Top Four and More (4.10.2026)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.
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VEXAS Syndrome - A Review
Beck et al has published a review of the VEXAS syndrome in The Lancet, focusing on the pathogenesis, spectrum, and treatment strategies.
https://t.co/Nik0TJm6Qu https://t.co/WS35PRnbBv
Dr. John Cush @RheumNow( View Tweet )
Machine learning predicts macrophage activation syndrome in adult Still's disease - 312 AOSD - XGBoost model had 5 predictors: ferritin, splenomegaly, Plt#, cholesterol, & ESR (AUC 0.839, sensit 0.824, specificity 0.710. https://t.co/QrogaCYPCT https://t.co/Z6WgCnFTfx
Dr. John Cush @RheumNow( View Tweet )
19 yr old male is Dx w/ Stills Dz (Fever 104F, pleuritis, organomegaly, WBC 24k, ESR 98, CRP 11 mg/L) - what drug do you prescribe first?
Dr. John Cush @RheumNow( View Tweet )
19 yr old male is Dx w/ Stills Dz (Fever 104F, pleuritis, organomegaly, WBC 24k, ESR 98, CRP 11 mg/L) - what drug do you prescribe first?
Dr. John Cush @RheumNow( View Tweet )
A multi-center, retrospective chart review of 82 Still's disease pts (63% female; mean Dx age 6.4 ± 4 yrs; F/U ~2.8 yrs). When analyzing Dz course, 34% were monophasic, 46% polyphasic (higher-than-expected), 19.5% persistent Dz. non-monophasic predicted by active 3 mos from Dx https://t.co/V7OxwEI4it
Dr. John Cush @RheumNow( View Tweet )
Disease activity defined in adult-onset Still's dz. Criteria developed using Italian cohort 187 & 41 from CONSIDER (canakinumab) trial. Active AOSD based on 5 criteria: fever, plus 1: skin rash, arthritis, pt global>2 cm, CRP > 10 mg/L; or any 3 without fever (AUC 0.93, 0.85, https://t.co/J94pkQqZFP
Dr. John Cush @RheumNow( View Tweet )
Moral Distress (3.27.2026)
Dr. Jack Cush reviews the journal reports and news from RheumNow.com. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
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A multi-center, retrospective chart review of 82 Still's disease pts (63% female; mean Dx age 6.4 ± 4 yrs; F/U ~2.8 yrs). When analyzing Dz course, 34% were monophasic, 46% polyphasic (higher-than-expected), 19.5% persistent Dz. non-monophasic predicted by active 3 mos from Dx https://t.co/XWJSsIE7Pn
Dr. John Cush @RheumNow( View Tweet )
Rheumatology Pitfalls (3.20.2026)
Dr. Jack Cush reviews the regulatory actions, news and journal reports from this past week on RheumNow.com.
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Outcomes of 87 VEXAS pts in the AutoInflammatory Disease Alliance (AIDA) - 75% had recurrent fever episodes. Fever episodes assoc w/ mortality, organ involvement (CV, GI, Lung), but not with complete response to biologics. https://t.co/j9vzBJNMj0 https://t.co/YGsE7LH3ml
Dr. John Cush @RheumNow( View Tweet )
A multi-center, retrospective chart review of 82 Still's disease pts (63% female; mean Dx age 6.4 ± 4 yrs; F/U ~2.8 yrs). When analyzing Dz course, 34% were monophasic, 46% polyphasic (higher-than-expected), 19.5% persistent Dz. non-monophasic predicted by active 3 mos from Dx https://t.co/qtONtpeA22
Dr. John Cush @RheumNow( View Tweet )
B cell Targeted CAR-T Therapy for Autoimmune Diseases
The review by Qi Li and colleagues provides a comprehensive examination of the progression, clinical applications, challenges, and future directions of B-cell-targeted CAR-T therapy across multiple autoimmune conditions. https://t.co/b1SmrOBbBU
Dr. John Cush @RheumNow( View Tweet )
UBER Rheumatology Ride (3.6.2026)
Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com
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Spectrum of skin Sxs in 518 pts w/ Stills dz from AutoInflammatory Dz Alliance (AIDA) Network Registry dedicated to Still’s disease includes Salmon evanescent rash (64%), macules (7.7%), urticaria (6%), persistent pruritic papules & plaques (PPPP) (4.8%) https://t.co/DW9NoaxNPP https://t.co/U5GrCutYT0
Links:
Dr. John Cush @RheumNow( View Tweet )
ANA Pollution (2.06.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory news from this past week on RheumNow.com
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🧬 PAPA Syndrome: When Sterile Inflammation Mimics Infection
(Pyogenic Arthritis, Pyoderma gangrenosum, Acne)
•A rare monogenic autoinflammatory disease
•Caused by gain-of-function mutations in PSTPIP1
🧠 Pathophysiology
•Mutant PSTPIP1 → increased interaction with pyrin https://t.co/tJ4INdgfky
Ravi Kumar @RheumattDoc( View Tweet )
This week’s RheumNow Live pre-Learn spotlight: Vasculitis & Autoimmune disease.
We’re diving into this important topic with expert-led talks from Drs. Nancy Olsen, Matthew Baker, and Clay Cockerell. To help you get the most out of their sessions, our speakers have shared key https://t.co/zLKY52Fi17
Dr. John Cush @RheumNow( View Tweet )
The 2025 Rheumatology Year in Review
The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.
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Rheumatologists can’t ignore hypereosinopilic syndrome anymore, not when it borders on our diseases and therapies. Great takeaways on subtypes and therapies from Giacomo Emmi in an elegant talk #EULAR2025
https://t.co/yzQVt1fLKW https://t.co/hrbEeppZhW
Links:
Dr. John Cush @RheumNow( View Tweet )
Hyperferritinemia is common in Hyperinflammatory syndromes but is a hallmark of Macrophage activation syndrome and Sepsis; and is a poor prognostic sign too. MAS is excessive activation of T-lymphocytes & macrophages leading to cytokine storm & multi-organ damage. https://t.co/PTJPhcvnzC
Dr. John Cush @RheumNow( View Tweet )
Best of 2025: Overview of the VEXAS Syndrome
A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.
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Telling You Where to Go (12.19.2025)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Who would've thunk - a PsA FMF connection? Labs to diagnose SSc-ILD? IgA-RF may be important or RZV may not work in JAK inhibitor treated patients?
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Disease Activity Criteria for Adult-Onset Still's Disease: EULAR Points to Consider
EULAR has published a "points to consider" (PtCs) guidance on the development of criteria for the assessment of the disease activity in adult-onset Still’s disease (AOSD).
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10 yr European retrospective study of haemophagocytic lymphohistiocytosis found 3345 deaths due HLH from 29 countries. Crude mortality rate = 5.3 per 10million PYs (range: 1.1-11.3). From 2011 to 2021, increasing from 3.9 to 6.6/10millPYs, varying by country, sex, age. https://t.co/58gCQ72saF
Dr. John Cush @RheumNow( View Tweet )
Therapeutic Updates
Dr. Jack Cush reviews the history, manifestations, diagnosis and treatment of Still's disease.
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Recent Blogs
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.
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Still’s disease and autoinflammatory disorders are rare conditions unified by recurrent fevers and inflammation of skin, joints, and other organs. While labs often support the diagnosis, these conditions are best diagnosed by genetic testing, or by specific criteria (in the absence of a genetic test). The following is a table that lists common misconceptions (myths) and their clarifying explanations.
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Podcasts
ACR 2025 Daily Podcasts Day2d
AOSD - Adult - Onset Still's Disease00:33:08 
ACR Fireside Chats - Still's disease Abstracts00:22:48
