NHANES, Numbers, & Risk (7.18.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".
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Interstitial Lung Disease and Lung Cancer Risk
A large prospective cohort study found that interstitial lung disease (ILD) is associated with an increased risk of lung cancer.
https://t.co/SdOT28qVfr https://t.co/6KhAijhfHw
Links:
Dr. John Cush @RheumNow( View Tweet )
Interstitial Lung Disease and Lung Cancer Risk
A large prospective cohort study found that interstitial lung disease (ILD) is associated with an increased risk of lung cancer.
This cohort study of 5,425,976 used a a sibling-controlled design to account for genetic factors. Data was taken from the Swedish Total Population Register
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RABBIT (German biologics register) study shows overall small increase in malignancy w/ JAKi vs bDMARDs. Risks greatest in those ≥ 60 yrs, w/ Hi Dz activity, on ≥3 prior csDMARDs. 2285 JAKi vs 4259 bDMARDs: 88 vs 135 malignancies CAs (IRs 11.6 vs 8.9; adj HR 1.40). JAKi risk https://t.co/PRn0G94CB0
Dr. John Cush @RheumNow( View Tweet )
Cancer Survival Outcomes in Autoimmune Skin Disease Patients
Patients with autoimmune skin diseases (ASDs) with cancer had significantly better cancer survival outcomes than those without ASD, suggesting coexistant autoimmune or inflammatory disease does not adversely affect a https://t.co/apnX4GGAdT
Dr. John Cush @RheumNow( View Tweet )
Hmmm Really? (7.11.2025)
Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?
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No Increased Malignancy Risk with Ixekizumab
A pooled analysis of 25 randomized clinical trials affirms the safety of ixekizumab (IXE) when used to treat patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA). The observed incidences of malignant neoplasms were consistent with the US general
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Case–control study RA pts > 65yrs in US. SEER (cancer) database (2014–2019). Overall cancer risk not associated with use of JAKi (adjOR 1.04), TNFi (0.98) or other bDMARDs (0.98). But, JAKi use was assoc w/ incr risk of lung CA (OR 1.40), esp in Males (2.12) & >2 yrs JAKi. Lower https://t.co/u2psafyN1I
Dr. John Cush @RheumNow( View Tweet )
Cancer Survival Outcomes in Autoimmune Skin Disease Patients
Patients with autoimmune skin diseases (ASDs) with cancer had significantly better cancer survival outcomes than those without ASD, suggesting coexistant autoimmune or inflammatory disease does not adversely affect a cancer prognosis.
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RABBIT (German biologics register) study shows overall small increase in malignancy w/ JAKi vs bDMARDs. Risks greatest in those ≥ 60 yrs, w/ Hi Dz activity, on ≥3 prior csDMARDs. 2285 JAKi vs 4259 bDMARDs: 88 vs 135 malignancies CAs (IRs 11.6 vs 8.9; adj HR 1.40). JAKi risk https://t.co/AlK2SWn6UR
Dr. John Cush @RheumNow( View Tweet )
Review of 104 irAE pts rx w/ JAK inhib. (82% tofacitinib). Checkpoint inhib was for Lung (20%), gastric (17%) & melanoma (16%). JAKi indications: myocarditis (70%), myositis (33%), hepatitis (24%). JAKi potentially effective esp in irAE pts unresponsive to cytokine Rx. https://t.co/8ezpAOzpRh
Dr. John Cush @RheumNow( View Tweet )
Clinical determinants of multiple drug failure in D2T RA
2000+ RA cohort 250+ refractory
-Low financial status
-Cancer Hx
-CV comorbidities
-Chronic use of NSAID or GCs
Protective: Regular participation in leisure activities
#POS0030 @RheumNow #EULAR2025 https://t.co/mdePGkHU82
Dr. John Cush @RheumNow( View Tweet )
Cancer risk in rheumatoid arthritis: anything new?
There is still a question I have a hard time answering with certainty when people living with rheumatoid arthritis ask me: Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many https://t.co/6rbZg5Fr2k
Dr. John Cush @RheumNow( View Tweet )
Key summary slide of research in the use of CD19 CAR T cells in rheumatology indications
Dinesh Khanna @RheumNow #EULAR2025 https://t.co/CoFHqaE1L1
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Autologous CAR T cell production, administration and monitoring
Dinesh Khanna @RheumNow #EULAR2025 https://t.co/zrXjxSCRgl
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Should we screen for #lung #cancer in #SSc high risk Pts? When >10 yrs?
Greek cohort of SSc since 1995
Disease duration 12 yrs,
smoking lung ca group ⬆️58% vs 29%
⬆️dcSSc
⬆️immunosuppression
OR >4X lung ca if dcSSc, IS
Less #DU
#PO0940 @RheumNow @eular_org #EULAR2025 https://t.co/L2zEkP8pAc
Links:
Janet Pope @Janetbirdope( View Tweet )
Should we still be worried about lymphoma developing in RA patients?
Incidence has plummeted with modern therapy, although still a small risk. TNFi and other bDMARDs don’t seem to confer any real risk.
So what should our approach be?
Karin Hellgren #EULAR2025 @RheumNow https://t.co/9ZodpojSaz
David Liew @drdavidliew( View Tweet )
Cancer risk in rheumatoid arthritis: anything new?
Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many confounding parameters, such as disease duration, disease state, and disease activity come into play. A promising session explored comorbidities in Rheumatoid Arthritis, in particular cancer and
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The definition of MAS. MAS is secondary HLH. Other causes of secondary HLH are infections, malignancy and iatrogenic.
Georgin-Lavialle S @RheumNow #EULAR2025 https://t.co/CpB78JBlVJ
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Clinical Pearl's for #MAS
Infections are still the most common cause.
Next is malignancy...
Then other causes like autoimmunity..
Ask a detailed history ! Sometimes check with the family when the pt can't give history..
#EULAR2025 @RheumNow https://t.co/fepercz5Af
Bella Mehta @bella_mehta( View Tweet )
JAKi: expanding RMD indications—but important safety concerns to consider
⚠️ Cancer: Neutral vs MTX/placebo, ↑ risk vs TNF
⚠️ Infection: ↑ with age, disease activity & GC use—not uniformly higher with JAKi
🗣️ Patients rank infection risk as top concern
@rheumnow #EULAR2025 https://t.co/RJRDWQjqNC
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Jiha Lee @JihaRheum( View Tweet )
#Cancer is not ⬆️in JAKi vs #bDMARDs in
#rheumatoid #arthritis
When adjusted for #confounders
#JAKPOT data
Now you see it (unadjusted ⬆️risk)
Now you don’t (adjusted =#malignancy)
JAKi vs bDMARDs in RA
EULAR2025 @RheumNow @eular_org
#JAK it out! new perspective on JAKi https://t.co/wCQ3dHNAVa
Links:
Janet Pope @Janetbirdope( View Tweet )
Would you use #CAR-T in #polyrefractory #RA
#EULAR2025 @RheumNow @eular_org
Janet Pope @Janetbirdope( View Tweet )
Clinical determinants of multiple drug failure in D2T RA
2000+ RA cohort 250+ refractory
-Low financial status
-Cancer Hx
-CV comorbidities
-Chronic use of NSAID or GCs
Protective: Regular participation in leisure activities
#POS0030 @RheumNow #EULAR2025 https://t.co/qNHQoHCb80
Links:
Aurelie Najm @AurelieRheumo( View Tweet )
#OP0066 Danish registry study finds no increased risk of cancer recurrence with bDMARDs vs csDMARDs in RA patients with prior solid tumor in remission. IPTW-adjusted HR for any bDMARD: 0.92 (95% CI 0.38–2.21).
📉 TNFi, ,RTX also not associated with recurrence
@RheumNow #EULAR2025
Jiha Lee @JihaRheum( View Tweet )
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