A Patient’s Plea for a New Paradigm in Autoimmune Disease
A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?
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Which autoimmune condition carries the highest relative risk for lymphoma? Test your knowledge in the latest RheumIQ quiz at https://t.co/TBlB4pmnKa https://t.co/sx8fpdHgHN
Dr. John Cush @RheumNow( View Tweet )
Neoplasia and Autoimmune Disease
Malignancy rivals cardiovascular disease as a leading cause of death in patients with systemic autoimmune diseases. Chronic inflammation and immune dysregulation can drive oncogenesis, while antitumor immune responses can trigger autoimmune phenomena (paraneoplastic syndromes, checkpoint
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Aspirin Cardiovascular Prevention in Giant Cell Arteritis
A retrospective target trial emulations has shown that low-dose aspirin (ASA) given with a giant cell arteritis (GCA) diagnosis is associated with a lower risk of major adverse cardiovascular events (MACE), but a higher risk of GI bleeding.
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Malignancies Not Increased with Biologic Therapies
The risk of malignancy in RA patients receiving biologic agents was evaluated by metanalysis of RCTs and found no significant increased risk of malignancy compared with other DMARDs or with placebo.
https://t.co/ZEO4jP5RwA https://t.co/C1YeTSh7ZN
Dr. John Cush @RheumNow( View Tweet )
Screening High Risk Myositis Patients for Cancer
An Italian retrospective study of 411 idiopathic inflammatory myopathies (IIM) patients applied IMACS criteria to assess the risk of cancer and found significantly more cancers in those at high risk.
https://t.co/AHvC5xfsCr https://t.co/Bd4VMRX9PU
Dr. John Cush @RheumNow( View Tweet )
Screening High Risk Myositis Patients for Cancer
An Italian retrospective study of 411 idiopathic inflammatory myopathies (IIM) patients applied IMACS criteria to assess the risk of cancer and found significantly more cancers in those at high risk.
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Italian retrospective study 411 IIM pts classified cancer risk per IMACS criteria: 44% high-, 38% intermed- 18% standard-risk. 9.2% had CA w/in 3yrs. Signif more in high-risk (OR 4.05). CA predictors: TIF1γ (OR 12.3), SAE1 (OR = 11.9) https://t.co/j4gA0g79bI https://t.co/Pt5nMs89bl
Dr. John Cush @RheumNow( View Tweet )
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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Hopkins Myositis study of 637 dermatomyositis pts - FLARES were assoc w/ DM Dz activity; manifest as rash (76%), motor weakness (58%), Pulm (19%), arthritis (12%). O
nly 2–5% of Flare pts had cancer Dx w/in 6–24-mos https://t.co/AKC9oIKAS7 https://t.co/26q8FfkUfl
Dr. John Cush @RheumNow( View Tweet )
5 yr Italian study of hospitalized autoimmune pts(2018-23) 4,896 IMID pts compared to 301,126 non-IMIM. IMID had signif higher risk cancer (adj OR 1.32) highest 1st yr. Decreased from 1.83 @ yr 1 to 1.2 @5+ yrs. IMID had more lung & bladder CA, leukemia lymphoma & melanoma https://t.co/UXqDHQtzv0
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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Myocarditis causes 17,000 deaths/Yr worldwide. Causes include A) iatrogenic/autoimmune: checkpoint inhibitors & gene therapy; B) High income countries: parvo B19, herpesvirus 6; C) low income: dengue, HIV, malaria and Trypanosoma cruzi (Chagas disease) https://t.co/0FjPyXygpz https://t.co/04J23AiqtK
Dr. John Cush @RheumNow( View Tweet )
Myocarditis causes 17,000 deaths/Yr worldwide. Causes include A) iatrogenic/autoimmune: checkpoint inhibitors & gene therapy; B) High income countries: parvo B19, herpesvirus 6; C) low income: dengue, HIV, malaria and Trypanosoma cruzi (Chagas disease) https://t.co/en4OnhWPda https://t.co/urwkjlVeg6
Dr. John Cush @RheumNow( View Tweet )
Italian population study of 37996 RA (prevalence 0.54%) pts w/ and 12875 incident cases (incid rate 33.1/100K), there were 1288 deaths/8yrs (MR 21.3/1K), median age=83; SMR 1.28 (1.21 to 1.35), higher <45 yrs (2.15). Leading causes CV (37%), cancer (21%) & infxn (11%) https://t.co/wPx5iqW7Nl
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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Rheumatic Immune-related Adverse Effects with Checkpoint Inhibitor Therapy
A retrospective study of patients who developed rheumatic immune-related adverse events (R-irAEs) after receiving immune checkpoint inhibitors (ICIs) at two oncology centers in Spain suggests that early https://t.co/hYf6GiR6TN
Dr. John Cush @RheumNow( View Tweet )
Rheumatic Immune-related Adverse Effects with Checkpoint Inhibitor Therapy
A retrospective study of patients who developed rheumatic immune-related adverse events (R-irAEs) after receiving immune checkpoint inhibitors (ICIs) at two oncology centers in Spain suggests that early https://t.co/jKCbIvfebm
Dr. John Cush @RheumNow( View Tweet )
Rheumatic Immune-related Adverse Effects with Checkpoint Inhibitor Therapy
A retrospective study of patients who developed rheumatic immune-related adverse events (R-irAEs) after receiving immune checkpoint inhibitors (ICIs) at two oncology centers in Spain suggests that early recognition can lead to effective management that allows continuation of cancer therapy.
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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/09BnvVYfiZ
Dr. John Cush @RheumNow( View Tweet )
CDC study of Death certificate data showed that btw 2018–2023, there were 14,936 #SLE deaths (43% w/ SLE as the underlying cause). Mortality rate per million: females 5.97 > males 1.16, blacks 10.7. Causes of death:heart disease (0.93), cancer (0.56), COVID-19 (0.51). https://t.co/qTe6O66wRO
Dr. John Cush @RheumNow( View Tweet )
SATISFACTION (2.27.2026)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Taiwan National retrospective study (2001-20) of 8732 newly Dx, biologic-naïve RA pts initiating b/tsDMARDs. Found no difference in malignancy event rates between DMARDs. 2.16% over 5-yr & 2.89% over 18yrs. (6384 Rx w/ TNFis, 667 w/ TCZ, 656 w/ ABA, 1025 on tsDMARDs) https://t.co/54ZMPywEYI
Dr. John Cush @RheumNow( View Tweet )
Referral Rules to Live By (2.20.2026)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Highlights include referral rules, combination biiologics in psoriasis and don't use JAK inhibitors in pregnancy.
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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 )
Recent Blogs
Cancer is the most difficult DMARD risk to discuss with patients. Few warnings could scare people away from a drug faster than the words “may increase risk of cancer,” yet the risks (even when substantiated) have all been low and may be counterbalanced by the benefits of disease control.
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Imagine that 100 years from now, your great granddaughter, an eminent rheumatologist, reviews the history of rheumatoid arthritis mimics.
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The quality of the meeting was on par with the host city, with extensive data presented on a range of topics, from social media to drug safety. The organization committee did a great job and I got the feeling that most people felt the congress was user friendly given the magnitude of the event. During this year’s meeting, I had the privilege of working with the RheumNow team, which gave me the opportunity to hone my social media skills and get my Twitter game on. After reviewing plenty of posters and going to numerous presentations, here are my top take home messages as classified by disease state.
Podcasts
EULAR 2021 - Day2b00:35:57
