Drug Safety

tylenol,acetaminophen,pills,tablets

Prenatal acetaminophen linked to increased autism and ADHD

EurekAlert!

Researchers at the Icahn School of Medicine at Mount Sinai have found that prenatal exposure to acetaminophen may increase the risk of neurodevelopmental disorders, including autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD), in children. The study, published today

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https://t.co/nk6sBThX0v
Dr. John Cush @RheumNow( View Tweet )
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/NIMMhgIRzH

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Dr. John Cush @RheumNow( View Tweet )
📊 PRESENTED AT EULAR 2025: Long-term safety of a JAKi! 📊 View safety across ~17,000 patient-years of data from 11 Phase 3 trials in adult patients with RA, PsA, AS, or nr-axSpA. This poster is sponsored by AbbVie Medical Affairs + Health Impact. https://t.co/x6jNuCszw2 https://t.co/cZjk6yz2ot

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Dr. John Cush @RheumNow( View Tweet )
TriNetX database study shows Beta blocker use assoc w/ more hip replacements (THA). 23K propensity matched pts (mean age 69) on or off BB compared. After 3 yrs BB use was assoc w/ higher risk of THA (HR 1.49; 1.4–1.59), esp w/ alpha-BBs (HR 1.64) https://t.co/W6ocMYI653 https://t.co/EiQ4WH94cD

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Dr. John Cush @RheumNow( View Tweet )
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/Hgqspu3wUm

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Dr. John Cush @RheumNow( View Tweet )
New IDSA recommendation: In hospitalized on systemic steroids w/ severe, critical, progressing COVID-19, when baricitinib or tocilizumab are not available, IDSA guideline panel suggests infliximab. https://t.co/ZCkkZXUDpi https://t.co/gbgkvj5R8Y

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Dr. John Cush @RheumNow( View Tweet )
ChildCAPTURE & BioCAPTURE registry studies of 117 pediatric & 243 young adult Psoriasis pts on biologics (753.4 Pt-Yrs) shows no sex differences in clinical responses, but shows females have more adverse events than males (both cohorts) https://t.co/5at9vCqwIO https://t.co/ScJkIH9G31

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Dr. John Cush @RheumNow( View Tweet )
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Antibiotics are not linked to Autoimmune disease in kids

EurekAlert!

The global incidence of autoimmune diseases among children has increased over the past few decades. A study published August 21st in the open-access journal PLOS Medicine by Ju-Young Shin at Sungkyunkwan University, Republic of Korea, and colleagues suggests that early

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Uncertainty with immunosuppressive for idiopathic inflammatory myopathies A current Cochrane review suggests a continued unmet need regarding the status and utility of targeted immunosuppressant and immunomodulatory treatments for IIM. https://t.co/evkwbX6U9j https://t.co/2s0Z9Y9Umm

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Dr. John Cush @RheumNow( View Tweet )
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Safety of Combination Targeted Therapies in Psoriatic Arthritis

MedPage Today

Treating psoriatic arthritis (PsA) patients with more than one targeted therapy appears to be just fine, with no increased risk of serious infections, insurance claims data indicate.

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Future,space,time

Rheums Speak: Future of Rheumatoid Arthritis

Jack Cush, MD

The third survey in this series addressed clinician views on future trends (AI), future therapies and lessons learned.

This survey captured 233 responses from rheumatologists (91), most (61%) from the USA. US respondents were from the Southeast (17.5%), Southwest (11.4%), Mid-Atlantic (

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Guidance on aromatase inhibitor-associated bone loss with hormone-sensitive breast cancer An updated joint position statement on the management of aromatase inhibitor-associated bone loss (AIBL) addresses the heightened fracture risk in women undergoing endocrine therapy for https://t.co/ZkvToBBGdB
Dr. John Cush @RheumNow( View Tweet )
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Uncertainty with immunosuppressive for idiopathic inflammatory myopathies

Jack Cush, MD

A current Cochrane review suggests a continued unmet need regarding the status and utility of targeted immunosuppressant and immunomodulatory treatments for the idiopathic inflammatory myopathies (IIM). Overall there has been little progress since the previous Cochrane review (2012) that found

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TNF Inhibitors in Takayasu's Arteritis

Jack Cush, MD

A large, retrospective, multicenter study demonstrated the efficacy of intravenous infliximab and  subcutaneous adalimumab in patients with Takayasu arteritis.

This multicentre study enrolled patients from Takayasu's referral centers in France, Italy, Spain, Armenia,

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Anifrolumab appears effective & safe in refractory Cutaneous LE. OL Study of 15 CLE, on HCQ, topical steroids, failed multiple DMARDs. All Rx w/ ANIF 300 mg IV q4wks. ALL improved, CLASI-A decr from 16 to 1 (p<0.001); CLASI-D decreased from 5 to 4 (p<0.001). DBPCT needed! https://t.co/umEYz0XDyt
Dr. John Cush @RheumNow( View Tweet )
Advances in Still's disease Rx: - using IL-1 or IL-6 inhibitors 1st line - New FDA approval of emapalumab (IFNg) for MAS - unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/8GhoamkV4N

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Dr. John Cush @RheumNow( View Tweet )
JAKne? Study of 2183 IBD pts on JAK inhib, 272 developed acne. Crude prevalence: 16% upadacitinib, 4% tofacitinib, 2% filgotinib (dose-dependent w/ UPA & Tofa). JAKne in pts 30–50 yrs; mild-moderate severity; in 1st 3 mos. Higher risk w/ prior hx acne vulgaris (OR 4.9) https://t.co/G29CvZ6aux
Dr. John Cush @RheumNow( View Tweet )
Biologic Switching in Psoriasis A systematic review and meta-analysis found that biologic switching was effective in a significant number of psoriasis patients; but there may be a price to pay. https://t.co/QEv5jx9AIo https://t.co/06keUfXwRT

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Dr. John Cush @RheumNow( View Tweet )
There's a transient (1 yr) increase in New Abx Rx among 399 PsA pts after starting a TNF inhibitor. Pre-TNFi, PsA pts were more likely to recv Abx vs controls (1.26 vs. 0.60/yr; p<0.001). Post TNFi Abx use incr to 1.64/yr (p<0.001) but returned to baseline thereafter. https://t.co/LHXn5d7oC9
Dr. John Cush @RheumNow( View Tweet )
RheumNow Podcast square

Teaching You How to Think… (8.15.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and  aphorisms to live by.

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Prospective study 1,237 pregnant women (APS excluded) - finding LA-RVVT, anti-β2GPI IgG, predicted preeclampsia & intrauterine fetal death (IUFDR) and were were in identifying obstetric antiphospholipid syndrome (APS) https://t.co/5zKpR9NTcw https://t.co/6HXID7gtwR

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Dr. John Cush @RheumNow( View Tweet )
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Biologic Switching in Psoriasis

Jack Cush, MD

A systematic review and meta-analysis found that biologic switching was effective in a significant number of psoriasis patients; but there may be a price to pay. 

Patients with psoriasis may be required to switch therapies, for a variet of reasons (

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Venous thromboembolism (VTE) risk goes up w/ age, obesity, estrogens; BUT a UK primary care database shows VTE risk signif higher in RA (n 23K) vs matched controls (n 94K): adj HR 1.46. Absolute VTE risk higher w/ age & BMI, but VTE higher in younger v older; normal vs. Hi BMI: https://t.co/htI2YqiF0c
Dr. John Cush @RheumNow( View Tweet )
French OL trial of PCV13 vaccination in 248 early, DMARD Naive RA pts starting MTX @ same time or after 1 month delay. 1 mo delay in MTX resulted in significantly higher responses (46%, 65%) vs. pts vax while taking MTX. Signif responses seen 1 yr later. RA activity equal betw. https://t.co/AnqK89ZJtE
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Hydroxychloroquine for Everyone

Jack Cush, MD
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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. Read Post

Best of 2023: New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?

Richard Conway, MBBChBAO, PhD
Lungs ILD
Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base.  Read Post
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