Cardio/Pulmonary

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

Links:

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>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 <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 )

RT @richardPAconway Dr Sparks shows risk factors for RA-ILD. Important for diagnosis (and screening?) Focus interventions on the modifiable ones! #RNL26 https://t.co/lE9Mkbq8oh
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway UIP is predominant radiologic pattern in RA-ILD. Contrast with our other diseases. But by no means exclusive - up to 50% of RA-ILD have a more inflammatory pattern. Important treatment implications! #RNL26 https://t.co/HmW1mz429i
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway Updated data on RA-ILD from Olmstead County. Cumulative incidence of 15.3% over 20 years! #RNL26 https://t.co/wVrTc3QM6Y
Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinmd Mucosal Hypothesis RA #RNL26 Demoruelle Mucosal origins of RA? Key sites of immune-environment interaction initiate local inflamm, becomes systemic Link of lung inflamm/immune dysregulation - ass w/ smoking, ILD NETs in lung drive RA path? Gut/oral microbes drive

Dr. John Cush @RheumNow( View Tweet )

Advances in RA-ILD Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26. https://t.co/xO7hBRKeqE https://t.co/rs1MS08Svl

Links:

Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway Dr Sparks. RA-ILD is common. Pooled prevalence of 11% from recent meta-analysis. Less common than SSc or IIM, but more frequent than we think! #RNL26 https://t.co/mJSmMakSBM
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway Dr Sparks. RA-ILD is common. Pooled prevalence of 11% from recent meta-analysis. Less common than SSc or IIM, but more frequent than we think! #RNL26 https://t.co/TCsDfeQjZC
Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinmd Mortality risk in RA #RNL26 Myasoedova Most common mortality: 1.5-1.6x increase risk CVD 2-3x increase risk ILD +ACPA increases risk in both https://t.co/Luwyy6UFg6
Dr. John Cush @RheumNow( View Tweet )
Sparks RNL26

Advances in RA-ILD

Richard Conway, MBBChBAO, PhD

Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26. 

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NEJM: Aortitis Due to Large-Vessel Vasculitis 63yoM w/ Hx HTN c/o 3 mos of CP, palpitations, abdominal pain. ESR-104, CRP 85 mg/L. CT showed thickening of the thoracic & abdominal aorta. After 6wks Rx w/ AZA, HCQ, Pred, ESR/CRP still high and pt stared on SC TCZ w/ improvement. https://t.co/1TBreptAFr
Dr. John Cush @RheumNow( View Tweet )
Gout pills injection

SGLT2 Inhibitors in Gout - Better Outcomes, Fewer Meds

EurekAlert!

Natalie McCormick, PhD, of the Rheumatology and Allergy Clinical Epidemiology Research (RACER) Center within the Division of Rheumatology in the Mass General Brigham Department of

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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.  Read Post
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Rx Updates (filtered for Topic)

Therapeutic Updates

The Impact of Obesity on Psoriatic Arthritis

Sponsored by Lilly Medical Affairs
Lilly February RX Update Revised Image
Image alt text: A person indoors raises one arm in a flexed pose while holding the elbow with the opposite hand. Is obesity common in your patients with PsA? Learn more about the intersection of disease pathogenesis between PsA and obesity and how weight intervention can affect PsA outcomes.
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