Cardio/Pulmonary

TriNetX retrospective cohort study of 1402 propensity matched Systemic Sclerosis pts on vs off SGLT2 inhib (2013-2025) & found SGLT2i significantly lowered all-cause mortality (HR 0.54), stroke (HR 0.64), & hospitalizations (HR 0.76), moreso in SSc without Hx of CHF (HR 0.62) https://t.co/t6GVrN6zoQ
Dr. John Cush @RheumNow( View Tweet )
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Turkey Tryptophan (11.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

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Subclinical Cardiac Dysfunction in Gout. ECHO study of 202 hyperuricemic (100 gout vs 102 asympt [asymSUA]) pts. VS. asymSUA, Gout pts had signific more LV Diastolic Dysfunc (31% vs 11%), lower LV ejection Fx (60 vs 65); questioning need for tailored CV monitoring in ^SUA pts https://t.co/gCOKKk7H05
Dr. John Cush @RheumNow( View Tweet )
Study of 2280 dermatomyositis (DM) & polymyositis (PM) pts looked at short term (ST: <3 mos) vs long term (LT) steroid (GC) use. Vs ST, LT GC use assoc w/ higher risks of heart failure (adj OR 1.8), osteoporosis (1.9), all-cause & PM/DM-related admission (3.8) & higher costs https://t.co/Q9xt06yzew
Dr. John Cush @RheumNow( View Tweet )
BP.jpg

Chronic pain may dramatically raise your blood pressure

Science Daily

Widespread chronic pain may stealthily drive up blood pressure, partly through its ties to depression and inflammation.

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CorEvitas observational registry of 3,696 w/ psoriatic arthritis (no hx of CV eents), followed for mean 3.7 yrs, showed that Dactylitis and enthesitis did not predict future CV events. But Dactylitis and enthesitis and Synovitis were all significantly interrelated. Cureus 17(11): https://t.co/kPgGKliUUs
Dr. John Cush @RheumNow( View Tweet )
ILD in Patients with Connective Tissue Disease Dr. Janet Pope reports on abstract 0154 (Incidence and Prevalence of Connective Tissue Diseases with Interstitial Lung Disease (CTD-ILD) in the United States) at #ACR25. https://t.co/WrJhsMizwV https://t.co/rkFny5ZjZQ

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Dr. John Cush @RheumNow( View Tweet )
25-Hydroxyvitamin D levels and Lupus Outcomes Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/CYwVy7ls7y
Dr. John Cush @RheumNow( View Tweet )
Cochrane review & metanalysis of Colchicine & CV outcomes. 12 studies, 22,983 prt (11,524 on colchicine). Good evidence colchicine signif. reduces the risk of MI (RR 0.74), stroke (RR 0.67), but does not incr serious adverse events (RR 0.98), but causes GI AEs (RR 1.68) https://t.co/wqOtGLdxep
Dr. John Cush @RheumNow( View Tweet )
25-Hydroxyvitamin D levels and Lupus Outcomes Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/4nhACulIw0
Dr. John Cush @RheumNow( View Tweet )
Hospital Mortality in Dermatomyositis A cohort study reveals that hospitalized patients with dermatomyositis have a higher in-hospital mortality rate in the presence of active rash, interstitial lung disease, and an elevated neutrophil-to-lymphocyte ratio at admission. https://t.co/6WIFVJT9w7
Dr. John Cush @RheumNow( View Tweet )
GLP-1 Receptor Agonists in PsA: Mortality and MACE Dr. Antoni Chan reports on abstract 0849 (Mortality and Major Adverse Cardiac Events (MACE) with GLP-1 Receptor Agonists in Psoriatic Arthritis), presented at #ACR25. https://t.co/XNyt3UIjgp https://t.co/RUnZCjXF9T

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Dr. John Cush @RheumNow( View Tweet )
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Treating During Pregnancy (11.14.2025)

Jack Cush, MD

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

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Gottrons,mechanics

Hospital Mortality in Dermatomyositis

Jack Cush, MD

A cohort study shows that hospitalized patients with dermatomyositis have higher in-hospital mortality in the presence of active rash, interstitial lung disease, and elevated neutrophil to lymphocyte ratio at admission.

Dermatomyositis (DM) has significiant

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Western Australia study of 1854 SLE pts (median 40 yrs old). Interstitial lung disease was seen in in 3.8% of SLE, 26 fold more than controls. Risk factors for ILD included older age, smoking and serositis. SLE-ILD pts had higher mortality rates (MR 52.0, CI 37.0–71.1).

Dr. John Cush @RheumNow( View Tweet )

ILD damage fibrosis path

More on Methotrexate and ILD Risk

Jack Cush, MD

To assess the progression of the interstitial lung disease related to Methotrexate (MTX) exposure, and to evaluate the lung involvement in RA non-ILD patients with MTX exposure, a systematic review was performed to assess whether RA patients receiving methotrexate (MTX) are at greater

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Nerandomilast for ILD Dr. Mike Putman reports on abstract 1662 (Efficacy and Safety of Nerandomilast in Patients with Autoimmune Disease-Related Progressive Pulmonary Fibrosis: Subgroup Analysis of the FIBRONEER-ILD trial). #ACR25 https://t.co/J0e4SbVgFE https://t.co/dlOM700yVQ

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Dr. John Cush @RheumNow( View Tweet )
GLP-1 Receptor Agonists: Impacts Beyond Metabolism? Across multiple abstracts, investigators have used a large real-world dataset, the TriNetX network, to explore how GLP-1 receptor agonists (GLP-1RAs) might influence cardiovascular, renal and immune-mediated outcomes in our https://t.co/Xl6M3xSvlq
Dr. John Cush @RheumNow( View Tweet )
Cush and Kavanaugh

ACR 2025 Rheumatology Round Up

Jack Cush, MD

Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.

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Upadacitinib is a Double Edged Vascular Sword in GCA Dr. David Liew discusses abstracts O751, O738, and O734 presented at #ACR25. https://t.co/eTmVehP2Cd https://t.co/vxehwRWM2D

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Dr. John Cush @RheumNow( View Tweet )
#2662 Using Medicare data to emulate real-world RA-ILD trials, investigators compared RTX vs ABA, TOC, JAKi & TNFi No sig differences in mortality, resp, hospitalisation or lung transplant across groups, suggesting other b/tsDMARDs may be as safe as RTX for RAILD @RheumNow #ACR25

Mrinalini Dey @DrMiniDey( View Tweet )

#2661 In >5000 veterans with RA-ILD, 8 distinct FVC trajectories were identified. >1/2showed a progressive decline (≥0.7%/yr). These progressive patterns predicted higher mortality & respiratory hospitalisations, underscoring major disease heterogeneity. @RheumNow #ACR25

Mrinalini Dey @DrMiniDey( View Tweet )

Inflammation skews lipid levels in RA: the “lipid paradox” Using data from CERTAIN and VARA, inflammation (hsCRP)-adjusted TC & LDL better predicted ASCVD events than standard lipids. Are we missing RA pts who need statins? @RheumNow #ACR25 A#2681

Jiha Lee @JihaRheum( View Tweet )

#2681 Tackling the “lipid paradox” in RA: inflammation-adjusted TC & LDL (using hsCRP correction) improved ASCVD risk prediction and flagged more high-risk patients than standard lipids. A smarter way to guide statin use in RA. @RheumNow #ACR25

Mrinalini Dey @DrMiniDey( View Tweet )

Observational study from VCRC AAV patinet, >70% had pulm involvement at some point As expected, nodules favor GPA (63% vs 12% MPA) & DAH favors MPA (61% vs 31%) More ILD in MPA (11% vs 1%) & more endobronchial in GPA (12% vs 2%) Helpful pearls! @RheumNow #ACR25 Abstr#0721 https://t.co/Iu5MdiTABR

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Mike Putman @EBRheum( View Tweet )

Recent Blogs

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.  Read Post
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