Emergencies, Independence & Hemorrhage (1.23.2026)
Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com
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Did you know theres a Subcutaneous (SC) rituximab (Hycela)? Its same RTX but combined w/ hyaluronidase, faster 5-7 minute injection Vs hours for IV RTX. FDA approved 2017 for Follicular Lymphoma (FL) and Diffuse Large B-cell Lymphoma (DLBCL). Give 1st dose IV, then use SC RTX. https://t.co/piQ2ZhAOyf
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French Retrospective study (2011-22) of 36129 adult psoriasis pts on biologics who recv antibiotics (9366/26% @ baseline, 61% during FU). Abx treatment assoc w/ 12% greater risk biologic D/C (HR 1.12); more for multiple Abx courses (HR 1.29; 95% CI, 1.24-1.35) https://t.co/2Jv5xCibyd
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BIOBADASER III Registry shows No Cancer Risk with b/tsDMARDs
A large, real-world cohort study of rheumatoid arthritis (RA) finds patients treated with biologic and targeted synthetic DMARDs (b/tsDMARDs) do not have an increased risk of cancer.
Researchers used 2000–2023 data for RA patients from the BIOBADASER III registry,
APPIPRA Study - Benefits of Early Treatment
EurekAlert!
Treating people who are at high risk of rheumatoid arthritis (RA) can delay the onset of the disease for several years, with benefits also continuing well after treatment has stopped.
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Emergency Department Visits by Rheumatoid Patients
A Canadian population study shows that rheumatoid arthritis (RA) patients have 30% higher emergency department (ED) visit rates for Ambulatory Care Sensitive Conditions (ACSCs) compared to age- and sex-matched population https://t.co/BL8AkXhkFG
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Rheum Survey> 40 yoF RA pt on Prednisone 5 mg/d is at increased risk for ?
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Are JAK Inhibitors Better at Pain Relief in RA?
MedPage Today
Among rheumatoid arthritis (RA) patients responding to upadacitinib (Rinvoq) or adalimumab, those receiving the former had significantly less residual pain with treatment, according to a post-hoc analysis of phase III trial data.
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German psoriasis registry PsoBest reports on 595 Rx w/ apremilast (417 APR monotherapy). Compared to Ptx Rx w/ other DMARDs/biologic drugs, APR pts higher age, more comorbidities. Nonserious AEs: ineffectiveness (14%), diarrhea (9%), nausea (7%), HA (6%). https://t.co/TviJmM7Fr9 https://t.co/tY89oHgUgV
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Emergency Department Visits by Rheumatoid Patients
A Canadian population study shows that rheumatoid arthritis (RA) patients have 30% higher emergency department (ED) visit rates for Ambulatory Care Sensitive Conditions (ACSCs) compared to age- and sex-matched population controls.
Diffuse Alveolar Hemorrhage in Rheumatic Disease
A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/K1fLo5iHpd
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Drugs that may cause toxic myopathy, presenting as muscle dysfunction w/ weakness and elevated muscle enzymes and possibly confused w/ idiopathic inflammatory myopathies (IIM) - full read review of mimickers of myositis. https://t.co/3wdLvkxcAX https://t.co/OqLjv45HXH
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Subcutaneous Anifrolumab in SLE
Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/ruZM3Qftxb
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Rheum Survey> 40 yoF RA pt on Prednisone 5 mg/d is at increased risk for ?
Dr. John Cush @RheumNow( View Tweet )
FDA & Administration are deregulating artificial intelligence & promote widespread use, includes use of wearables & other AI-enabled devices. Commissioner Marty Makary updated two guidance docs defining use general wellness devices, clinical decision support software https://t.co/KnkYqCiroa
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Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Mu3OyA4EOD
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Metanalysis of 21 clinical trials, 2,100 adults, shows cannabis-based medicines (vs placebo) over 2-26 weeks are not effective in treating chronic neuropathy nerve pain, regardless if given as THC of CBD. https://t.co/ZOJrcMGZkr https://t.co/nqCWoFmaWp
Links:
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In Dec 2025, the FDA qualified total hip bone mineral density (BMD) assessed by DXA as a validated surrogate endpoint for osteoporosis clinical trials. Previously OP trials required fracture endpoints as primary efficacy measures, necessitating large 2-5 yr studies https://t.co/5t9rftwX4A
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ADJUST trial (248 JIA pts w/ Uveitis & inactive >6mos, either continued or weaned off adalimumab. ADA weaning resulted in more flares (68% vs 14%, mostly uveitis) w/ no protection from background DMARD Rx. Restarting ADA was mostly effective. https://t.co/ZWHfPl2UNl https://t.co/Fk1HES2UIc
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FIBROSCANS in 60 RA pts on #MTX for 5 yrs w/ liver studies. Mean age = 39.5yrs, w/ Dz Dur 8.2 yrs, mean BMI 24.4 & MTX 12.5–25 mg for ~8 yrs (cum dose 6728mg). All had normal AST, ALT, APRI, Abd US; fibroscan score = 170 ((steatosis grade 0). Only 4(6.7 %) had mild, fibrosis https://t.co/7SACsEYi37
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The 2025 Rheumatology Year in Review
The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.
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Diffuse Alveolar Hemorrhage in Rheumatic Disease
A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/vpzF8Dnspr
Dr. John Cush @RheumNow( View Tweet )
Subcutaneous Anifrolumab in SLE
Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/3DWNEXaO2x
Dr. John Cush @RheumNow( View Tweet )
Systematic review of cardiovascular death in systemic immune-mediated Dz (SIDs): 39 studies, 171,748 pts - SIDs assoc w/ signif. higher CV mortality (HR 1.26; 1.09-1.47; p = 0.002), especially for RA, SLE, GPA & females. 92% of CV deaths from acute coronary syndrome (ACS) https://t.co/ogLhqKMwON
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Metanalysis of Tramadol included 19 PBO-RCTs, 6506 pts, showing a very modest benefit on chronic pain (low certainty of evidence), but a doubling of risk for serious adverse events (OR 2.13); including nausea (NNH 7), dizziness (NNH 8), constipation (NNH 9), somnolence (NNH 13) https://t.co/0ZEIoy1gqC
Dr. John Cush @RheumNow( View Tweet )
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