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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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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Italian retrospective study 411 IIM pts classified cancer risk per IMACS criteria: 44% high-, 38% intermed- 18% standard-risk. 9.2% had CA w/in 3yrs. Signif more in high-risk (OR 4.05). CA predictors: TIF1γ (OR 12.3), SAE1 (OR = 11.9) https://t.co/j4gA0g79bI https://t.co/Pt5nMs89bl
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Top Four and More (4.10.2026)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.
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VEXAS Syndrome - A Review
Beck et al has published a review of the VEXAS syndrome in The Lancet, focusing on the pathogenesis, spectrum, and treatment strategies.
https://t.co/Nik0TJm6Qu https://t.co/WS35PRnbBv
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VEXAS Syndrome - A Review
Beck et al has published a review of the VEXAS syndrome in The Lancet, focusing on the pathogenesis, spectrum, and treatment strategies.
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UBER Rheumatology Ride (3.6.2026)
Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com
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RT @ericdeinmd
Mucosal Hypothesis RA #RNL26
Demoruelle
ACPA can predate RA development
Nam et al: non-specific jt pain: 42% developed RA in 12 mos
Circiumaro et al: MSK complaints 38% devel RA in 36 mo
APIPPRA: 29% at 12 mo, 37% at 24 mo, StopRA 18% in 12 mo, 33% at 36 mo https://t.co/DxGhhFL1gO
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RT @ericdeinmd
Mortality risk in RA #RNL26
Myasoedova
Premature deaths in up to 1/4 of pts
Decline in mortality in RA after year 2000
Full siblings of RA also high mortality (shared genetic or environ factors affect risk?)
Risks: Seropositivity, esp ACPA, CRP, extra-artic https://t.co/ytm6odmtgR
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The challenge may be that lupus has multiple endotypes with variable rates of progression/trajectories. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/BA4KRKebIv
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RA outcomes according to onset: typica RA vs undifferentiated inflam arthritis (UIA) or palindromic rheumatism (PR). Progress to RA = RA > UIA > PR. PR has more +FHx & ACPA; UIA more females w/ Knee Sxs. Best remission rates w/ PR onsets. https://t.co/JJRCdKcs1u https://t.co/n385f6EF59
Links:
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🧬 PAPA Syndrome: When Sterile Inflammation Mimics Infection
(Pyogenic Arthritis, Pyoderma gangrenosum, Acne)
•A rare monogenic autoinflammatory disease
•Caused by gain-of-function mutations in PSTPIP1
🧠 Pathophysiology
•Mutant PSTPIP1 → increased interaction with pyrin https://t.co/tJ4INdgfky
Ravi Kumar @RheumattDoc( View Tweet )
A 2 yr. old female pt reported w/ a a novel P435S gain-of-function variant in TLR7 (thought pathogenic in SLE) - pt dx w/ juvenile SLE, recurrent infection, and neuroinflammatory features. A review of 12 other TLR7 GOF variants revealed similar SLE associations. https://t.co/NU553QwCtj
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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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A 2 yr. old female pt reported w/ a a novel P435S gain-of-function variant in TLR7 (thought pathogenic in SLE) - pt dx w/ juvenile SLE, recurrent infection, and neuroinflammatory features. A review of 12 other TLR7 GOF variants revealed similar SLE associations. https://t.co/TGgKDQ0D7F
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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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HLA-B27: still the most important genetic factor in axSpA susceptibility, but has lower frequency African American, South American & Middle Eastern pop. B27 discerns clinical subsets of SpA and PsA, particularly acute anterior uveitis or axSpA with psoriasis, https://t.co/Yg7DBOTW8o
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Disease Activity Criteria for Adult-Onset Still's Disease: EULAR Points to Consider
EULAR has published a "points to consider" (PtCs) guidance on the development of criteria for the assessment of the disease activity in adult-onset Still’s disease (AOSD).
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RHEUM Survey> In RA, seropositivity correlates best with what?
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Retrospective cohort study of 546 DM or clinically amyopathic DM pts. 5 factors were signif assoc w/ cancers (1 point ea): 1) TIFF-1-γ Ab (OR 3.8), poikiloderma (OR 3.1), DM subtype (2.8), anemia (2.4), but ILD was protective (OR 0.39). Markedly elevated DM cancer risk seen w/ https://t.co/OdygNQY2u3
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Hematologic Malignancies Increased in Systemic Sclerosis
Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.
https://t.co/K1WuMC0mXI https://t.co/MGkvwESqIe
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Retrospective cohort study of 546 DM or clinically amyopathic DM pts. 5 factors were signif assoc w/ cancers (1 point ea): 1) TIFF-1-γ Ab (OR 3.8), poikiloderma (OR 3.1), DM subtype (2.8), anemia (2.4), but ILD was protective (OR 0.39). Markedly elevated DM cancer risk seen w/ https://t.co/r564RbZys2
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Study of 489,569 UK Biobank participants (40 to 69yrs) betw 2006–2010 showed incident RA in 5404. Having self reported eating disorders (anorexia nervosa, bulimia, etc) was associated with a higher risk of developing RA (ad HR 1.76; 1.12–2.76), moreso in men (HR 5.09). https://t.co/GPV3YoE3kt
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Myelodysplastic & chr myelomonocytic leukemia pts rarely get lupus. Review of 19 w/ SLE & 5 w/ CLE; these were older (65 yrs), more male (15M/9F), w/ less renal [10%] & articular [36%] Dz w/ less dsDNA [32%]. Thought to be clonal inflammatory, & not autoinflammatory, process. https://t.co/EAvkJm6GQs
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Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/JfcycqHvhl
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Recent Blogs
Cush and Dao are at it again. This time it's whether men or women are better patients. Cush says men are better patients; Dao says Er, not so fast bub! This is their light-hearted, gender biased debate on the best patients: Men vs. Women.
