Lupus

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Keep HCQ Blood Levels Up to Avoid Cardiovascular Disease in Lupus

MedPage Today

Key Takeaways

  • Hydroxychloroquine (HCQ) is the mainstay of treatment for systemic lupus erythematosus (SLE), but adherence issues and variability in blood levels may compromise its effectiveness.
  • This study examined the
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6 mos. RCT of low-dose baricitinib (Bari) plus danazol for refractory ITP (n 216); Pts Rx w/ either Bari+DNZ vs DNZ alone. At 6-mos a durable response was seen in 45% of Bari+DNZ vs 20% in DNZ monotherapy (P < 0.001). AEs were equal (48% vs 45%), More studies needed on this https://t.co/YbF49ZNA0E
Dr. John Cush @RheumNow( View Tweet )
Machine learning study of 657 multiethnic Lupus pts - 14% had organic & 30% had neuropsychiatric damage. High Glucocorticoid dose was the strongest predictor or organic Dz. NP damage predicted by MD global, fatigue, pain, & steroids https://t.co/LVK57LxKk6 https://t.co/VLisZT7ReY

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Dr. John Cush @RheumNow( View Tweet )
heart in a puzzle

Arrhythmias in Autoimmune Rheumatic Disease

Jack Cush, MD

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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Cerebral atrophy is common in SLE - assoc w/ age (OR 1.1), higher education (0.22), NPSLE (OR 4.6), cognitive impairment & lower dsDNA titers. 70 pts (mean age 40, Dz dur 12yrs). Cerebral atrophy 53% (mostly 76% mild). https://t.co/ewRmNj8zNA https://t.co/yT8TCXZREA

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Dr. John Cush @RheumNow( View Tweet )
Interferon-α as an Immunologic Driver of Sjögren's Disease Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and can be elevated a decade before diagnosis. This study assessed the role of type 1 interferon (IFNα) in its onset and https://t.co/Clj9u5COzQ
Dr. John Cush @RheumNow( View Tweet )
Yesterday the EMA approved upadacitinib (Rinvoq) for the Treatment of Adults and Adolescents with Non-Segmental Vitiligo - the 1st therapy approved for the most common form of vitiligo. Based on positive results from the Phase 3 Viti-Up trials https://t.co/MMv5LjZclQ https://t.co/zN41GC5T15

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Dr. John Cush @RheumNow( View Tweet )
Interferon-α as an Immunologic Driver of Sjögren's Disease Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and can be elevated a decade before diagnosis. This study assessed the role of type 1 interferon (IFNα) in its onset and https://t.co/0BDDvR5cUB
Dr. John Cush @RheumNow( View Tweet )
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$2 Million in Research Grants for Juvenile Arthritis

Jack Cush, MD

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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Primary biliary cholangitis is a chronic cholestatic disease characterized by autoimmune-mediated destruction of bile ducts, leading to fibrosis, cirrhosis, & liver failure. Ursodeoxycholic acid is 1st line Rx. New Rx include elafibranor & seladelpar (activates peroxisome https://t.co/tKloXvJYek
Dr. John Cush @RheumNow( View Tweet )
GI dz & malnutrition in scleroderma (SSc) is common, assessed by BMI. Among 450 SSc (F/U 5.3 yrs), lower BMI were significantly assoc w/ pseudoobstruction, smaller oral aperture, higher Medsger vascular severity scores. Defines those at risk https://t.co/JY9YFOWE5C https://t.co/xFZ0rCXjQv

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Dr. John Cush @RheumNow( View Tweet )
Among 784,091 pts in a UK acute MI registry, 715 (0.1%) had SLE. SLE pts were younger & more female. SLE w/ MI had signif higher adjusted all-cause mortality from 30 days (HR 1.62) to 5 years (HR 1.84), despite age & having less traditional cardiovascular comorbidities https://t.co/78oHVWTdTJ
Dr. John Cush @RheumNow( View Tweet )
Chinese cohort of 209 AOSD pts identifed 49 (23%) w/ lung dz (by CXR), yet 69% were asymptomatic. Significcant risk factors for AOSD-LD were pleuritis, MAS (HR 2.62), & Dz relapse (HR 2.6). Imaging patterns: acute exudative pattern most prevalent, followed by interstitial and https://t.co/2IPJWRJicP
Dr. John Cush @RheumNow( View Tweet )
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Chikungunya Club Meeting (7.24.2026)

Jack Cush, MD

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

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Sjogren,board

Interferon-α as an Immunologic Driver of Sjögren's Disease

Jack Cush, MD

Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and
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Metanalysis of 51 studies shows vaccination is suboptimal in Rheum. Influenza Vax rates: RA 50%, SLE 42%, AS 43% & Psa 53%. Pneumococcal vaccinations even lower: 37%, 30%, 39% and 41%. More by with age & comorbidites and by rheumatologists (vs PCPs) https://t.co/3DborC9BLW https://t.co/MPDeJUH0HI

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Dr. John Cush @RheumNow( View Tweet )
Systemic sclerosis metanalysis of 31 studies (32,134 pts) shows malignancy risk signif increased (SIR 1.66; CI 1.32 - 2.08). Highest: esophageal, liver, cervical, lung, & Heme (SIR 3.35 - 13.95). 7.4 yr mean from SSc to CA dx. https://t.co/IhxvfkMqkf https://t.co/dTFjD4iqth

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Dr. John Cush @RheumNow( View Tweet )
Metanalysis of 31 studies (14,548 pts) looked at infection in idiopathic inflamm myopathy (IIMs). Infection prevalence was 24%, primarily Respiratory tract. PJP, aspergillosis, H zoster most prevalent pathogens. Risk factors: older age, male, DM, HTN,MDA5+ (OR 3.41), rapidly https://t.co/Go51MUOQlG
Dr. John Cush @RheumNow( View Tweet )
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ACP Position Paper on Dietary Supplements

Jack Cush, MD

More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives. The paper notes that under DSHEA, dietary

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EMD Serono Announces FDA Breakthrough Therapy Designation for Enpatoran (TLR 7/8 inhibitors) for use in Cutaneous Lupus; based on the results from the Phase 2 WILLOW study https://t.co/TNM4whC0Qk https://t.co/70Cibg1gkW

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Dr. John Cush @RheumNow( View Tweet )
DMARD Efficacy in RA-ILD A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional,

Dr. John Cush @RheumNow( View Tweet )

CAR-T

CAR-T Therapy: EULAR 2026 Conference Recap

Jack Cush, MD

CAR-T therapy in autoimmune disease is moving fast - but is it ready to move beyond specialized referral centers? This EULAR 2026 recap covers the mechanistic data, relapse biology, and access innovations shaping that answer.

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EULAR26: Vasculitis updates: Glucorticoid use in AAV and GCA EULAR recommends a combination of glucocorticoids with either rituximab or cyclophosphamide for remission induction in life-threatening or organ-threatening AAV, followed by gradual tapering of glucocorticoids. https://t.co/9HI9SwMSSv
Dr. John Cush @RheumNow( View Tweet )
Insights into Treating Lupus - A Rheum Survey RheumNow recently surveyed clinicians to better understand current practice patterns, educational needs, and barriers to the use of new, advanced therapies in systemic lupus erythematosus (SLE). A total of 197 clinicians completed https://t.co/HNaUK5Q9uq
Dr. John Cush @RheumNow( View Tweet )
ICYMI: B Cells at the Brink in Sjögren Disease The current issue of Arthritis & Rheumatology reviews current understanding of the immunopathogenesis of Sjögren disease (SjD) and how that has influenced the quest for drug development for this most systemic autoimmune disorder. https://t.co/OBFqHYof5m
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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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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Podcasts

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