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Genetics

Rheums Speak: Future of Rheumatoid Arthritis

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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2025 ACR Guidance on Diagnosis and Management of VEXAS

The ACR has published a formal international consensus guidance on VEXAS as a resource for clinicians seeking to understand the disease and its management. 

VEXAS is a rare genetic disorder; the acronym stands for Vacuoles E1 enzyme X-linked

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Aging Quiets Lupus UCSF researchers have found that epigentic changes in interferon genes over time may lead to lupus being less active as they age. https://t.co/MLBFLXnXOQ https://t.co/9aacdZPoED
Dr. John Cush @RheumNow( View Tweet )
Juvenile Idiopathic Arthritis - NEJM Review Sandborg et al. has published an overview of juvenile idiopathic arthritis (JIA) - its classification, biology, genetics, , clinical presentations and treatment advances in the New England Journal of Medicine (NEJM). https://t.co/ykI9zAUXaF
Dr. John Cush @RheumNow( View Tweet )
DID YOU KNOW? >30% of Systemic Sclerosis pts present without Raynauds!. Data from 2 large US cohorts, of SSc dx with puffy fingers/hands or other symptoms. Such patients presented with more severe skin and musculoskeletal disease. https://t.co/NP3KeUL5iX https://t.co/XWiAIljujL
Dr. John Cush @RheumNow( View Tweet )

Repurposing & Pipeline (8.8.2025)

Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.

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RA leads to ILD: but ILD does not lead to RA

Rheumatoid arthritis is a common autoimmune disease, and approximately 30%-40% of patients develop pulmonary complications such as idiopathic pulmonary fibrosis (IPF), but the causal relationship between the two has long been unclear.

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"FLAME" - machine learning model developed to predict SLE flares. Data from 28,433 SLE pts (2011-2022) looked at clinical & social determinants of health (SDoH) to predict 3 mo flare risk. AUROC = 0.67; SHAP analysis identified HA, OBS, & pyuria as predictors. Is this the https://t.co/6Eqqc9w2oV
Dr. John Cush @RheumNow( View Tweet )
PsA is worse in women--why? 100 PsA pts, serum study of differentially expressed proteins - 20 times more sex-specific DEPs in PsA males than females (PsA vs controls). In women leukotriene A-4; and in men IL-36, NEK7 & PIK3CA/PIK3R1 were significant predictors. https://t.co/JzI1n6Hf5G
Dr. John Cush @RheumNow( View Tweet )
Clinical Associations with Anti-RNA Polymerase III Antibodies A systematic review of anti-RNA polymerase III antibodies (ARA) in systemic sclerosis (SSc) patients finds ARA positivity in only 9% of SSc patients, but come with a higher risk of many potentially worrisome https://t.co/p1KVUFPJvN
Dr. John Cush @RheumNow( View Tweet )
Pesticides and Rheumatoid Arthritis? Women exposed to pesticides through farm work or as farmers' wives face increased risk for developing rheumatoid arthritis (RA), a new analysis of Agricultural Health Study (AHS) data indicated. https://t.co/ISddKbnxMY https://t.co/E5tpX5D70X
Dr. John Cush @RheumNow( View Tweet )
Fibrosis in IgG4-related disease due to the overexpression of early growth response-1 (EGR-1) by Epithelial cells that facilitates tissue fibrosis https://t.co/PBMqjr0MVV https://t.co/d9b7k2zwYE https://t.co/25aIjIrYm3
Dr. John Cush @RheumNow( View Tweet )
Study of a Chinese systemic JIA cohort using scRNA-seq and Bulk RNA-seq, found a potential biomarker w. UBE2D1 expression closely related to Dz activity levels, reflecting enhanced monocyte activity in sJIA patients. UBE2D1 may complement others S100A8/A9, IL-18, ferritin https://t.co/hp7sFR6kLa
Dr. John Cush @RheumNow( View Tweet )

NHANES, Numbers, & Risk (7.18.2025)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".

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Study of a Chinese systemic JIA cohort using scRNA-seq and Bulk RNA-seq, found a potential biomarker w. UBE2D1 expression closely related to Dz activity levels, reflecting enhanced monocyte activity in sJIA patients. UBE2D1 may complement others S100A8/A9, IL-18, ferritin https://t.co/IDeEvitIrB
Dr. John Cush @RheumNow( View Tweet )
BMJ - UK population study of 1.5 million adults finds pts w/ autoimmune dz have twice the risk of affective disorders (depression, bipolar dz, anxiety) significantly higher (p<0.001) (28.8% vs 17.9% in gen. population. Signif regardless of age, sex, ethnicity, income, Fam Hx, https://t.co/dsJxkvD4Nu
Dr. John Cush @RheumNow( View Tweet )

ICYMI: Axial Involvement in Psoriatic Arthritis

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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PCR: Prevalence, Cost, & Risk (6.27.2025)

Dr. Jack Cush reviews the news and journal reports from last week on RheumNow.com

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HLA-B27 Testing in Practice

A single center study shows HLA-B27 testing is often performed by both by rheumatologists and nonrheumatologists for a wide array of reasons and often along with other serologic tests. Optimal use of HLA-B27 testing has yet to be defined.

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Predictors and Outcomes in Systemic Sclerosis The VEDOSS project has previously shown that 70% of patients with Raynaud’s phenomenon and at least one red flag – systemic sclerosis (SSc)-specific antibodies, puffy fingers, or an SSc pattern on nailfold capillaroscopy –will https://t.co/9dJn1qMQfy
Dr. John Cush @RheumNow( View Tweet )
#EULAR2025 Abstr#OP0265 Do we have convenient biomarkers to help predict new ANA+ referral who would progress to #SLE #Sjogren at 12 mths? Proteomics analysis identified IFN and B-cell markers. Validation is needed and to incorporate clinical items into prognostic model @RheumNow https://t.co/TWClLTKQ0b
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
What ‘CAR’ to drive? #CAR-T buzz was at #EULAR2025 In multiple #rheumatic #diseases #SLE #Scleroderma #Sjogrens #myositis Even #axial #SpA Who - active, not a lot of damage Which target 🎯 Which priming regiment What will results be compared to? Who will pay? @RheumNow

Janet Pope @Janetbirdope( View Tweet )

E3N cohort 78000+ women >30yrs follow up 698 incident RA cases) In non smokers, RA asso w/ -tall at birth HR=1.55 In smokers, RA risk associated w/ -prematurity HR=1.63 -in utero exposure to tobacco HR=1.83 (ns) #EULAR2025 @RheumNow POS0226 https://t.co/xC3k3kiKsZ
Aurelie Najm @AurelieRheumo( View Tweet )
Acute Dactylitis in #Psoriatic_Arthritis 🔹️1216 patients Canada 🇨🇦 🔹️52% had at least one episode of acute dactylitis in a median 12 years 🔹️Positive association with HLA-B27 and HLA-B27/C02 🔹️No association with HLA-B51 #EULAR2025 @RheumNow OP0180 by Kharouf et al. https://t.co/oNNMBcvVb4
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Is RA just one disease? No, & increasingly more efforts to subgroup RA on diff levels Simple approach - derived phenotypes map (independent of ACPA): - to broad histopath - to MTX response Omics is good, but still need to do the simple stuff better! #EULAR2025 OP0328 @RheumNow https://t.co/a8Vl7Kcjso
David Liew @drdavidliew( View Tweet )
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