Follow the Money (4.23.2026)
Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week.
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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
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Dr. John Cush @RheumNow( View Tweet )
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/hgYMJJDKGA https://t.co/41sZkXPM7W
Dr. John Cush @RheumNow( View Tweet )
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
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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
Dr. John Cush @RheumNow( View Tweet )
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.
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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 )
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 risk of GI bleeding.
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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
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
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
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
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
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
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 )
Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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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
Dr. John Cush @RheumNow( View Tweet )
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.
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Still's Disease Update
Arthritis Research & Therapy has published an overarching review of Still's disease - claiming it to be a single acquired and complex autoinflammatory disease in which both pediatric and adult forms share core pathogenic mechanisms, genetic associations and clinical presentations, with minor
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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/SyhK12KhHY
Dr. John Cush @RheumNow( View Tweet )
Opioids Down, Gabapentins Up
The number of U.S. patients prescribed long-term opioid therapy declined from 2015 to 2023, but co-prescribing of opioids with gabapentinoids increased, prescription data showed.
https://t.co/iXEUfR18Is https://t.co/6DCUvGAW6N
Dr. John Cush @RheumNow( View Tweet )
NHIS 10yr survey of 195,600 Americans shows Chronic pain assoc w/ double rates of smoking & vaping. Smoking decr over time, but always higher in chronic pain pts (17.7% 2014, 13.1% in 2023) than w/o pain (12.5% 2014, 7.5% 2023). E-cigs incr over time, more w/ chronic pain https://t.co/iW7IDwHyJa
Dr. John Cush @RheumNow( View Tweet )
Litifilimab in Cutaneous Lupus Erythematosus
Biogen has announced positive results of their Phase 2 study, evaluating litifilimab in patients with active cutaneous lupus erythematosus (CLE), presented at the recent American Academy of Dermatology (AAD) Annual Meeting.
Litifilimab is an investigational monoclonal antibody that
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2023 FDA’s removal of REMS in-person Rx requirement for mifepristone was assoc w/ large increase in mifepristone Rx at pharmacies (most thru mail order where abortion is legal and telehealth Rxing is permitted https://t.co/9NHMmxUpLl https://t.co/jkV5DmIaJt
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
