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Drug Safety

VA/DoD 2025 Obesity Guidelines

Annals of Internal Medicine has published the updated 2025 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines on adult Overweight and Obesity management. Here is a review of the guidelines, including five key takeaways for rheumatologists.

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Rheumatology Pay Up (9.25.2026)

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

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Estimated > 7million Americans (~1/3 US GLP1 Rxs) get GLP-1 drugs from online compounding source- but these are not FDA approved. They maybe cheaper, but dosing/quality is suspect. FDA needs to close the 503B loophole to outlaw these copycat Rxs https://t.co/Xu7MeP0Ytt https://t.co/nYGr3auqzx
Dr. John Cush @RheumNow( View Tweet )

Gabapentin Use Rose as Restrictions Fell, Study Shows

MedPage Today

Gabapentin use jumped quickly in Michigan after the drug was removed from the state's controlled substance schedule in 2024, a cross-sectional study showed.

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Steroid Delusions in Giant Cell Arteritis

A real world analysis of drug use in giant cell arteritis (GCA) patients shows that despite intending to taper patients off glucocorticoids (GC) by 24 months, 75% remained on GCs for ≥ 48 months.

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True or False: The TriNetX retrospective study found that JAK inhibitors significantly increased VTE risk in rheumatoid arthritis patients undergoing hip or knee replacement compared to TNF inhibitors. Check your knowledge in the latest RheumIQ quiz at https://t.co/LHFv1P6XZe.

Dr. John Cush @RheumNow( View Tweet )

Endocrine Society - State of Obesity Science and Management

The Endocrine Society has published a scientific statement reframing obesity as a heterogeneous, chronically dysregulated fat-mass disorder, the biology of which is being tested effectively by GLP-1/GIP receptor agonists. Is this precision-medicine? We await long-term safety data, while

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True or False: According to a metanalysis of 87 studies, higher BMI and smoking were linked to reduced methotrexate efficacy in rheumatoid arthritis. Check your knowledge in the latest RheumIQ quiz at https://t.co/LHFv1P6XZe.

Dr. John Cush @RheumNow( View Tweet )

Join us for Tuesday Nite Rheumatology on September 22 for: Obesity Treatment & Safety Experts will tackle: • GLP-1/GIP therapies • Lifestyle & bariatric interventions • Treatment selection & safety • Cost & compounding concerns • Sarcopenia & bone health • The future of https://t.co/BCSOUot5FL
Dr. John Cush @RheumNow( View Tweet )

ACR Updates Osteoarthritis Guidance

ACR

The American College of Rheumatology (ACR) has released updated clinical guidance for the treatment and management of osteoarthritis (OA) of the knee, hip, and hand. The evidence-based recommendations update the 2019 ACR/Arthritis Foundation guideline and are designed to support individualized,

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Added IVIG is Effective in Myositis

A small randomized controlled trial demonstrates that intravenous immunoglobulin (IVIG) added to cortocosteroids lead to greater and faster improvements in patients with newly

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Bariatric Surgery in the Era of GLP-1RA

Weight loss with lifestyle changes alone is difficult to sustain for most people. One reason for this is the weight loss associated endocrine milieu, which can decrease energy expenditure and increase the drive to eat. Therefore, we frequently use medications and/or bariatric surgery.

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A Day of Infamy (9.11.2026)

Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz

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Meta-analysis 24 studies (3015 hidradenitis suppurativa pts) taking IL-17 inhibitor, IBD adverse events were rare, w/ no difference in IBD risk betw IL-17i & PBO (0.23% vs 0 of 2572 vs 1066 pts respectively) thru wk 16. The reported assocn of IL-17 inhibitors w/ IBD risk is https://t.co/kDwR5Fc1zI
Dr. John Cush @RheumNow( View Tweet )

JAMA: Review of Adult Rheumatoid Arthritis

Smolen, Kerschbaumer, Aletaha, and Robinson have published a comprehensive review article of rheumatoid arthritis (RA) in JAMA, noting significant changes to our understanding and treatment guidelines.

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Treating Obesity is Disease-Modifying (9.4.2026) Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow. New drugs approved, new drugs halted and some drugs out of control. https://t.co/ojBOosSWMX https://t.co/K4DvUK24Pb
Dr. John Cush @RheumNow( View Tweet )
12 mos Danish study of 157 822 first-time semaglutide for obesity management (SOM) intiators. 77 483 discontinued treatment w/in 12 mos. (13% at 3 mo, 27% 6 mos, 39% @ 9 mos. D/C more likely in younger, men, low-income, on GI or psych meds, & pts with comorbididities. Few https://t.co/oJLnrxXFz0
Dr. John Cush @RheumNow( View Tweet )
True or False: In a Korean National Health Insurance study, gout patients on allopurinol had a significantly higher risk of fractures, with the highest risk seen in those with low adherence. Did you get it right? Take this week's RheumIQ and see: https://t.co/UaXqHKWizt. https://t.co/7nILMVUeGw
Dr. John Cush @RheumNow( View Tweet )
Novartis & BMS CAR-T Cell Trials on Hold Reuters and the Wall Street Journal report that both Novartis and Bristol Myers Squibb (BMS) have paused their autoimmune disease CAR-T cell trials due to safety concerns, including deaths. https://t.co/ffcAHhtdBh https://t.co/zKlFcBdEod
Dr. John Cush @RheumNow( View Tweet )

Treating Obesity is Disease-Modifying (9.4.2026)

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  New drugs approved, new drugs halted and some drugs out of control. Ready to test your knowlege? Take this week's quiz!

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BMI Affects JAK Inhibitor Responses in Rheumatoid Arthritis

A meta-analysis of Janus kinase (JAKi) inhibitors clinical trials in rheumatoid arthritis (RA) has shown higher BMI was associated with poorer responses and a reduced treatment benefit with JAK inhibitors in RA patients.

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EBR Journal Club: Dapirolizumab Pegol in SLE (PHOENYCS GO)

The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal to an important RCT in rheumatology. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How great are the benefits and harms? And what didn’t they show me

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Novartis & BMS CAR-T Cell Trials on Hold

Reuters and the Wall Street Journal report that both Novartis and Bristol Myers Squibb (BMS) have paused their autoimmune disease CAR-

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Rheums! Do you have a Rheumatology question or case for Dr. Cush? Record it here, and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/LZ59KW8HdA https://t.co/DwHdvpTYax
Dr. John Cush @RheumNow( View Tweet )

FDA Approves Brepocitinib to Treat Dermatomyositis

The FDA and Priovant recently annouced approval of brepocitinib (Lisraya), a JAK1/TYK2 inhibitor, for the indication of adults with dermatomyositis (DM). This is the first oral (once daily) agent approved for DM.

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