Drug Safety

Effectiveness of IL-6 Receptor Inhibitors versus Methotrexate or any Conventional Immunomodulators in Patients with Steroid Refractory Polymyalgia Rheumatica Sponsored by Sanofi https://t.co/TR4E0JvcTn https://t.co/t48JlXeUjA

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Dr. John Cush @RheumNow( View Tweet )
heart.coronary

Is High Dose Aspirin Needed in Kawasaki Disease?

Jack Cush, MD

Does aspirin add any advantage to intravenous immunoglobulin (IVIG) alone in children with Kawasaki disease (KD)? A randomized clinical trial IVIG alone was not inferior to IVIG plus aspirin, suggesting that high-dose aspirin during initial IVIG treatment did not reduce coronary artery

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Should Lupus Nephritis Receive PJP Prophylaxis? A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and https://t.co/zzRIVG0Sq3
Dr. John Cush @RheumNow( View Tweet )
FDA reports higher rate of allergic/hypersensitivity type reactions w/ certainlots of Immune Globulin Intravenous (IGIV) and Immune Globulin Subcutaneous (IGSC) ; these have voluntarily withdrawn by the manufacturers https://t.co/N73Cc8rfAS https://t.co/OTROyomvv8

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Uveitis Risk with Slow Adalimumab Weaning Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated. https://t.co/KgQsK6fVnr
Dr. John Cush @RheumNow( View Tweet )
2nd Opinions in Rheumatology https://t.co/R4CjJHEaL4 https://t.co/0quDwdANyU

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Vamorolone: a New Steroid on the Horizon? Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases. It is a dissociated steroidal compound with reduced side effects, and in an animal model of inflammation has shown effective https://t.co/38WTOAuuJy
Dr. John Cush @RheumNow( View Tweet )
Bimekizumab efficacy and safety in patients with psoriatic arthritis who had skin and nail psoriasis at baseline: Up to 2-year results from two phase 3 studies Sponsored by UCB https://t.co/461bFRZwjw

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Dr. John Cush @RheumNow( View Tweet )

RheumNow Podcast square

EMR Messaging Woes (4.11.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com

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Metanalysis showed no increased risk of serious infx (SIE) w/ JAK inhibitors use in pts w/ immune-mediated inflammatory skin diseases -- 32 RCTs, 11,917 pts found SIE in 0.62% on JAKi vs 0.51% controls. Meta-analysis found no significant increase in risk of serious infection https://t.co/ugH72nk8bZ
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Korean insurance claims study (2008–2021) 183,212 psoriasis & PsA pts, found Biologic Rx assoc w/ lower risk of new-onset & recurrent MACEs vs phototherapy (adj HR, 0.45 & 0.34). Nonbiologic systemic Rx lowered MACE risk (v photoRx) only in pts w/ prior Hx MACE (0.79) https://t.co/1RC8bMSZJ3
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Does DMARD Rx affect neurocognitive function in older pts? bDMARDs targeting TNF-α & IL-6 may mitigate neuroinflammation & preserve cognitive function. But, cognitive impact of csDMARDs (MTX) is complex, w/ conflicting reports on its role in vascular dementia. https://t.co/u3kSKHRvpI
Dr. John Cush @RheumNow( View Tweet )
pills-384846_640%20%281%29.jpg

Should Lupus Nephritis Receive PJP Prophylaxis?

Jack Cush, MD

A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and risk factors. 

There are no clear guidelines

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MMWR: While PRE-overdose opioid prescribing is a risk marker for fatal overdose from opioids alone, stimulants alone, or both; PRE-overdose stimulant prescribing might not be a risk marker for fatal overdose attributable to stimulants. https://t.co/ReVbpligeT https://t.co/PnjeqaCySX

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Dr. John Cush @RheumNow( View Tweet )
Inebilizumab, an anti-CD19+ (B cell)mAb was tested in myasthenia gravis in phase 3, 238 pt trial and shows to signif. improv function and reduce disease severity in acetylcholine recpt Ab+ or muscle-specific kinase Ab+ myasthenia gravis pts. https://t.co/vBBjf8AUug https://t.co/cUbK4PJEvf

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EMA's EudraVigilance (safety) database study of 10,319 MTX reports (age: 62 yrs, 73% F). Adverse rxns (ADR): 365 kidney & 1,082 liver related. MTX renal ADRs were older, w/ comeds (NSAIDs, Tylenol, metamizole, steroids). More deaths w/ renal ADRs than liver(21% vs 6%); mostly w/ https://t.co/tQ9PSOTtyx
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EMA has approved upadacitinib (Rinvoq) for use in the EU to treat adult patients with giant cell arteritis (GCA) - approval is based on data from the Phase 3 SELECT-GCA trial demonstrating sustained remission and key secondary endpoints https://t.co/Y2tyZPC9Et https://t.co/SHPz2Q94Vs

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JAMA Staphylococcus aureus Review - s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%) - bacteremia (≥48 hs) has 39% 90-day mortality risk https://t.co/1UQoz7JDPU https://t.co/xTAkakv2he

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Dr. John Cush @RheumNow( View Tweet )
hands pregnant

Pregnancy-Related Deaths in the US

Jack Cush, MD

A CDC cross-sectional national study showed an increase in pregnancy-related deaths in the US from 2018 to 2022, with highest rates among American Indian, Alaska Native women, and non-Hispanic Black women. 

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Does DMARD Rx affect neurocognitive function in older pts? bDMARDs targeting TNF-α & IL-6 may mitigate neuroinflammation & preserve cognitive function. But, cognitive impact of csDMARDs (MTX) is complex, w/ conflicting reports on its role in vascular dementia. https://t.co/6uMmOOdRoF
Dr. John Cush @RheumNow( View Tweet )
Danish registry study of 1431 AAV pts ((median age: 69 yrs, 52M; F/U 4.8 yrs) shows AAV had more LVH (17% vs 12%), ST-T (10% vs 7%), aFib (9.6% vs 7.5%), QTc prolong (6% vs 3.6%). Only AAV w/ major ECG abnls had incr risk of CV mortality [HR 1.99; 1.49-2.65) https://t.co/OB8b9pC6kw
Dr. John Cush @RheumNow( View Tweet )
pediatric eye uveitis

Uveitis Risk with Slow Adalimumab Weaning

MedPage Today

Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.

Read Article
EMA's EudraVigilance (safety) database study of 10,319 MTX reports (age: 62 yrs, 73% F). Adverse rxns (ADR): 365 kidney & 1,082 liver related. MTX renal ADRs were older, w/ comeds (NSAIDs, Tylenol, metamizole, steroids). More deaths w/ renal ADRs than liver(21% vs 6%); mostly w/ https://t.co/sZYZla0q1X
Dr. John Cush @RheumNow( View Tweet )
JAMA Staphylococcus aureus Review - s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%) - bacteremia (≥48 hs) has 39% 90-day mortality risk https://t.co/atao3mF32L https://t.co/oMSJVNKvJN

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Dr. John Cush @RheumNow( View Tweet )
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/YkUspqd92h https://t.co/cmAUWaScri

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

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

Advancing PMR

Eric L. Matteson, MD, MPH
Dr. Eric Matteson
Even though polymyalgia rheumatica is not perceived by many physicians as a severe diagnosis, its diagnosis and management actually propose significant challenges. I'd like to talk about those challenges, and what directions our path forward can include to advance our understanding and improve the treatment of patients who have PMR. Read Post
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