Drug Safety

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

Links:

Dr. John Cush @RheumNow( View Tweet )

38420215_s.jpg

Neoplasia and Autoimmune Disease

Jack Cush, MD

Malignancy rivals cardiovascular disease as a leading cause of death in patients with systemic autoimmune diseases. Chronic inflammation and immune dysregulation can drive oncogenesis, while antitumor immune responses can trigger autoimmune phenomena (paraneoplastic syndromes, checkpoint

Read Article
TRACE study of 90 axSpA pts Rx w/ either TNFi or secukinumab (150 or 300 mg)- at wk 56, 59% achieved clinical-remission & 43% achieved w56-MRI-remission (SPARCC) w/ benefits by wk 4. Predictors of clinical remission: ASDAS & BMI (@wk16); none @wk56 https://t.co/CEsAeRMvUE https://t.co/SfSAm3u4IM

Links:

Dr. John Cush @RheumNow( View Tweet )
choices2.jpg

Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA

Jack Cush, MD

After the first tumour necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid arthritis (RA) responded by switching to upadacitinib, compared to cycling to a second TNFi, adalimumab.

Read Article
FDA has accepted Genetech application for obinutuzumab (Gazyva) to treat SLE (currently only approved for lupus nephritis) - based on Phase III ALLEGORY study w/ Gazyva showing signif reduced dz activity https://t.co/louTYyN6bN https://t.co/Hy1gGliamn

Links:

Dr. John Cush @RheumNow( View Tweet )
Severe thrombocytopenia (TP) assoc w/ severe APS & increased mortality. Retro study of 432 #APS pts - 142 w/ TP (33%): 13% severe TP (<50L G/L). Severe TP assoc w/ ITP & CAP -had higher mortality https://t.co/7f8VpIcEJy

Links:

Dr. John Cush @RheumNow( View Tweet )

TriNetX study of 7,929 RA pts Rx w/ bDMARDs (n 2668) w/in 6 mos of elective hand surgery - perioperative bDMARD continuation (34%) was not associated with significant increases in risks of wound healing failures (1.4% vs 1.4%) or SSI (2% vs 1.5%) https://t.co/NY6l2jRswb https://t.co/IxoYtLNGvf

Links:

Dr. John Cush @RheumNow( View Tweet )
Mortality in Rheumatoid Arthritis: A Story of Decline, Delay, or Plateau? Dr. Elena Myasoedova In this https://t.co/4UQlqwujiR 2026 podcast, Dr. Elena Myasoedova examines mortality trends in RA, exploring whether we are seeing continued decline, delayed impact, or a concerning https://t.co/yUob3Tv0tR

Links:

Dr. John Cush @RheumNow( View Tweet )
RheumNow Podcast square

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. 

Read Article
DESIR axSpA inception cohort study of 631 pts (no HTN), found no signif association between NSAID use & incident HTN. Over 10 YRs, 88 developed HTN (HR 1.01, 1.00–1.02) https://t.co/Gs9mPwthEj https://t.co/4sfpHmFTsu

Links:

Dr. John Cush @RheumNow( View Tweet )
Severe thrombocytopenia (TP) assoc w/ severe APS & increased mortality. Retro study of 432 #APS pts - 142 w/ TP (33%): 13% severe TP (<50L G/L). Severe TP assoc w/ ITP & CAP -had higher mortality https://t.co/p0bvLKupUe

Links:

Dr. John Cush @RheumNow( View Tweet )

GI.Sxs_.jpg

NSAIDs in Inflammatory Bowel Disease?

MedPage Today

At least some patients with inflammatory bowel disease (IBD) can safely use common drugs for musculoskeletal aches and pains, a large study of insurance claims data suggested, contradicting a widespread concern that these products can trigger IBD flares.

Read Article
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 )
ASA.jpg

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.

Read Article
obesity.knee_.arthritis.jpg

Weight-loss drugs may affect joints directly

EulrekAlert!

A new study from Aarhus University shows that the hormone GLP-1, which is mimicked in medication for diabetes and weight loss, is present in joint fluid. In the long term, this may open up new treatments for arthritis.

Rsearchers from the Department of Biomedicine at Aarhus

Read Article
Adjunctive Prednisolone for Kawasaki Disease An NEJM study has shown that glucocorticoids provide no added benefit when added to standard primary treatment in Kawasaki disease patients. https://t.co/dS1uwufh69 https://t.co/wpxyOYXp8l

Links:

Dr. John Cush @RheumNow( View Tweet )
Gabapentinoid use 2008-2018: worldwide there was an annual incr of +17.2% (from 4.2/d to 18.3/d per 10K pop. Highest gaba use in high income countries, 6X higher than lower income (40/d vs 6.1/d) https://t.co/jXjxNj1Uyz https://t.co/GmQJ3UGGw9

Links:

Dr. John Cush @RheumNow( View Tweet )
Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/rS69epQiif

Links:

Dr. John Cush @RheumNow( View Tweet )
A LESSON FOR GC OVERUSE: Inappropriate PPI use was Twice as successful w/ reduced w/ GP & Pt-facing intervention (15 vs 7%) vs usual care or GP-only intervention. Study of 1498 GPs, 34K pts https://t.co/QWW0VYVpzU https://t.co/X3V6NMawq2

Links:

Dr. John Cush @RheumNow( View Tweet )
Malignancies Not Increased with Biologic Therapies The risk of malignancy in RA patients receiving biologic agents was evaluated by metanalysis of RCTs and found no significant increased risk of malignancy compared with other DMARDs or with placebo. https://t.co/ZEO4jP5RwA https://t.co/C1YeTSh7ZN

Links:

Dr. John Cush @RheumNow( View Tweet )
TRACE study in 90 active axSpA, biologic-naïve, Rx w/ secukinumab 150 mg; @wk16 ASDAS remission in 30 (35%)& 55 incr SEC to 300 mg. By wk 24, 22% of 300 mg achieved ASDAS remission; but without signif change in MRI inflamm (SPARCC). Most MRI changes in 1st 4wks https://t.co/pMMtrxxDLh
Dr. John Cush @RheumNow( View Tweet )
Cross-sectional study from UK Clinical Practice Research Datalink Aurum looked at > 40K w/ #PMR Rx w/ steroids - 67% were coprescribed bisphosphonates (BP) & 79% Rx PPIs/H2RAs (less in males & pts deprived areas) resulting more Fx w/in 12 mos (2.32% vs 1.4%). https://t.co/b2DFJMjqCu
Dr. John Cush @RheumNow( View Tweet )
RheumNow Podcast square

Prescribing Lessons (4.17.2026)

Jack Cush, MD

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

Read Article
Retrospective study of 374 newly diagnosed microscopic polyangiitis (MPA) pts - 97 (26%) had severe infections w/in 6 mos - signif higher risk w/ high dose prednisone & chronic lung Dz. most common: bacterial (43%) & lung infx https://t.co/XXAxUZw7kx https://t.co/atK8Ob9zyQ

Links:

Dr. John Cush @RheumNow( View Tweet )
Kawasaki.jpg

Adjunctive Prednisolone for Kawasaki Disease

Jack Cush, MD

An NEJM study has shown that glucocorticoids provide no added benefit when added to standard primary treatment in Kawasaki disease patients.

Read Article

Therapeutic Updates

Lupus Nephritis

Sponsored by RheumNow
Management of CKD in Lupus Nephritis Patients
View our six video perspectives on lupus nephritis, including Management of CKD in Lupus Nephritis.
Read Post

Recent Blogs

Advanced Practice Rheum

Difficult to Treat Rheumatoid Arthritis

Jack Cush, MD
D2T RA Cover
Dr. Cush addresses the management of difficult-to-treat rheumatoid arthritis (D2TRA).
Read Article
Advanced Practice Rheum

Methotrexate

Jack Cush, MD
APR MTX Cover
In this session, Dr. Jack Cush reviews methotrexate.
Read Article

Hydroxychloroquine for Everyone

Jack Cush, MD
ra.hands2_.JPG
Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit.
Read Post
How well do you know this week's rheumatology news?
Take the rheumIQ quiz
Take the RheumIQ Quiz

Podcasts

  • ACR 2025 Daily Podcasts Day2d
  • EULAR 2021 - Day2b 00:35:57
×