Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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152 pts w/ immune thrombocytopenia (ITP) Rx in DBRPCT of Ianalumab (9mg or 3 mg/kg) or PBO q mo x 4 mos (all on Eltrombopag). Time to Rx failure signif longer w/ ianalumab. Stable 6 month response better w/ 9-mg group vs PBO (62% vs 39%; P=0.045) https://t.co/J04trYAwLu https://t.co/Alm8V2SAXn
Dr. John Cush @RheumNow( View Tweet )
Litifilimab in Cutaneous Lupus Erythematosus
Biogen has announced positive results of their Phase 2 study, evaluating litifilimab in patients with active cutaneous lupus erythematosus (CLE), presented at the recent American Academy of Dermatology (AAD) Annual Meeting. https://t.co/3Wb6iFViOm
Dr. John Cush @RheumNow( View Tweet )
Still's Disease Update
Arthritis Research & Therapy has published an overarching review of Still's disease - claiming it to be a single acquired and complex autoinflammatory disease in which both pediatric and adult forms share core pathogenic mechanisms, genetic associations and clinical presentations, with minor
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Litifilimab in Cutaneous Lupus Erythematosus
Biogen has announced positive results of their Phase 2 study, evaluating litifilimab in patients with active cutaneous lupus erythematosus (CLE), presented at the recent American Academy of Dermatology (AAD) Annual Meeting.
Litifilimab is an investigational monoclonal antibody that
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Modest Benefits with AI Scribes on EHR Documentation
EurekAlert!
Documenting a patient visit in the electronic health record (EHR) is essential to healthcare delivery, but also a major contributor to clinician burnout. Artificial intelligence (AI)-enabled ambient documentation, or “AI scribes,” can automatically generate draft clinical notes for review
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OL phase 2 study 50 active systemic JIA pts Randomized to IL-1 inhibitor, firsekibart or TCZ q2wk x 24 wks. At day 28, modified ACR Pedi 30response (no fever) favored FIRS 3mg dose (94% vs 75% vs 82%). Also higher ACR Pedi 70/90 responses & steriod tapers. https://t.co/8bdCLUFFLT https://t.co/ddQe7k25UE
Links:
Dr. John Cush @RheumNow( View Tweet )
Couldn’t attend https://t.co/4UQlqwujiR 2026?
You can now watch the entire meeting On Demand.
This high-impact program features leading experts discussing:
• RA outcomes and pathogenesis
• Obesity, inflammation, and rheumatic disease
• Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3
Links:
Dr. John Cush @RheumNow( View Tweet )
Malignancies Not Increased with Biologic Therapies
The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo
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JAMA Guideline on the Management of Crohn Disease
JAMA has published a current Clinical Guidelines Synopsis on the Management of Crohn Disease (CD) in Adults.
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Brepocitinib in Dermatomyositis
The NEJM reports that brepocitinib, an oral TYK2–JAK1 inhibitor, was studied in a phase 3 trial of refractory dermatomyositis (DM) patients and shown to have significant benefits at the higher dose.
https://t.co/gYLP5artRZ https://t.co/PHYXEzzM2j
Dr. John Cush @RheumNow( View Tweet )
AAD 2026 Annual Mtg presents new data on another TYK2 inhibitor. In 2 phase 3 RCTs (ONWARD1 ONWARD2) envudeucitinib was superior to placebo & apremilast in 1700 plaque psoriasis pts https://t.co/DPlzDw5m7N
Dr. John Cush @RheumNow( View Tweet )
Brepocitinib in Dermatomyositis
The NEJM reports that brepocitinib, an oral TYK2–JAK1 inhibitor, was studied in a phase 3 trial of refractory dermatomyositis (DM) patients and shown to have significant benefits at the higher dose.
https://t.co/YNxrVTIubb https://t.co/uFY3kMOvui
Dr. John Cush @RheumNow( View Tweet )
AFFINITY Study - Combination Biologic Therapy in PsA
A pilot trial assessed the efficacy and safety of the guselkumab+golimumab (COMBO) combination versus GUS monotherapy in active PsA (failing a prior tumor necrosis factor inhibitor (TNFi-IR) and showed superiority in ACR 50 https://t.co/f2CB8FnZMB
Dr. John Cush @RheumNow( View Tweet )
Review: Rheumatoid Arthritis–Associated Interstitial Lung Disease
RA-ILD represents the most severe extra-articular manifestation of rheumatoid arthritis, affecting an estimated 1% of the adult population in the US and Northern Europe. Prevalence estimates vary widely (up to 58%), reflecting different diagnostic criteria, imaging modalities, and study
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Long-Term Bimekizumab Safety Data
Adverse effects from bimekizumab through 2 years or more of treatment for psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) were about as expected from shorter-term data, results from long-term extension studies indicated. https://t.co/hp2jVSGk8G
Dr. John Cush @RheumNow( View Tweet )
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
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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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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
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
