored by Aurinia
Aurinia 2026 May RX Update
Two experts in lupus care offer a balanced perspective on applying the updated ACR Guideline recommendations and the clinical nuances of managing lupus nephritis.
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Navigating the Path to SLE Remission

AZ RX Update
Watch rheumatologists Dr Anca Askanase and Dr Cristina Arriens discuss their clinical perspectives on how to target and achieve DORIS remission in clinical practice.
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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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Recent Blogs

Advanced Practice Rheum

Systemic Lupus Erythematosus

Jack Cush, MD
APR SLE VIDEO COVER
Dr. Cush reviews systemic lupus erythematosus.
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Advanced Practice Rheum

Evaluation of Rheumatic Complaints

Jack Cush, MD
Eval of Rheum Complaints Cover Image
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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rheumthought

CNS Lupus (NPSLE)

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