Cardio/Pulmonary

Systematic review 14 studies assessed Lung ultrasound (LUS) (vs HRCT) to detect RA-ILD (using threshold of ≥ 5 B-lines) found sensitivity was 86.8% (95% CI 80.1–91.4), specificity 75.4% (95% CI 62.3–85.1), and AUC 0.890 https://t.co/GlNpsPBwtS https://t.co/FJ6B5E5CWy

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Dr. John Cush @RheumNow( View Tweet )
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Scleroderma-Specific Autoantibodies in Early Systemic Sclerosis

Jack Cush, MD

Prognostication is tenous in early scleroderma, especially in those with diffuse cutaneous systemic sclerosis (dcSSc). dcSSc has associated with substantial morbidity and disease-specific mortality. Analysis of an early SSc registry shows that anti-RNA

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Study of 119 Rheum pts on GLP-1 Rx (65% T2DM, 35% obesity; mean BMI 35). @ 12 mos wt loss −7.7 kg & 56% improved ≥1 BMI category. Signif decr in A1c, FBS, lipids, LDL, TG, ESR & CRP. GLP-1RAs useful cardiometabolic benefits https://t.co/fdNtvGu8Vb~ https://t.co/EdAqXfsjW0

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Dr. John Cush @RheumNow( View Tweet )
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Early RA Referral Clinics Work (9.18.2026)

Jack Cush, MD

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

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Research at Cedars-Sinai used synthetic noncoding RNA TY1 in a bleomycin mouse model of scleroderma, noting improved exercise tolerance, CV function, lung hydroxyproline, skin thickness, less fibrosis. TY1 attenuates the cGAS/STING pathway https://t.co/jOwlPokxKE https://t.co/aIgIPzZbGa

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Dr. John Cush @RheumNow( View Tweet )
A Day of Infamy (9.11.2026) Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. https://t.co/gzaqNz3i5k https://t.co/c8ShScutqC

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Metanalysis 11 studies & 104277 gout & hyperuricemic pts shows erectile dysfunction is signif. increased (RR1.37; 1.14-1.65) related to lower testosterone & estradiol. Other factors: obesity, age, DM, CVD. https://t.co/1ufih2E3UN https://t.co/NgQuHt4vR1

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Dr. John Cush @RheumNow( View Tweet )
Waist size matters! Using NHANES data (1999-2018) the weight-adjusted waist index (WWI) calculated on 5582 CKD pts. WWI was signif assoc w/ all-cause mortality (adj HR  1.17) & CV (1.24); these assoc partially mediated by NLR (inflammation) ~6.6%, showing both central adiposity https://t.co/kNf4nqiD2a
Dr. John Cush @RheumNow( View Tweet )
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A Day of Infamy (9.11.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz

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Swedish Pt Registry of 4317 AAV pts showed GPA & MPA had signif incr risk of CV dz (HR 2.04) & thromboembolism (HR 2.45); males incr MI risk (HR 2.25) & females incr ischemic stroke risk (HR 1.64). Sibs had no excess CVD-TE risk. The highest CVD-TE risk occurred within 3 mos. of https://t.co/FdbIXoCZf0
Dr. John Cush @RheumNow( View Tweet )
Sleep and Obesity: A Bidirectional Relationship In July 2026, JAMA published a concise review of the bidirectional relationship between sleep health and obesity. Obesity affects roughly 40% of US adults, and sleep problems affect nearly one-third. This review outlines the https://t.co/cA6P4aOHR0
Dr. John Cush @RheumNow( View Tweet )
Guidelines for Adult-Onset IgA Vasculitis A EUVAS-sponsored expert panel of 37 specialists across rheumatology, nephrology, dermatology, and pathology published evidence-based guidelines for adult-onset IgAV, which behaves very differently in adults than the usually https://t.co/12T8lJhPFe
Dr. John Cush @RheumNow( View Tweet )
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NME: New Molecular Entities (8.28.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com. Take this week's RheumIQ and test your knowledge!

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JAMA Review: Postural Orthostatic Tachycardia Syndrome (POTS)

Jack Cush, MD

Postural orthostatic tachycardia syndrome (POTS) is a chronic autonomic disorder affecting an estimated 0.1%–1% of the US population, with peak incidence at ages 13–29 and a striking 90% female predominance.

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Risk of Venous Thromboembolism in RA RA confers a 50–100% excess risk of venous thromboembolism (VTE) that remains even when remission is achieved. Disease control reduces but does not eliminate thrombotic risk. https://t.co/GXvuucL3ze https://t.co/fTw6UY7eZH

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Dr. John Cush @RheumNow( View Tweet )
Risk of Venous Thromboembolism in Rheumatoid Arthritis RA confers a 50–100% excess risk of venous thromboembolism (VTE) compared with the general population, with adjusted hazard/odds ratios ranging from 1.3–2.2 across large cohort studies (Vojinovic, Askling, Antovic; https://t.co/IsS6vqo6vU
Dr. John Cush @RheumNow( View Tweet )
Italian SPRING cohort of #SSc pts found only 5.3% (of 1689 pts) without the typical scleroderma pattern on nailfold change by NVC. They had milder dz, with less vascular dz (pitting scars 33 vs 48%), telangiectasias (52 vs 74%), calcinosis 3.4 vs 12%) & higher DLCOs at 12, 24, https://t.co/AoNAhVYfII
Dr. John Cush @RheumNow( View Tweet )
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Risk of Venous Thromboembolism in Rheumatoid Arthritis

Jack Cush, MD

RA confers a 50–100% excess risk of venous thromboembolism (VTE) compared with the general population, with adjusted hazard/odds ratios ranging from 1.3–2.2 across large cohort studies (Vojinovic, Askling, Antovic; Rheumatology, 2026).

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Multiple chronic conditions (MCCs; AKA multimorbidity) is highly prevalent in AIRDs; complicates Rx & increases adverse outcomes & all-cause mortality. MMCs 86% in RA, 81.5% in SLE, w/ a notable patterns of cardiopulmonary and mental health disorders https://t.co/AOWCsEodXR https://t.co/NyAR0TUQkE

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Dr. John Cush @RheumNow( View Tweet )
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Doubting RS3PE (8.14.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.

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ZEUS Trial: IL-6 Inhibition Fails to Cut Cardiovascular Events

Jack Cush, MD

The phase 3 ZEUS trial (published in JAMA Dec. 2025)  tested the IL-6 ligand inhibitor ziltivekimab in over 6,000 patients with atherosclerotic cardiovascular disease, chronic kidney disease, and elevated hsCRP—a population enriched for an inflammatory driver of risk.

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Air Pollution Increases RA Activity and Flares Koreans with rheumatoid arthritis (RA) showed increased disease activity and higher flare rates when exposed to relatively high levels of small atmospheric particulate matter, researchers reported. https://t.co/9dZkTzivRz https://t.co/Reic3P5U6r

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Dr. John Cush @RheumNow( View Tweet )
Arrhythmias in Autoimmune Rheumatic Disease A new review in the Journal of Cardiovascular Development and Disease (Tamirisa et al) synthesizes how SLE, RA, and SSc have an increased risk of arrhythmias and SCD attributable to shared immune pathways. These facts substantiate the https://t.co/j9AW26LE66
Dr. John Cush @RheumNow( View Tweet )
JAMA Review of Hip Fracture The July 16th edition of JAMA reviews the highly prevalent problem of hip fractures - a major global health burden: 14.2 million occur worldwide annually (280,000 in the US), with global incidence higher in women (833.9/100,000) than men https://t.co/TiiCjoq2Hj
Dr. John Cush @RheumNow( View Tweet )
heart in a puzzle

Arrhythmias in Autoimmune Rheumatic Disease

Jack Cush, MD

A new review in the Journal of Cardiovascular Development and Disease (Tamirisa et al) synthesizes how systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis have an increased risk of arrhythmias and sudden cardiac death attributable to shared immune pathways.

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Therapeutic Updates

ILD Treatment and Guidelines

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Watch our 11-video series on ILD Treatment and Guidelines including videos on assessing ILD, guidelines caveats and concerns, and more.
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Recent Blogs

rheumthought

Overlap Syndrome with ILD

Jack Cush, MD
Cush RheumThought ILD

How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?

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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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rheumthought

Screening and Overdiagnosis of ILD in RA

Michael Putman, MD, MSCI
Putman RheumThoughts
Dr. Michael Putman (Milwaukee, WI) reviews his approach to screening for ILD and RA, the potential for overdiagnosis and how this impacts treatment choices. Does this differ from your approach?
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