Lupus

Optimizing Hydroxychloroquine Blood Levels in Lupus A large observational cohort study suggests that monitoring hydroxychloroquine (HCQ) blood levels is effective in systemic lupus erythematosus (SLE) patients with a target therapeutic range (for HCQ level monitoring) of https://t.co/7pggMk2pTO
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Reefer Madness (12.12.2025) Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow. B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs. https://t.co/SKEYlhTfLz https://t.co/mBX4GIQxKe

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Dr. John Cush @RheumNow( View Tweet )
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Optimizing Hydroxychloroquine Blood Levels in Lupus

Jack Cush, MD

A large observational cohort study suggests that monitoring hydroxychloroquine (HCQ) blood levels is effective in systemic lupus erythematosus (SLE) patients with a target therapeutic range (for HCQ level monitoring) of 750-1150 ng/ml.

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Roche announced that the European Commission has approved obinutuzumab (Gazyvaro in EU/UK & Gazyva in US) in combination with mycophenolate mofetil for the treatment of adult patients with active Class III or IV, with or without concomitant Class V, lupus nephritis. https://t.co/usUidNVMNY
Dr. John Cush @RheumNow( View Tweet )
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Reefer Madness (12.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com.  B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.

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QD Clinics - Mission: APP Partners in Care Week 1 QD300: Flare or Beware (featuring Lindsay Tom, PA-C and Phong Nguyen, MD) QD301: CAR-T Cell Therapy for Lupus (featuring Philip Mease, MD and Cayla Alexander, DNP) QD302: Unweanable PMR (featuring Jack Cush, MD, and Leilani Law, https://t.co/Ow2KMAzwGK
Dr. John Cush @RheumNow( View Tweet )
The countdown is on! ⏱️ Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one. ✅ Register now at https://t.co/4UQlqwujiR 🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu

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I agree that multiple assessments are needed to Dx NP-SLE; but my order of preference (for Dx yield) is: A) Hx c/w cerebritis; B) imaging to r/o other causes; C) CSF IgG index w/ Q albumin

Dr. John Cush @RheumNow( View Tweet )

purpura

B Cell Targeting in Idiopathic Thrombocytopenic Purpura

EurekAlert!

The New England Journal of Medicine  has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune

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QD Clinic: CAR-T Cell Therapy for Lupus Philip Mease, MD and Cayla Alexander, DNP, ARNP, Seattle, Washington, discuss the case of a patient with lupus who underwent CAR-T cell therapy for her disease. This QD clinic is presented as part of RheumNow's "Mission: APP Partners in https://t.co/WXWOLupWna
Dr. John Cush @RheumNow( View Tweet )
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Turkey Tryptophan (11.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

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Vitamin D and Lupus Outcomes (11.21.2025) Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow. https://t.co/M2e4kMi5H7 https://t.co/wEcAjWJSk7

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25-Hydroxyvitamin D levels and Lupus Outcomes Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/CYwVy7ls7y
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Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual

Dr. John Cush @RheumNow( View Tweet )

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Vitamin D and Lupus Outcomes (11.21.2025)

Jack Cush, MD

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

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Myelodysplastic & chr myelomonocytic leukemia pts rarely get lupus. Review of 19 w/ SLE & 5 w/ CLE; these were older (65 yrs), more male (15M/9F), w/ less renal [10%] & articular [36%] Dz w/ less dsDNA [32%]. Thought to be clonal inflammatory, & not autoinflammatory, process. https://t.co/EAvkJm6GQs
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25-Hydroxyvitamin D levels and Lupus Outcomes Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/4nhACulIw0
Dr. John Cush @RheumNow( View Tweet )
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A New Disease Activity Score for Antiphospholipid Syndrome?

EurekAlert!

APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and non-thrombotic (TMN) symptoms. These can range in severity, and people may have

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Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual

Dr. John Cush @RheumNow( View Tweet )

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Pulse Steroids and Mycophenolate in Juvenile Dermatomyositis

Jack Cush, MD

JAMA Dermatology has published a pilot study demonstrating the safety and efficacy of intermittent intravenous methylprednisolone pulse (IVMP) therapy plus mycophenolate in 28 patients with juvenile dermatomyositis (JDM).

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Review of neonatal Fc receptor (FcRn) blockers, being developed by J&J, argenx & UCB, showing utility in autoimmune dz as they reduce autoantibodies. FcRn inhibitor market may be worth USD 3.3 billion by 2035. Approved for myasthenia gravis & being developed in Sjögren’s, SLE, https://t.co/mBUla87dK5
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Postmenopausal women on estrogen hormone therapy (HT) had a modest incr risk (HR 1.33; 1.32-1.35; P < .001). of a new autoimmune Dz over next 5-10 yrs (vs those not on HT) TriNetX study of 889,413 HT vs 2,6 mill (not HT) - 6.7% vs 5.3% developed autoimmune dz at 5 yrs. https://t.co/fsi32XIzLe
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25-Hydroxyvitamin D levels and Lupus Outcomes

MedPage Today

Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said.

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+ANA's are common in pregnancy. Study of 2159 Chinese 1st trimester pregnant women found ANAs positivity in 14.7 % (1:100 most common titer; speckled most common pattern). ANA+ assoc w/ smoking, age 30-34 yrs, multiparity, thyroid Dz & hypertension https://t.co/mRQGajVe3g https://t.co/DqE1KC4Kgo

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Dr. John Cush @RheumNow( View Tweet )
SLE Prospect. Observational Study of 826 SLE pts over 3 yr for outcomes& IFN signature (IFNGS). 71% were IFNGS-high. IFNGS-high pts were younger. on GC w/ Hi SLEDAI-2K. SLEDAI-2K decreased over time, regardless of IFNGS. By 36mos, 45% had ≥1 flare; higher in IFNGS. https://t.co/CT70CvnOQ9
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Recent Blogs

Advanced Practice Rheum

Evaluation of Rheumatic Complaints

Jack Cush, MD
Evaluation of MSK cover
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice. Read Post
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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
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