Cardio/Pulmonary

Gout Control Lowers Cardiovascular Events A large target emulation trial suggests that gout patients prescribed urate-lowering treatment who achieve a serum urate level lower than 6 mg/dL significantly lower their risk of cardiovascular events. https://t.co/LcBg7yCw4c https://t.co/dBYdnq9XLJ

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Dr. John Cush @RheumNow( View Tweet )
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/8VnmVsuU2h

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Dr. John Cush @RheumNow( View Tweet )
Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis In this prospective observational study 811 CIA patients analyze outcomes in patients with and without MetS, including cardiovascular death/hospitalization and all-cause death/hospitalization. https://t.co/WT3wTpeGPi
Dr. John Cush @RheumNow( View Tweet )
CV.CP_.Heart_.pericarditis

Gout Control Lowers Cardiovascular Events

Jack Cush, MD

A large target emulation trial suggests that gout patients prescribed urate-lowering treatment who achieve a serum urate level lower than 6 mg/dL significantly lower their risk of cardiovascular events.

Cohorts were derived from the Clinical Practice Research

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Global trends in systemic sclerosis (SSc) mortality. Betw 2001-23, in 74 countries, 85,291 SSc deaths (79% females). While SSc-Crude mortality increased from 1.97 (2001) to 2.34 (2023), the age-standardized mortality decreased from 1.58 to 1.29. declining in Americas & Europe. https://t.co/lvHbF5HLPY
Dr. John Cush @RheumNow( View Tweet )
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/TmoodnuJTe

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Dr. John Cush @RheumNow( View Tweet )
24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/pAEqYJIKaw
Dr. John Cush @RheumNow( View Tweet )
Level, monitor, calculate, glucose, diabetes

Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis

Jack Cush, MD

Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.

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More Comorbidity in Difficult to Treat RA

Jack Cush, MD

A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).

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True or False: Low-dose aspirin given at giant cell arteritis diagnosis is associated with a lower risk of major adverse cardiovascular events. Put your answer to the test in the latest RheumIQ quiz at https://t.co/XLPVoyCbLB. https://t.co/C5CSwuv5mF

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Dr. John Cush @RheumNow( View Tweet )
Study of 216 RA pts - Serum IL-8 independently assoc w/ RA Dz activity. CRP & IL-6 significantly associated w/ higher IL-8 levels, but RF & CCP did not. IL-8 also correlated w/ CV risk (SCORE2) & carotid intima media thickness https://t.co/aqUoAeXFFP https://t.co/ZW7OAx8YGK

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Dr. John Cush @RheumNow( View Tweet )
Smoking is most established environmental risk factor for RA- Dz risk, severity, & RA-ILD. Role of other airborne pollutants is mixed: particulate matter & nitrogen dioxide show inconsistent associations w/ RA https://t.co/Fkemc5hAUB

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Dr. John Cush @RheumNow( View Tweet )

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Follow the Money (4.23.2026)

Jack Cush, MD

Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week. 

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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 https://t.co/dpGzjKZYkA
Dr. John Cush @RheumNow( View Tweet )
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Aspirin Cardiovascular Prevention in Giant Cell Arteritis

Jack Cush, MD

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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Retrospective clinicopathologic review of 170 AORTIC surgical pathology cases (2009-16) - showed 87% w/ atherosclerosis, 13% aortitis/periaortitis and 2.4% atherosclerosis w/ excessive inflammation. Lymphoplasmacytic inflammation was most common w/ aortitis/periaortitis. https://t.co/CuP30dqRQU
Dr. John Cush @RheumNow( View Tweet )
ILD in RA – Dr. Jeffrey Sparks In this https://t.co/4UQlqwujiR 2026 podcast, Dr. Jeffrey Sparks reviews the latest advances shaping diagnosis and management of ILD in RA. 🎧 Listen here: https://t.co/U5cZVlgAka #Rheumatology #ILD #RNL2026 https://t.co/LidiS3Wj9d

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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/0FjPyXygpz https://t.co/04J23AiqtK

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Dr. John Cush @RheumNow( View Tweet )
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What’s New PsA? (4.3.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and major articles from this week, including FDA safety warnings, reports from AAD, PsA trials.

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Review: Rheumatoid Arthritis–Associated Interstitial Lung Disease

Jack Cush, MD

RA-ILD represents the most severe extra-articular manifestation of rheumatoid arthritis, affecting an estimated 1% of the adult population in the US and Northern Europe. Prevalence estimates vary widely  (up to 58%), reflecting different diagnostic criteria, imaging modalities, and study

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Moral Distress (3.27.2026)

Jack Cush, MD

Dr. Jack Cush reviews the journal reports and news from RheumNow.com.  This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.

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Retrospective TriNetX Network cohort study of adult PsA (N 123,031) pts, propensity- matched to non-PsA controls. PsA had signif higher CV morbidity: MACE (HR 1.74); mortality (HR 1.95); CHF (HR 1.96), MI (HR 1.71), & CVA (HR 1.49). bDMARDs reduced MACE (HR 0.95) & mortality (HR https://t.co/bHrq9KpwBM
Dr. John Cush @RheumNow( View Tweet )
Outcomes of 87 VEXAS pts in the AutoInflammatory Disease Alliance (AIDA) - 75% had recurrent fever episodes. Fever episodes assoc w/ mortality, organ involvement (CV, GI, Lung), but not with complete response to biologics. https://t.co/j9vzBJNMj0 https://t.co/YGsE7LH3ml

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Dr. John Cush @RheumNow( View Tweet )
Single center prospective cohort study of 137 Takayasu’s arteritis (TAK) pts found the prevalence of coronary arteritis was 13 (9%). TAK coronary arteritis pts were not distinguished by demographics, angiographic patterns. 50% had complications from vascular grafts or stents https://t.co/xRR7TSi5FW
Dr. John Cush @RheumNow( View Tweet )
ILD found in 3% of #PsA pts. Metanalysis of 6 studies, 14,272 pts found ILD pooled prevalence was 3% in PsA; highers ((6%) in studies w/ CT, HRCT. Smoking was a signif. risk factor for ILD in PsA (OR 2.94, 95% CI: 1.22–7.12; I2 = 1.8%). https://t.co/9mY4Eiqc9d

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Dr. John Cush @RheumNow( View Tweet )

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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