Novel Rx

Enzyme Porcupine inhibition of Wnt signaling is a promising treatment forsclerosteosis - rare Dz caused by SOST mutations & loss of functional sclerostin. Results in high bone mass & skeletal overgrowth (Sxs of facial paralysis, hearing loss, incr intracranial pressure https://t.co/9DYO82quiC
Dr. John Cush @RheumNow( View Tweet )
Phase 3 trial shows inebilizumab reduces flares in IgG4-related disease (10% vs 60% in placebo; HR 0.13, p<0.001) and boosts remission rates without background immunosuppressants. CD19+ B-cell depletion shows promise as a new treatment. #Rheum @RheumNow https://t.co/7iSyPfnMV0 https://t.co/M51b0dipMs

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Natasha Salman, DO @DrNatashaSalman( View Tweet )
The IL-17A inhibitor, secukinumab, is in late-stage development forthe treatment of giant cell arteritis and polymyalgia rheumatica. https://t.co/JzzqS7bSjd https://t.co/9Qm0YsJmOL

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Dr. John Cush @RheumNow( View Tweet )
The IL-17A inhibitor, secukinumab, is in late-stage development forthe treatment of giant cell arteritis and polymyalgia rheumatica. https://t.co/JzzqS7bSjd https://t.co/PNvHdJsKlL

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Dr. John Cush @RheumNow( View Tweet )
heart.coronary

Is High Dose Aspirin Needed in Kawasaki Disease?

Jack Cush, MD

Does aspirin add any advantage to intravenous immunoglobulin (IVIG) alone in children with Kawasaki disease (KD)? A randomized clinical trial IVIG alone was not inferior to IVIG plus aspirin, suggesting that high-dose aspirin during initial IVIG treatment did not reduce coronary artery

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#JIA #biologics and #tsDMARDs: Are all patients getting the same access? MDTs, share your insights on on-label and off-label prescribing and help improve future care. 💬 Take the survey by 15 April: https://t.co/vC2Pv5vmH4 https://t.co/rRM5rH0QQl

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BSR @RheumatologyUK( View Tweet )
Full read state of the art review of treatments for Axial Spondyloarthritis Concluding unmet needs: -Suboptimal Tx Response - Limited Drug Options - No Biomarkers - Extra-Axial Dz - Non-Inflammatory Pain https://t.co/K3oqRCgTCP https://t.co/IPn09jMFM2

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Dr. John Cush @RheumNow( View Tweet )
2nd Opinions in Rheumatology https://t.co/R4CjJHEaL4 https://t.co/0quDwdANyU

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Dr. John Cush @RheumNow( View Tweet )
Vamorolone: a New Steroid on the Horizon? Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases. It is a dissociated steroidal compound with reduced side effects, and in an animal model of inflammation has shown effective https://t.co/38WTOAuuJy
Dr. John Cush @RheumNow( View Tweet )
Bimekizumab efficacy and safety in patients with psoriatic arthritis who had skin and nail psoriasis at baseline: Up to 2-year results from two phase 3 studies Sponsored by UCB https://t.co/461bFRZwjw

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Dr. John Cush @RheumNow( View Tweet )

Sjogrens is a hot area in drug development: “Sjogren’s Syndrome Pipeline Insight 2025” report provides comprehensive insights about 20+ companies and 22+ pipeline drugs, including: nipocalimab VAY736 (ianalumab) HZN-1116 AMG 329 R-2487 https://t.co/sVbyPLi2Um https://t.co/IlvthM7qyG

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Dr. John Cush @RheumNow( View Tweet )
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EMR Messaging Woes (4.11.2025)

Jack Cush, MD

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

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Inebilizumab, an anti-CD19+ (B cell)mAb was tested in myasthenia gravis in phase 3, 238 pt trial and shows to signif. improv function and reduce disease severity in acetylcholine recpt Ab+ or muscle-specific kinase Ab+ myasthenia gravis pts. https://t.co/vBBjf8AUug https://t.co/cUbK4PJEvf

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Dr. John Cush @RheumNow( View Tweet )
EMA has approved upadacitinib (Rinvoq) for use in the EU to treat adult patients with giant cell arteritis (GCA) - approval is based on data from the Phase 3 SELECT-GCA trial demonstrating sustained remission and key secondary endpoints https://t.co/Y2tyZPC9Et https://t.co/SHPz2Q94Vs

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Dr. John Cush @RheumNow( View Tweet )
Korean insurance claims study (2008–2021) 183,212 psoriasis & PsA pts, found Biologic Rx assoc w/ lower risk of new-onset & recurrent MACEs vs phototherapy (adj HR, 0.45 & 0.34). Nonbiologic systemic Rx lowered MACE risk (v photoRx) only in pts w/ prior Hx MACE (0.79) https://t.co/08wNm1AbpC
Dr. John Cush @RheumNow( View Tweet )
Does DMARD Rx affect neurocognitive function in older pts? bDMARDs targeting TNF-α & IL-6 may mitigate neuroinflammation & preserve cognitive function. But, cognitive impact of csDMARDs (MTX) is complex, w/ conflicting reports on its role in vascular dementia. https://t.co/6uMmOOdRoF
Dr. John Cush @RheumNow( View Tweet )
EMA has approved upadacitinib (Rinvoq) for use in the EU to treat adult patients with giant cell arteritis (GCA) - approval is based on data from the Phase 3 SELECT-GCA trial demonstrating sustained remission and key secondary endpoints https://t.co/ycPNuB8C8y https://t.co/MCJNltn8Lj

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Dr. John Cush @RheumNow( View Tweet )
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/YkUspqd92h https://t.co/cmAUWaScri

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Dr. John Cush @RheumNow( View Tweet )
FDA announced approval of Inebilizumab (Uplizna; Amgen), 1st approved Rx for IgG4-related disease (targets CD19+ B cells). IG4-related Dz is estimated to affect 20,000 in the USA. List price is $140,248.50 per dose, After two initial loading doses it is given q 6 mos. https://t.co/aD9yBVJukQ
Dr. John Cush @RheumNow( View Tweet )
Vamorolone: a New Steroid on the Horizon? Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases. It is a dissociated steroidal compound with reduced side effects, and in an animal model of inflammation has shown effective https://t.co/zHDyJbU23q
Dr. John Cush @RheumNow( View Tweet )
Upadacitinib for Giant-Cell Arteritis - A Phase 3 Trial The NEJM has published a randomized controlled trial in giant-cell arteritis (GCA) patients, demonstrating significant efficacy and safety of upadacitinib (UPA), given as 15 mg daily, as compared to placebo. https://t.co/Njmg2PKAbq
Dr. John Cush @RheumNow( View Tweet )
1st Line Biologics vs. csDMARDs in Adult Still's Disease A German multicentre, retrospective study assessed the first-line efficacy of biologics and conventional synthetic DMARD therapy in patients with adult-onset Still's disease (AOSD) and found biologic agents were https://t.co/NaxACbmyxl
Dr. John Cush @RheumNow( View Tweet )
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/0Ra8eUeBOi https://t.co/0dwOSxjVxs

Links:

Dr. John Cush @RheumNow( View Tweet )
FDA announced approval of Inebilizumab (Uplizna; Amgen), 1st approved Rx for IgG4-related disease (targets CD19+ B cells). IG4-related Dz is estimated to affect 20,000 in the USA. List price is $140,248.50 per dose, After two initial loading doses it is given q 6 mos. https://t.co/zHD2Yv3PjI
Dr. John Cush @RheumNow( View Tweet )
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An Epidural Letdown (4.4.2025)

Jack Cush, MD

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

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Recent Blogs

Best of 2023: New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?

Richard Conway, MBBChBAO, PhD
Lungs ILD
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.  Read Post

Choice Overload (and the Way Out)

Jack Cush, MD
paint,choice,overload,color
I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”. Read Post
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