Drug Safety

Femoral BMD & osteoporosis are independent predictors (nverse relationship) of all-cause mortality in postmenopausal women. NHANES study(2005-2018) of 2,977 postmenopausal F, OP yielded 47% incr mortality (HR 1.47) https://t.co/67Jv63X0Hx https://t.co/4vbFDydTY7

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Dr. John Cush @RheumNow( View Tweet )
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Toll-Like Receptor Drugs Effective in Cutaneous Lupus

MedPage Today

Enpatoran, an investigational oral drug that inhibits Toll-like receptors (TLR) 7 and 8, was superior to placebo in relieving lupus skin manifestations in a dose-finding phase II trial.

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No link between pregnancy tylenol & autism. JAMA Pediatrics data from 1.5 million Danish children( 1997 -2022); ~2% were tylenol exposed during preg. 2% of these Dx w/ Dx w/ autism (vs. 3% not exposed) https://t.co/Pp1tE54Dic https://t.co/qu61jKolpN

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Dr. John Cush @RheumNow( View Tweet )
FDA has published final guidance on Postapproval Pregnancy Safety Studies; how to study outcomes in pregnant women exposed to drugs & biologics- updates on registries,statistical methods, complementary studies, rare Rx exposures https://t.co/NWxrgB0dPQ https://t.co/ckyaJ07MQ0

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Dr. John Cush @RheumNow( View Tweet )
ANCA assoc. pachymeningitis (AAP) is rare. 230 systemic vasculitis, from 177 reports (108 MPO+, 71 PR3+); age~60; HA & cranial neuropathy (hearing/visual loss, diplopia) common. 89% w/ systemic Sxs (ENT, lungs, orbits, kidneys). Look for abnl ESR/CRP, CSF https://t.co/bHQegYYl5V https://t.co/hpfu8iaIkx

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Dr. John Cush @RheumNow( View Tweet )
CorEvitas RA registry study of 9601 RA pts starting b/tsDMARDs (52K yrs F/U) - 10.4% had eGFR<60 9CRI). Achieving CDAI remission was lower w/ CRI - 28% vs 19%(adj HR 0·76 [0·66–0·88]) https://t.co/E42N3PQHwG https://t.co/WNIGGCpCfZ

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Dr. John Cush @RheumNow( View Tweet )
A Review of Hydroxychloroquine Ocular Toxicity While HCQ is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal https://t.co/BrENoaBAVx
Dr. John Cush @RheumNow( View Tweet )
JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/SgVyk9fSCd

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Dr. John Cush @RheumNow( View Tweet )
Steroids Corticosteroids remain a cornerstone of rheumatologic therapy — rapidly effective but chronically dangerous, as their power to suppress inflammation through inhibition of prostaglandins, lipoxygenase, pro-inflammatory cytokines, and proteases comes at the cost of a https://t.co/PKdnFi1XSr
Dr. John Cush @RheumNow( View Tweet )
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Influential Rheumatoid Factors (5.8.2026)

Jack Cush, MD

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

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Medicare analysis of RA pts w/ metastatic nonsmall cell lung CA (mNSCLC) looked at 663 ICI-treated pts - 46% Rx w/ glucocorticoids (median Pred 6.6 mg/d). GC use was not associated with survival outcomes https://t.co/mwQeAgyKTC https://t.co/SR2XRD5Rhx

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Dr. John Cush @RheumNow( View Tweet )
eye%20exa.jpg (keep)

A Review of Hydroxychloroquine Ocular Toxicity

Jack Cush, MD

While hydroxychloroquine (HCQ) is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal toxicity, risk stratification, and evidence-

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Full read review of Preclinical Rheumatoid Arthritis: - Mucosal Origin Hypothesis - Gut Microbiota - Smoking & environment - Periodontitis - Immunosenescence - T cell abnormalities - Drug prevention https://t.co/UgqNBnKLMT https://t.co/2YZEiRCKNi

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Dr. John Cush @RheumNow( View Tweet )
Taiwan, real-world study 267 RA new DMARD starts w/ tofacitinib (145) or TNFi (122). Post adjustments; no significant difference in Efficacy, AEs, Serious AE (20 v 21%), MACE (0 v 0.8%), CA (2% vs 0.8%), deaths (1.4% vs 3.3), SIE (13% vs 8.2%) or H zoster (12% v 3%) https://t.co/XLsdfKyeGx
Dr. John Cush @RheumNow( View Tweet )
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A Patient’s Plea for a New Paradigm in Autoimmune Disease

Jack Cush, MD

A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?

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Breaking the Rules: Dual-Advanced Combinations in Rheumatology

Jack Cush, MD

For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes. 

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JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/cq3CuIuMKX

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Dr. John Cush @RheumNow( View Tweet )
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Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis

Jack Cush, MD

Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.

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Steroids Corticosteroids remain a cornerstone of rheumatologic therapy — rapidly effective but chronically dangerous, as their power to suppress inflammation through inhibition of prostaglandins, lipoxygenase, pro-inflammatory cytokines, and proteases comes at the cost of a https://t.co/fKGgYF3yWA
Dr. John Cush @RheumNow( View Tweet )
COVID Virus Persistence with DMARD Use Drugs commonly used to treat systemic autoimmune rheumatic diseases (SARDs) may prolong SARS-CoV-2 circulation after COVID-19 infection in patients with these conditions, with researchers documenting substantially increased viral antigen https://t.co/szeILIbmjF
Dr. John Cush @RheumNow( View Tweet )
FDA Targeting the Safety of Avacopan The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market. https://t.co/Otl0WQaOqo
Dr. John Cush @RheumNow( View Tweet )
Anifrolumab (Saphnelo) approved in the US for subcutaneous self-administration as a new autoinjector for the treatment of systemic lupus erythematosus based on SC-TULIP study. Presumeably, all prior CRL issues resolved to FDA satisfaction... https://t.co/ZtZmJLcGYa https://t.co/4B2YDpFaep

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Dr. John Cush @RheumNow( View Tweet )
FDA Targeting the Safety of Avacopan The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market. https://t.co/4PyIoqwNIL
Dr. John Cush @RheumNow( View Tweet )
APR: Steroids https://t.co/FxqGaijo6w https://t.co/OrybGNXsdf

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Dr. John Cush @RheumNow( View Tweet )
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COVID Virus Persistence with DMARD Use

MedPage Today

Drugs commonly used to treat systemic autoimmune rheumatic diseases (SARDs) may keep the SARS-CoV-2 circulating after COVID-19 infection in patients with these conditions, with researchers documenting substantially increased viral antigen persistence compared with other post-COVID patients.

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Therapeutic Updates

Lupus Nephritis

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Management of CKD in Lupus Nephritis Patients
View our six video perspectives on lupus nephritis, including Management of CKD in Lupus Nephritis.
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Recent Blogs

Advanced Practice Rheum

Steroids

Jack Cush, MD
STEROIDS COVER
In this Advanced Practice Rheum, Dr. Jack Cush reviews steroids.
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Advanced Practice Rheum

Difficult to Treat Rheumatoid Arthritis

Jack Cush, MD
D2T RA Cover
Dr. Cush addresses the management of difficult-to-treat rheumatoid arthritis (D2TRA).
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Advanced Practice Rheum

Methotrexate

Jack Cush, MD
APR MTX Cover
In this session, Dr. Jack Cush reviews methotrexate.
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