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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Systemic Treatments for Chronic Plaque Psoriasis
JAMA Dermatology has published a review of the pharmacologic landscape on managing adults with moderate to severe plaque psoriasis.
https://t.co/fJQDvZDdbs https://t.co/IYAsdujsMf
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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
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Systemic Treatments for Chronic Plaque Psoriasis
JAMA Dermatology has published a review of the pharmacologic landscape on managing adults with moderate to severe plaque psoriasis. Armstrong et al
Spotty Medicare Coverage for Newer Rheumatoid Arthritis Meds
MedPage Today
Medicare coverage of targeted disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) -- both under Medicare Advantage and in separate Part D plans -- is likely to leave many patients wanting, researchers found.
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FDA has approved secukinumab (Cosentyx) for use pediatric patients (aged >12yrs) with moderate to severe hidradenitis suppurativa https://t.co/oX4LGU16QP
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REVEAL, a 5-yr real-world study of 236 SLE pts initiating anifrolumab (basekbube SLEDAI-2K 7 for mucocutaneous (67%) & MSK (49%) dz. At 6 months, 26% achieved remission, 66% reached LLDAS, and 57% achieved LLDAS5. Authors claim rapid onset of action https://t.co/16OQatOcPj https://t.co/mU9aciCNcH
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NEJM: Obinutuzumab in Active Systemic Lupus Erythematosus
A phase 3 trial of obinutuzumab, an anti-CD20 monoclonal antibody, showed potent B-cell depletion and clinical efficacy active systemic lupus erythematosus without evidence of nephritis.
https://t.co/OEuNAZlgzp https://t.co/yjUmJITAmQ
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Pilot phase I open-label trial of the PPARγ agonist pioglitazone (ACTOS; 45 mg/d) in 13 pts w/ inclusion body myositis (IBM) showed promise. After 32 weeks, no clinical improvement but proteomic muscle metabalomics & PPARGC1A expression improved. https://t.co/MtiTnwRfaE https://t.co/jUthouMSnP
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FDA Approves Icotrokinra for Plaque Psoriasis
Today the FDA approved an oral IL-23 inhibitor, icotrokinra (Icotyde), for use in moderate-to-severe plaque psoriasis in adults and children 12 years of age and older (who weigh at least 40 kg) who are candidates for systemic therapy or phototherapy.
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FDA has approved secukinumab (Cosentyx) for use pediatric patients (aged >12yrs) with moderate to severe hidradenitis suppurativa https://t.co/G1BtS15sWT
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2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management
The European Alliance of Associations for Rheumatology (EULAR) has updated their rheumatoid arthritis (RA) management recommendations, notably with fewer recommendations (total of 9, down from 11 in 2022 version), by merging and removing previous recommendations.
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UCB announced topline results of the BE-BOLD head-to-head study where bimekizumab (IL-17i) was superior to risankizumab (IL-23i) study; 553 active PsA in achieving an ACR50 response at 16 weeks. Enrolled PsA pts were either bilogic naïve or who had previous exposure to 1 TNFi
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NEJM: Obinutuzumab in Active Systemic Lupus Erythematosus
A phase 3 trial of obinutuzumab, an anti-CD20 monoclonal antibody, showed potent B-cell depletion and clinical efficacy active systemic lupus erythematosus without evidence of nephritis.
https://t.co/b5qHBotxbI https://t.co/dqzZodOokq
Dr. John Cush @RheumNow( View Tweet )
UCB announced topline results of the BE-BOLD head-to-head study where bimekizumab (IL-17i) was superior to risankizumab (IL-23i) study; 553 active PsA in achieving an ACR50 response at 16 weeks. Enrolled PsA pts were either bilogic naïve or who had previous exposure to 1 TNFi
Dr. John Cush @RheumNow( View Tweet )
TYK2 Inhibitor Deucravacitinib FDA Approved for Psoriatic Arthritis
On Friday, March 6th, the FDA approved deucravacitinib (Sotyktu) for the treatment of adults with active PsA based on the results of the pivotal Phase 3 POETYK PsA-1 and POETYK PsA-2 clinical trials. https://t.co/a6rmortnoS
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NEJM: Obinutuzumab in Active Systemic Lupus Erythematosus
A phase 3 trial of obinutuzumab, an anti-CD20 monoclonal antibody, showed potent B-cell depletion and clinical efficacy active systemic lupus erythematosus without evidence of nephritis.
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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
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FDA has approved deucravacitinib (Sotyktu) the Treatment of Adults with Active Psoriatic Arthritis based on the results of the pivotal Phase 3 POETYK PsA-1 and POETYK PsA-2 clinical trials. Sotyktu is the only tyrosine kinase 2 (TYK2) inhibitor to be approved for PsA https://t.co/8xBrgPfENH
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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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Open-label experience with upadacitinib in 27 Behcets pts (median 36 yrs) w/ median BDCAF 4 (2–7). At 6 mos overall response seen in 23/27 (85%) (16 CRs, 7 PRs) w/ signif reductions in BDCAF, CRP, ESR, & steroid dose by week 24. 3 pts relapsed during F/U https://t.co/VXkskVyWgT
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Osteoporosis: Thinking outside the box
As rheumatologists, most of us manage osteoporosis in some form every single day. We have newer agents, newer sequencing strategies, and an increasing number of patients asking for “less medicinal” options that go beyond a prescription. At RWCS, Dr. Gina Woods opened her talk by reframing
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FDA has granted Fast Track designation to J&Js nipocalimab for use in #SLE based on the results of a Phase 2b JASMINE study in which nipocalimab demonstrated reduction in lupus disease activity and potential for steroid sparing https://t.co/puQN6ecScj https://t.co/au422eamLR
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IL-23i fails in GCA? Small RCT of 53 GCA pts (age 71 yrs; 60% new; 40% relapsing GCA) 35 given Guselkumab vs 18 on PBO. Wk 28 GC free remission in 40% vs 33% (P .64), also w/ similar flare rates (31% v 39%). results didnt supportguselkumab use in GCA. https://t.co/AMTmiDBc94 https://t.co/KdWTX9K2Bo
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B cell Targeted CAR-T Therapy for Autoimmune Diseases
EurekAlert!
Chimeric antigen receptor T (CAR-T) cell therapy has emerged as a transformative approach in modern medicine, demonstrating remarkable efficacy in targeting pathogenic B-cell lineages with unprecedented specificity. Originally developed for B cell malignancies, this innovative immunotherapy
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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.
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Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base.
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Podcasts
ACR 2025 Daily Podcasts Day3b
ACR 2025 SpA Topic Podcasts Compilation 1
ACR 2025 CAR-T Topic Podcasts Compilation 1
