Cardio/Pulmonary

Treat-to-Target and Cardiovascular Benefits in Gout A new user cohort study of 109 504 gout patients who achieved a serum urate level less than 6 mg/dL was associated with a significantly lower risk of cardiovascular events. https://t.co/SVT7C9vT1E https://t.co/frCn8MSk4n

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Dr. John Cush @RheumNow( View Tweet )
Gout.T2T.jpg

Treat-to-Target and Cardiovascular Benefits in Gout

Jack Cush, MD

A new user cohort study of 109 504 gout patients, achieving a serum urate level less than 6 mg/dL, was associated with a significantly lower risk of cardiovascular events.

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UK Retrospective analysis of 2 RA cohorts, 2,701 pts (F/U 6 yrs) = 101 (3.7%) Dx with ILD. (12 @ baseline, 46 w/ F/U, 43 @ death). ILD Dx signif. assoc w/ onset age (aOR 1.03), seropositivity (aOR 2.58), ever smoking (aOR 1.7). https://t.co/Zvkb1Wjpa4 https://t.co/YMkWDc3rMr

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Dr. John Cush @RheumNow( View Tweet )
RT @RichardPAConway ACR/Chest and EULAR/ERS guidelines for RA-ILD presented by Dr Sparks. I'm posting the one I use ;) #RNL26 https://t.co/fwTjB2bIqg
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAConway Data from Scott Matson's group showing that immunosuppressing RA-ILD (agnostic to agent) results in stabilisation of the previous downward trajectory of pulmonary function tests. #RNL26 https://t.co/TMNeCsPDep
Dr. John Cush @RheumNow( View Tweet )
RT @RichardPAConway UIP pattern RA-ILD is where the big problem is. We are less good at treating this. Perhaps the newer agents such as nerandomilast will change this? #RNL26 https://t.co/lzKFulaomD
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAConway Target trial emulation from Dr Sparks group in RA-ILD. Abatatacept and JAKi seem to be better than RTX. TNFi and IL-6i appear similar to RTX. Thought provoking! #RNL26 https://t.co/vmg7ot9m8b
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAConway Data from Scott Matson's group showing that immunosuppressing RA-ILD (agnostic to agent) results in stabilisation of the previous downward trajectory of pulmonary function tests. #RNL26 https://t.co/MoYoM0K1cs
Dr. John Cush @RheumNow( View Tweet )
UK Biobank registry analyzed assoc. betw sleep duration, insomnia, & shift with osteoarthritis endpoints (KOA, HOA, TKA, THA) - all incr/highest in pts w/ <6 hrs nightly sleep. Night shift workers had 24% higher knee OA risk (HR=1.24) & 28% higher TKA risk (HR=1.28). https://t.co/UnxXH2I92R
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAConway The new kid on the block in RA-ILD (and other PPF). Nerandomilast, an anti-fibrotic with additional anti-inflammatory/immunomodulating functions. Demonstrated significant mortality benefit in ILD. #RNL26 https://t.co/8DU3WyPQGy
Dr. John Cush @RheumNow( View Tweet )
RT @RichardPAConway ACR/Chest and EULAR/ERS guidelines for RA-ILD presented by Dr Sparks. I'm posting the one I use ;) #RNL26 https://t.co/a6vwQWbjE7
Dr. John Cush @RheumNow( View Tweet )
Screening study of lung US (LUS) vs HRCT in 73 RA pts (DAS28 3.47) Chest HRCT identified ILD in 29%. LUS identified ILD in 22% of patients. LUS sensitivity was 59%; specificity 94%. ROC. This study demonstrates the good diagnostic performance of LUS in RA- ILD detection https://t.co/E8avnbvUiw
Dr. John Cush @RheumNow( View Tweet )
RT @RichardPAConway UIP pattern RA-ILD is where the big problem is. We are less good at treating this. Perhaps the newer agents such as nerandomilast will change this? #RNL26 https://t.co/Z0BXxyNrCI
Dr. John Cush @RheumNow( View Tweet )
Terkeltaub RNL26 Gout lecture

Disease Modification, Disparities and the Next Therapeutic Frontier in Gout

Audrey Gibson, PA-C

Gout management has entered what Dr. Robert Terkeltaub MD from UC San Diego described as its “disease-modifying era,” during his talk at RheumNow Live 2026. In a recent comprehensive review of the past, present, and future of gout therapy, the central message was clear: “We can really apply

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RT @gibson_rheumPAC Gout flares are not benign. Recent flares double MI/stroke risk and markedly increase CV mortality—making flare prevention vital.#RNL26 https://t.co/gKvqo3vFYb
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway We have improved RA mortality in many areas but respiratory (mainly ILD) and infectious issues remain stubbornly elevated. #RNL26 https://t.co/ViucOIOOzY https://t.co/3kIqPMeKKX

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Dr. John Cush @RheumNow( View Tweet )
RT @richardPAConway AUC of various published screening strategies for RA-ILD. We often say 0.80 is an acceptable cut off but ideally would like a bit better #RNL26 https://t.co/L19uJ7ETwc
Dr. John Cush @RheumNow( View Tweet )
RT @RichardPAConway Odds ratios for ILD in early RA from SAIL-RA study. Again disease activity stands out. #RNL26 https://t.co/9cXjOFl3Th
Dr. John Cush @RheumNow( View Tweet )
RheumNow Podcast square

Maui Potpourri (2.13.2026)

Jack Cush, MD

Dr. Jack Cush reviews the hot item takeaways from last week's RheumNow.Live 2026.

  1. Diet & Obesity Management in Rheumatology - Uzma Haque, MD
  2. Mitigating risk for Rheum patients undergoing orthopedic surgery - Susan Goodman, MD
  3. Paradoxical skin reactions – Joseph
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RT @richardPAconway Who to screen for RA-ILD is a tricky one. It is not feasible to screen everyone. This is from ACR/Chest 2023 ILD guidelines and is based on identified risk factors. #RNL26 https://t.co/NtAWYCVclJ
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway Disease activity is a strong risk factor for RA-ILD. Particularly for moderate/high disease activity but there appears to be a linear relationship (at least above a certain threshold) #RNL26 https://t.co/ot8ttdmu5G
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway Lifetime risk of ILD by RA/sex/MUC5B status. We can see the synergistic effect. Also note RA&gt;MUC5B in general. #RNL26 https://t.co/L5MOVVGIt3
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway MUC5B is strong risk factor for RA-ILD. Specifically for UIP. Associated with both older-onset RA, and ILD earlier following RA presentation. #RNL26 https://t.co/qeLp1BqOEM
Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinmd RA-ILD #RNL26 Jeff Sparks MTX and ILD - Rare MTX-induced pneumonitis. 7 cases in n=4786 (0.3% cases) vs &lt;0.1 on PBO, rare diff from ILD - No increase in incident ILD - meta-analysis of 7 studies show OR 0.49 https://t.co/k2XeAzBsYB
Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinmd #RNL26 RA-ILD Jeff Sparks ILD pooled prevalence 0.11 Sparks: "prevalence is high but not so high that we don't screen everyone," means lots of subclinical ILD Subtypes: UIP 50-60%, fibrotic NSIP 30-40%, inflammatory Less common: LIP, DIP, RB-ILD, DAD

Dr. John Cush @RheumNow( View Tweet )

Therapeutic Updates

ILD Treatment and Guidelines

Hinze title card
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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Podcasts

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