VEXAS Syndrome - A Review
Beck et al has published a review of the VEXAS syndrome in The Lancet, focusing on the pathogenesis, spectrum, and treatment strategies.
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Danish real-world study anifrolumab use in 36 #SLE pts. SLEDAI-2K decreased from 8 (baseline) to 2 @ mos 3; @6 mos 52% had SLEDAI-2K=0. 87% had PGA ≤0.5 w/ LLDAS, & 70% DORIS remission. Pred use declined by >50%. Herpes infx were most freq AE https://t.co/tbMOyOioeU https://t.co/jDJgImjgQt
Dr. John Cush @RheumNow( View Tweet )
UK Our Future Health study of 1,563,155 finds affective Dz (depression, bipolar, anxiety) signific higher (p<0.001)in autoimmune pts vs gen. pop. (29% vs 18%) - dx by PHQ-9, GAD-7. (OR 1.86), even after adjustments income and pain, etc. https://t.co/HoKBeAZxbS https://t.co/LnC4lqqgq7
Dr. John Cush @RheumNow( View Tweet )
ILD in RA - Recent Advances. Dr. Jeffrey Sparks
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/R3hWpqxo8q
#Rheumatology #ILD https://t.co/XsA6hiiTrd
Dr. John Cush @RheumNow( View Tweet )
Open label RCT in 116 DMARD-naïve #RA pts Rx w/ tofacitinib or MTX (after 1 IM steroid injx). @3 mos, TOFA signif better than MTX for >50% SDAI improv(94 v 75%), CDAI[14.5 v 7.3), DAS28-CRP[1.7 v 1.2] https://t.co/smOuLlVFyX https://t.co/xGvbiu62OB
Dr. John Cush @RheumNow( View Tweet )
Japanese ANSWER study Rx 7268 RA pts initiating bDMARDs or JAKi by orthos or Rheums. Vs Rheums, Ortho Rx RA had longer Dz duration, more seropositivity, functional impairment, less comorbidity, more MTX/GC/TNFi, less AE D/Cs - responses & outcomes were similar https://t.co/1ryA8C2p1b
Dr. John Cush @RheumNow( View Tweet )
Updated CRA/SPARCC Recommendations for Axial Spondyloarthritis
In 2024, the Canadian Rheumatology Association (CMA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) published a comprehensive set of 56 treatment recommendations for the management of axial spondyloarthritis. This first update is focused on the reassessment of IL-17i
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What's it like to have RA? MARY: "I can manage the pain, the exhaustion, and side effects of the meds. The hard part is grief. I grieve for me, the adventurer that decided what she wanted and boldly went after it, no matter what. I trusted myself to handle whatever came. Now https://t.co/GakWIy2XCt
Dr. John Cush @RheumNow( View Tweet )
FDA has issued a drug safety warning for avacopan (Tavneos), dentifying 76 cases of drug-induced liver injury, including 7 cases of rare vanishing bile duct syndrome (VBDS). There were 8 deaths https://t.co/2GkYNg1Apn https://t.co/fW2qafKCew
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
Dr. John Cush @RheumNow( View Tweet )
Target trial emulation: biologics or JAK vs RTX in RA-ILD -- abatacept (n=694), JAKi (156), IL-6i (389), or TNFi (734), PS-matched =# RTX; no significant differences (HR 0.74-1.09 NS) in outcomes of resp hosp, lung transplant & death. But ABA (HR 0.84) & JAKi (HR 0.62) had less https://t.co/c9IVwQYwMN
Dr. John Cush @RheumNow( View Tweet )
What's it like to have RA? LISA: "It only took me three short years to go from rock climbing to a power wheel chair and that stage of the disease was frightening and painful and you feel hopeless and as if your life plan is being stolen from you. Once I was able to start https://t.co/d49htc8k4m
Dr. John Cush @RheumNow( View Tweet )
Retrospective study of 1st SLE pregnancies from LUNA Registry. Fetal loss was associated w/ aPL (OR 2.46) & pulse steroids (2.46), but not w/ SSA Abs (1.32). 247 pregs, 194 live births, 53 fetal loss. Ro+ vs Ro- no difference in live births or preterm births https://t.co/bsMMvVyffw
Dr. John Cush @RheumNow( View Tweet )
5 Retrospective cohorts of PM/DM pts showed IIM (myositis) had signif higher risks of IIM patients HTN w/ pregnancy (OR 2.73), & C-section (OR 2.03). Also more preterm birth (3.7), SGA/IUGR (1.9) https://t.co/w6qymR0I2w https://t.co/ovtwdleRfE
Dr. John Cush @RheumNow( View Tweet )
What’s New PsA? (4.3.2026)
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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Update on Primary CNS Angiitis
The Journal of Neurology has posted a review and update of Primary CNS vasculitis (PCNSV), also termed primary angiitis of the CNS (PACNS). PCNSV is rare, potentially fatal, and highly treatable, making timely recognition and accurate diagnosis critical.
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Brepocitinib in Dermatomyositis
The NEJM reports that brepocitinib, an oral TYK2–JAK1 inhibitor, was studied in a phase 3 trial of refractory dermatomyositis (DM) patients and shown to have significant benefits at the higher dose.
https://t.co/YNxrVTIubb https://t.co/uFY3kMOvui
Dr. John Cush @RheumNow( View Tweet )
FDA has issued a drug safety warning for avacopan (Tavneos), dentifying 76 cases of drug-induced liver injury, including 7 cases of rare vanishing bile duct syndrome (VBDS). There were 8 deaths https://t.co/WkBhs1rNpf https://t.co/ZXdHsAJUOQ
Dr. John Cush @RheumNow( View Tweet )
FDA Safety Warning: Avacopan and Serious Liver Injury
Yesterday the FDA issued a Drug Safety Communication alerting patients and health care professionals about postmarketing identification of serious (drug induced) liver injury, including fatal cases, associated with the use of avacopan (Tavneos) in patients with ANCA- associated vasculitis.
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Moral Distress (3.27.2026)
Dr. Jack Cush reviews the journal reports and news from RheumNow. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
https://t.co/LdNcsUcHc2 https://t.co/tRYeDhQ3hC
Dr. John Cush @RheumNow( View Tweet )
Ixekizumab With Tirzepatide Efficacy in Obese Psoriatic Arthritis
The TOGETHER-PsA trial has demonstrated the efficacy and safety of ixekizumab (IXE) administered with tirzepatide (TZP) in adult active psoriatic arthritis (PsA) patients who were overweight or obese.
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/en4OnhWPda https://t.co/urwkjlVeg6
Dr. John Cush @RheumNow( View Tweet )
Brepocitinib in Dermatomyositis
The NEJM reports that brepocitinib, an oral TYK2–JAK1 inhibitor, was studied in a phase 3 trial of refractory dermatomyositis (DM) patients and shown to have significant benefits at the higher dose.
Read Article
AFFINITY Study - Combination Biologic Therapy in Psoriatic Arthritis
A pilot trial assessed the efficacy and safety of the guselkumab+golimumab (COMBO) combination versus guselkumab (GUS) monotherapy in active PsA (failing a prior tumor necrosis factor inhibitor (TNFi-IR) and showed superiority in ACR 50 responses but not
Target trial emulation: biologics or JAK vs RTX in RA-ILD -- abatacept (n=694), JAKi (156), IL-6i (389), or TNFi (734), PS-matched =# RTX; no significant differences (HR 0.74-1.09 NS) in outcomes of resp hosp, lung transplant & death. But ABA (HR 0.84) & JAKi (HR 0.62) had less https://t.co/2ZVyf8neVH
Dr. John Cush @RheumNow( View Tweet )
Therapeutic Updates
Lupus Nephritis
Sponsored by RheumNow
View our six video perspectives on lupus nephritis, including Management of CKD in Lupus Nephritis.
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Recent Blogs
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.
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Podcasts
ACR 2025 Daily Podcasts Day2d
EULAR 2021 - Day2b00:35:57
