GI/Liver

Optimal Management of Rheumatoid Arthritis Patients and Liver Disease https://t.co/KpdY1MEM1w https://t.co/vETGMJgHf3

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Dr. John Cush @RheumNow( View Tweet )
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The Cartel is Coming for Rheumatology

Eric Dein, MD

"What Do Blockbuster Drugs & The Black Market All Have in Common?" asked Dr. Madelaine Feldman at RheumNow Live 2025. They thrive, she explained, on market exclusivity "... until they don't." At first glance, the pharmaceutical marketplace may not appear like a crime drug ring, but Dr.

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Hepatitis B (Keep)

AGA Guideline: Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals

Jack Cush, MD

The American Gastroenterology Association has published its revised clinical practice guidelines for the prevention and treatment of hepatitis B virus (HBV) reactivation in at-risk patients, particularly those with immune-mediated disease, receiving immunomodulatory therapy and steroids.

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Celecoxib Lowers Colon Cancer Recurrence Risk

Jack Cush, MD

The Alliance for Clinical Trials in Oncology today announced the results of a data analysis from a randomized phase III clinical trial involving patients with stage III colon cancer, which found that adding the drug

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Weak Data (1.24.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com, and features Dr. Charity Dean, the Keynote speaker at RheumNow Live 2025, and why she is an inspiration.

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Palmar fasciitis & polyarthritis syndrome (PFPAS). JAMA case 50yoM w/ progressive hand swelling, stiffness, thickening, erythema, hepato-splenomegaly. Skin Bx dermal fibrous tissue. WBC 152k, LDH 889, lead to CML dx made by BM Fx (myeloid-erythroid ratio 21 w/ myeloblasts). +… https://t.co/7gj3mvOSqs https://t.co/56tLd1jsNf
Dr. John Cush @RheumNow( View Tweet )
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Fallen Angels (1.17.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com; and pays homage to colleagues who passed away in 2024.

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Leeds study of 19 pts at-risk for RA (ACPA+ & arthralgia) finds low-diversity gut microbiome & in the 10 mos preceding the transition to RA, microbiome becomes more unstable w/ accumulation of Prevotellaceae, particularly Prevotella copri https://t.co/Va9Z0NWHj9 https://t.co/ciM7QtEF5S

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Dr. John Cush @RheumNow( View Tweet )
Leeds study of 19 pts at-risk for RA (ACPA+ & arthralgia) finds low-diversity gut microbiome & in the 10 mos preceding the transition to RA, microbiome becomes more unstable w/ accumulation of Prevotellaceae, particularly Prevotella copri https://t.co/rbYMCl1FcO https://t.co/LWqppg36cn

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Dr. John Cush @RheumNow( View Tweet )
Retrospectively review of 165 #EGPA pts, GI manifestations were assoc w/ Eosinophils > 19.5%, weight loss, & myalgia; & included abdominal pain (78%), diarrhea (40%), N/V (33%); GI hemorrhage (27%), ulcers (17%), obstruction (10%), & pancreatitis (6%) https://t.co/EzsGcFs2l2 https://t.co/mQrgjTG6NV

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Dr. John Cush @RheumNow( View Tweet )
54K Peptic Ulcers Annually (12.13.2024) https://t.co/18FiQx1YQA https://t.co/32UZi9XafS

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Dr. John Cush @RheumNow( View Tweet )
If high +ANA and NO #rheumatic #disease LOOK 👀 at #LIVER #Autoimmune #hepatitis And #alcoholic #liver #dx #ACRBest #ACR24 @rheumnow abst#0627 https://t.co/0bwfgNnB0e

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Dr. John Cush @RheumNow( View Tweet )

To Behcet’s or not to Behcet’s? -Aphtous ulcers have unique features(broad ddx) -Oral+Genital ulcers=CAP not necessary BD. -Pathergy test ⬆️specific and not limited to skin! -Pulmonary arterial aneurysms=almost pathognomonic. -Do not get confused by HLAs. #ACR24 @RheumNow… https://t.co/3nWgILNVYw

Dr. John Cush @RheumNow( View Tweet )

95 IBD pts had Magnetic resonance enterography (MRE). While 6/95 (6.3%) developed IBD-arthritis (mean 11 mos), finding Sacroiliitison MRE did not increase this risk. IBD arthritis risk was linked to arthralgia (OR 84) & extraintestinal manifestations (OR 7.4)… https://t.co/NGWGKn75jG https://t.co/IqY6XHWqqy
Dr. John Cush @RheumNow( View Tweet )
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Bah Humbug Vitamin D (12.20.2024)

Jack Cush, MD

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

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54K Peptic Ulcers Annually (12.13.2024) Dr. Jack Cush reviews the news and journal reports from the past week on https://t.co/V10S4oVFsv https://t.co/rHw1qgxzIP https://t.co/cOdGQ5cAPD

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Dr. John Cush @RheumNow( View Tweet )
Avacopan, a C5aR antagonist, for Rx of ANCA-Assoc GPA & MPA. Main warning for liver AE. In RCTs, abnl LFTs seen in 11.6-13.3% and 4.2% D/C drug for liver probs. Recent Japanese report of 22 AAV pts with AVACO Liver injury seen in 9 pts - Severe, incr total bilirubin in 4, 1 pt… https://t.co/LyuIQhwOoQ https://t.co/TAmQ9vph4V
Dr. John Cush @RheumNow( View Tweet )
Safety of Acetaminophen in the Elderly New research, led by experts at the University of Nottingham, has found that repeated doses of paracetamol in people aged 65 and over, can lead to an increased risk of gastrointestinal, cardiovascular and renal complications.… https://t.co/rLchNTh6C8 https://t.co/y2DUx6TQR0
Dr. John Cush @RheumNow( View Tweet )
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54K Peptic Ulcers Annually (12.13.2024)

Jack Cush, MD

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

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In US, peptic ulcer disease affects 1% of population w/ ~ 54 000admitted to hospital annually w/ bleeding peptic ulcers. But only 10% of PUD pts present w/ upper abdominal pain. Prime causes are Helicobacter pylori infection (42%) & NSAID use (36%) https://t.co/0VvA7lI0MQ https://t.co/YWv4SDNVLC

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Dr. John Cush @RheumNow( View Tweet )
JAMA Images in Dermatology - Palmar Fasciitis and Polyarthritis Syndrome -- 50yoM w/ 6 mo. hx of hand/finger swelling, stiffness, thickening, and erythema, impairing mobility. Also found to have hepato-/splenomegaly, WBC 151K, LDH 889; abnl BM Bx. Pt dx w/ palmar fasciitis & CML… https://t.co/1Z9Oz0sRa7 https://t.co/HRSJcv4lzZ
Dr. John Cush @RheumNow( View Tweet )
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ACR24: Rheumatology Roundup

Jack Cush, MD

Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.

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ANA+ and no Autoimmune Disease? Check the liver Dr. Janet Pope discusses abstract 0627, presented at #ACR24. https://t.co/4HV2kqjibL https://t.co/kmVcvUZtRQ

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Dr. John Cush @RheumNow( View Tweet )
Differential diagnosis of ACA+ 1. SSc 2. Sjogren Syndrome 3. PBC 4. Overalp syndrome https://t.co/JmqDaaZerJ

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Dr. Dinesh Khanna @sclerodermaUM( View Tweet )
A#2647 DADA2 cohort 101 pts in India Median delay dx 5 years - 5 pts of >20 yr - 39 pts w GI involvement- bad outcomes Skin most common - largely livedo, then ulcers/nodules CNS common w ischemia Many Rx before dx 12 deaths (11.8%) - 8 GI, 3 CVA, 1 suicide #ACR24 @RheumNow https://t.co/Q8kiVbJq8I

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Eric Dein @ericdeinmd( View Tweet )

Recent Blogs

Best of 2022: The Contribution of the Gut Microbiome and Diet to Joint Inflammation in PsA

Christopher Ritchlin, MD, MPH
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Interactions of the gut microbiota in humans promote the release of a variety of metabolites with profound effects on human health and immune regulation. Read Post

Best of 2022: Methotrexate in PsA

Philip Mease, MD
Methotrexate
Until the publication of the SEAM trial, evidence in the medical literature for the efficacy of the most commonly used drug for psoriatic arthritis worldwide, methotrexate, has been lukewarm at best. Yet we all employ it commonly, either as monotherapy or in combination with biologic or targeted synthetic DMARD treatment. It is inexpensive and widely available, and only modestly toxic. Read Post
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