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Drug Safety

2026 Resolutions (1.9.2026)

Dr. Jack Cush reviews the news, announcements and journal articles from this past week on RheumNow.com. More on Variable bendability, a better way to treat RA, and a novel advance for GLP1a in PsA; and 2026 Resolutions!

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Shortened Leukocyte telomere length (PBL-TL) is assoc w/ systemic sclerosis–ILD. Study of PBL-TL in 244 SSc vs 314 controls, found signif shorter PBL-TL in SSC. Short PBL-TL was assoc w/ ILD & Pulm HTN, more lung related hospitalizations, but not w/ Raynauds, skin or vascular dz

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Plenty of evidence that toxic environmental exposures increase #RA risk. Full read, intelligent report from Stanhope et al showing how (healthy environmental) green space exposures are protective & capable of preventing RA!! Lifestyle is gigantically important in your https://t.co/LUWmHhUT7F
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Assess Reproductive Health in SLE Clinic Visits Systemic Lupus Erythematosus (SLE) mainly affects women of childbearing age, increasing their risk of infertility, miscarriages, and pregnancy complications due to disease factors and medications. Rheumatologists should actively https://t.co/hqWSpqJ6HN
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J&J announced positive topline results from Phase 2b JASMINE study showing the efficacy of of nipocalimab, FcRn blocker that reduces AutoAbs & B cell activity. Study met its 24 wk primary endpoint (SRI-4 response) vs placebo. There were no new safety signals https://t.co/87FZIogmkW
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GLP-1 Agonist plus IL-17 Inhibition in Obese Psoriatic Arthritis

Lilly announced the topline results from its phase 3b "TOGETHER PsA" trial, showing that the combination use of ixekizumab (Taltz) and tirzepatide (Zepbound) was superior to IXE alone, yielding both significant weight loss and ACR50 disease control in adults with active psoriatic arthritis (PsA

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Nordic Registry Study on NSAID use of ~750K, w/ 34-40% under 60 yrs. 48-58% started NSAIDs before Dx of OA. NSAID use incr w/ age from 18 to 55 yrs, then declined. OA pts have a substantial risk of GI complications in all age groups, including those under 60 yrs. Need to consider https://t.co/PLoUVI4Hys
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58 newly Dx #PMR pts (on <8 wks steroids/GC) randomised 1:1 MTX 25 mg/wk or placebo, w/ 24-week GC-tapering protocol. @wk 52 GC-free remission achieved in 80% of MTX vs 46% of placebo pts (risk difference 34%, 1-sided 95% CI: 14%, 1-sided P = .0042) https://t.co/75SLx5LtqZ https://t.co/HtDAJe5VI2
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Subcutaneous Anifrolumab Effective in Lupus

ACR

A new study published in Arthritis & Rheumatology demonstrates that subcutaneous administration of anifrolumab provides efficacy comparable to intravenous administration, offering a promising alternative for at-home care of patients living with moderate-to-severe systemic lupus erythematosus

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Systematic review of Difficult-to-treat RA (D2T-RA): 23 articles, 27,987 RA pts from 13 countries - pooled prevalence of D2T-RA was 11.7% (10.9% overall; 13.2% in b/tsDMARDs-treated RA). 47% D2T-RA had persistent inflammatory refractory RA (PIRRA). Prevalence decreased w/ https://t.co/0Gatzbfxid
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APP Pearls “Steroids: Set a stop date upfront, educate on side effects, and teach "every milligram matters." Prevents dependence and eases tapering” - Barbara A. Slusher, MSW, PA-C, DFAAPA, DipACLM

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Glucocorticoid Injections in Knee Osteoarthritis

A randomized clinical trial of 60 patients found that glucocorticoid injections into the infrapatellar fat pad (IPFP) did not significantly reduce pain scores in patients with inflammatory knee osteoarthritis (compared to placebo).

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UK study of 1846 RA pts starting a b/tsDMARDs, ~30% on steroids & majority (2/3) continued use over the first year of new novel treatment. This suggests these aer either severe RA pts or that we are not vigilant in limiting/weaning/stopping steroids in RA patients - which is it? https://t.co/7NWeAWTjSy
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Japan retrospective study of 38 RA pts who developed MTX assoc lymphoproliferative disorder (LPD) - 22 w/ spontaneous regression (SR) vs 16 non-SR (w/ 5 deaths). non-SR Pt had higher LDH levels at Dx & lower lymphocyte recovery 1 mo. post MTX withdrawal & higher mortality risk https://t.co/SsBQRxFvD1
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JAMA teaching case: 57 yoF w/ RA Rx w/ HCQ, NSAID, TNFi (ETN -->ADA) develops a new rash - pruritic vesicles/papular on neck, mouth, ears, chest, hands w/ some becoming ulcerated plaques, ESR >100. WHAT TO DO? A) steroids; B) stop ADA; C) Benadryl or D) Read more? Pt had https://t.co/DQpeUOC5I3
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APP Pearls “It’s important to explain the difference between an overreactive immune system vs. a weakened immune system” - Miguel Rodriguez, ANP

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Best of 2025: 2025 BSR Guideline for Treatment of Axial Spondyloarthritis

Editor's note: This article was originally published April 22, 2025, and is being shared again as part of RheumNow's 'Best of 2025' series as we close out the year. Enjoy!

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Best of 2025: Glucocorticoids in SLE: how to start, how to follow, how to stop 70+ years after their debut, glucocorticoids remain a fast, powerful tool for SLE—but long-term toxicity comes at a high cost. Guidelines now favor GC “bridging therapy”: use briefly, taper fast. The https://t.co/RS0JQquv6j
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2025 update of EULAR recommendations on lupus nephritis At the 2025 EULAR congress in Barcelona, Prof Dimitrios Boumpas presented updated EULAR recommendations on managing lupus nephritis (LN). The key change is that the historic standard of care (mycophenolate with https://t.co/78J1L80Zxe
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Best of 2025: Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients

More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the

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Best of 2025: ERS/EULAR guidelines for CTD-related interstitial lung disease

The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in

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GC dose and tapering may influence serious infection risk in patients with GCA. Discover the key safety outcomes observed during a year of JAKi therapy in a Phase 3 trial. Sponsored by AbbVie Medical Affairs +Health Impact. https://t.co/xIC7Vqx659 https://t.co/6n3XfXeeg2
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Rapid rituximab infusions are safe & efficient. Metanalysis of 7 RCTs, 538 pts w/ autoimmune/rheumatic dz, showed infusions(RTX 1000 mg) of 90-120 min (w/ premedication) had low risk (3-15%) of mild (Grades 1, 2) infusion Rxns; only 6 Grade 3 Rxns https://t.co/uVKuhhc80F https://t.co/9EhyBpSaAE
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Best of 2025: Contraception in SLE

Pregnancy in SLE gets a lot of press in the rheumatology literature, and deservedly so, since pregnancy risks can be markedly increased. It was not that many years ago that women with SLE were counseled to avoid pregnancy.

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Best of 2025: Hydroxychloroquine for Everyone

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

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