Novel Rx

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Early vs Delayed Belimumab in Lupus

Jack Cush, MD

An economic evaluation of early vs delayed use of the Blys inhibitor, belimumab (BEL), in systemic lupus erythematosus (SLE) has shown both cost effectiveness and clinical utility of early BEL initiation in active lupus patients.

While most would advocate for using your best therapy

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RT @RichardPAConway UIP pattern RA-ILD is where the big problem is. We are less good at treating this. Perhaps the newer agents such as nerandomilast will change this? #RNL26 https://t.co/lzKFulaomD
Dr. John Cush @RheumNow( View Tweet )
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Diagnosing and Managing GCA and Takayasu’s Arteritis

Adela Castro, MD

Giant-cell arteritis and Takayasu’s arteritis are both large-vessel vasculitides, but each brings its own diagnostic and management challenges. Many of the difficulties overlap because they are rare, heterogeneous, and lack perfect diagnostic tests or specific biomarkers.

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Early: BITE compassionate use CD19×CD3 T cell engager blinatumomab in 5 antisynthetase myositis & BCMA×CD3 teclistamab in 5 scleroderma pts, all Tx refractory. Both showed rapid clinical, serologic, histologic benefits, with cytokine release syndr as AE of concern https://t.co/CTppiWim0a
Dr. John Cush @RheumNow( View Tweet )
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A Modern Approach to Osteoporosis Management

Adela Castro, MD

Currently, fewer than half of patients diagnosed with osteoporosis receive appropriate pharmacologic therapy. This treatment gap reflects several challenges in osteoporosis management, including limited disease awareness, barriers to medication access, clinician discomfort with therapy selection

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Together PSO Trial - Combination Ixekizumab and Tirzepatide

Jack Cush, MD

Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over IXE alone.

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RT @richardPAConway The new kid on the block in RA-ILD (and other PPF). Nerandomilast, an anti-fibrotic with additional anti-inflammatory/immunomodulating functions. Demonstrated significant mortality benefit in ILD. #RNL26 https://t.co/8DU3WyPQGy
Dr. John Cush @RheumNow( View Tweet )
Genentech announced results of Phase III, MAJESTY OL study of obinutuzumab vs tacrolimus in 142 pts w/ primary membranous nephropathy & found signif more complete remissions at 2 yrs in obintuzumab Rx pts. Obintuzumab (Gazyva) if FDA approved for lupus nephritis. https://t.co/maJbvUCkBe
Dr. John Cush @RheumNow( View Tweet )
RT @RichardPAConway UIP pattern RA-ILD is where the big problem is. We are less good at treating this. Perhaps the newer agents such as nerandomilast will change this? #RNL26 https://t.co/Z0BXxyNrCI
Dr. John Cush @RheumNow( View Tweet )
Terkeltaub RNL26 Gout lecture

Disease Modification, Disparities and the Next Therapeutic Frontier in Gout

Audrey Gibson, PA-C

Gout management has entered what Dr. Robert Terkeltaub MD from UC San Diego described as its “disease-modifying era,” during his talk at RheumNow Live 2026. In a recent comprehensive review of the past, present, and future of gout therapy, the central message was clear: “We can really apply

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Haque and Goodman

Obesity, Surgery, and Optimizing Patient Care

Eric Dein, MD

Rheumatologic care involves multidisciplinary approaches and collaboration with specialties to treat complex, systemic diseases. While many Pods at RheumNow Live are disease specific, the Pod II focused on Advancing Practice on important and emerging areas affecting rheumatologic patients. This

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Vasculitis

Richard Conway, MBBChBAO, PhD

Sunday’s vasculitis session at RNL26 was a fantastic update on inflamed blood vessels, large and small, by two experts in the field: rheumatologist Dr. Mike Putman and dermatopathologist Dr. Clay Cockerell.

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Advances in RA-ILD

Richard Conway, MBBChBAO, PhD

Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26. 

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FDA has announced "Breakthrough Designation" for 3 drugs + 1 test being developed: ** Biogen: litifilimab (targets dendritic cells) for cutaneous lupus ** Novartis: Ianalumab (BAFF blockade) for Sjogrens ** J&J: Nipocaiimab (FcRn) for Sjogrens ** Encarta: pocket Lyme test https://t.co/RMKg14rejq
Dr. John Cush @RheumNow( View Tweet )
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ANA Pollution (2.06.2026)

Jack Cush, MD

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

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FDA sent a complete response letter to AstraZeneca on their application (BLA) for anifrolumabs (Saphnelo) subcutaneous use in SLE. Despite a positive TULIP-SC trial & EU approval of SC-anifrolumab, FDA & sponsor still have to work things out. CRL reasons are unknown https://t.co/3dNwEyolrj
Dr. John Cush @RheumNow( View Tweet )
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FDA vs. Amgen: At Odds Over Avacopan

MedPage Today

The FDA has requested that Amgen voluntarily withdraw avacopan (Tavneos), a treatment for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, but the company said it has no plans to pull the drug from the market.

Originally developed by ChemoCentryx, the oral

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ALTO: Long-Term Abatacept Outcomes in At-Risk RA

Jack Cush, MD

Lancet Rheumatology has published the ALTO results - long term outcomes of the APIPPRA trial, demonstrating that treatment with abatacept (ABA) in at risk patients can delay progression to rheumatoid arthritis (RA) for up to 4 years.

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Potential New Rheumatology Drugs for 2026. These have had successful phase III RCTs and will need to be reviewed by regulators: ** deucravacitinib (Sotyktu) Tyk2 inhib for PsA ** Icotrokinra (Icotyde) oral IL-23i for psoriasis ** brepocitinib TYK2/JAK1 inhibitor for https://t.co/CQmfjIDMp3
Dr. John Cush @RheumNow( View Tweet )
FDA has announced "Breakthrough Designation" for 3 drugs + 1 test being developed: ** Biogen: litifilimab (targets dendritic cells) for cutaneous lupus ** Novartis: Ianalumab (BAFF blockade) for Sjogrens ** J&J: Nipocaiimab (FcRn) for Sjogrens ** Encarta: pocket Lyme test https://t.co/zODOTWyqP8
Dr. John Cush @RheumNow( View Tweet )
The EMA CHMP has started a review of oral complement C5 inhibitor avacopan (Tavneos) based on serious questions about amendments to the data from the pivotal ADVOCATE study. The drug was approved in 2021 for use in GPA & MPA. https://t.co/a5ggUqk1dG

Links:

Dr. John Cush @RheumNow( View Tweet )

B Cells at the Brink in Sjögren Disease The current issue of Arthritis & Rheumatology reviews the current understanding of the immunopathogenesis of Sjögren disease (SjD) and how this understanding has informed drug development for this systemic autoimmune disorder. https://t.co/p3dn1Ca2ag
Dr. John Cush @RheumNow( View Tweet )
Roche Canada announced that Health Canada has approved obinutuzumab (Gazyva) for the treatment of adult patients with active lupus nephritis who are receiving standard therapy. Following four initial doses in the first year, Gazyva can be administered twice yearly https://t.co/P4dCVkoPCH
Dr. John Cush @RheumNow( View Tweet )
APPIPRA Study - Benefits of Early Treatment Treating people who are at high risk of rheumatoid arthritis (RA) can delay the onset of the disease for several years, with benefits also continuing well after treatment has stopped. https://t.co/GYguq7VlqT https://t.co/5Z0BXIm3cM

Links:

Dr. John Cush @RheumNow( View Tweet )
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RheumNow Live Preview (1.30.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com - and the top 5 reasons to attend RheumNow Live 2026, which is one week away.

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Recent Blogs

Advanced Practice Rheum

Difficult to Treat Rheumatoid Arthritis

Jack Cush, MD
D2T RA Cover
Dr. Cush addresses the management of difficult-to-treat rheumatoid arthritis (D2TRA).
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Hydroxychloroquine for Everyone

Jack Cush, MD
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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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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. 
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