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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Hidden in Plain Sight: IBD
As a PA with six years of experience in rheumatology and a background in gastroenterology, today I'm discussing the clinical overlap between inflammatory arthritis—particularly psoriatic arthritis and spondyloarthropathies—and inflammatory bowel https://t.co/Aatc4jkbpH
Dr. John Cush @RheumNow( View Tweet )
Hidden in Plain Sight: IBD
As a PA with six years of experience in rheumatology and a background in gastroenterology, today I'm discussing the clinical overlap between inflammatory arthritis—particularly psoriatic arthritis and spondyloarthropathies—and inflammatory bowel disease.
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Study of 177 #SSc pts (116 w/ SSc-ILD vs 61 without ILD). SSc-ILD had more dcSSc, Raynaud’s & GI Dz. SSc-ILD predicted by triad of elevated NLR, PT, anti-SCL-70 (AUC of 0.879; sensitivity 82.6%; specificity 85.0%). NLR: neutrophil to lymphocyte ratio; PT: prolonged prothrombin https://t.co/iI6ZnZgJE7
Dr. John Cush @RheumNow( View Tweet )
Turkey Tryptophan (11.28.2025)
Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
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20-40% of Autoimmune hepatitis (AIH) is associated with other autoimmune diseases - lead by autoimmune thyroiditis, type 1 DM, ulcerative colitis, Crohn disease, & celiac (but less so for RA, PBC, SLE, Sjögren syndrome, vitiligo). AIH Dx Abs include ANA, ASMA, LKM1. https://t.co/FphWZwwohx
Dr. John Cush @RheumNow( View Tweet )
ACR 2025 Rheumatology Round Up
Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.
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Fighting fire with butyrate 🔥🚒
♦️probiotics and prebiotics
Dr. Nisha Manek on inflammation and butyrate - it reduces gut inflamm thru the NFKB pathway
#ACR25 @RheumNow https://t.co/19XTrKn1iN
sheila @RHEUMarampa( View Tweet )
Microbiome may hold key to methotrexate response in RA
Methotrexate (MTX) remains the cornerstone of rheumatoid arthritis (RA) treatment, yet it remains unclear as to how to predict who will respond to it. Two studies presented at ACR (Abstracts 2639 and 2643) suggest the answer may be hiding in the gut.
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Gut microbiome on Urate metabolism study- 1500 men and women.
From 3 cohorts- Framingham, nurses health and men's lifestyle with blood and stool data
Focused on 5 urate metbolizing genes
Abst#2590 #ACR25 @RheumNow https://t.co/YxBb3WfcbB
Bella Mehta @bella_mehta( View Tweet )
Dr. John Stone on IgG4RD
⬆️ common in males
⬆️internal organ involvement
🔸Mimics cancer
🔸Indolence makes it dangerous —-> organ complications
Diagnosis highly dependent on the rheumatologist based on clinical features, serologies, imaging & pathological data
#ACR25 @Rheumnow https://t.co/St4EbA7Dcj
sheila @RHEUMarampa( View Tweet )
In case you have a (gut) feeling something’s off…
Abstract 2315: The gut microbiome in #SpA 🔬
⬆️ Proteobacteria (incl. Escherichia spp)
⬇️ Firmicutes (“good” bacteria)
Higher disease activity ↔️ lower alpha diversity
@RheumNow #ACR25
Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
In a cohort of 269,304 IBD patients, NSAID use showed a small increase in IBD-related hospitalisation (HR 1.08), meeting non-inferiority threshold (HR <1.2). No risk in UC (HR 0.96); modest risk in Crohn’s (HR 1.16). Relooks at the current paradigm of blanket NSAID avoidance in https://t.co/O8MWg1BP50
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Mayer et al. NSAIDs in IBD. Retrospective cohort study. 250000 individuals. Non-inferiority study. No increased IBD-related hospitalisation in UC, but an increase in all-cause hospitalisation. @RheumNow #ACR25 Abstr#1434 https://t.co/he2Xmcqslk
Richard Conway @RichardPAConway( View Tweet )
Pre-ACR25 (10.24.2025)
Dr. Jack Cush reviews the news and info reports the day before ACR 2025
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5–10% of axSpA [ts jave comorbid IBD. Southern Swedish study 152 (r- & nr-) axSpA pts found elevated fecal calprotectin (≥ 50 mg/kg) & this was assoc. w/ more damage w/ higher mSASSS values for all axSpA (adj OR 2.2) & in r-axSpA (adj OR 2.9) https://t.co/Hi1lE4so1r https://t.co/YYCGYYasfL
Dr. John Cush @RheumNow( View Tweet )
A high ANA titer (≥1:640) in individuals without an autoimmune disease was found to be strongly associated with liver-related disorders, including nonalcoholic and alcoholic liver disease
Arthritis Care & Research
https://t.co/tkMpPFPnhc https://t.co/Bk9JXWTsOU
Links:
ACR_Journals @ACR_Journals( View Tweet )
Bad Actor Cofactor (10.17.2025)
Dr. Jack Cush reviews the news and journal reports, discusses pediatric reports, pregnancy data, diet and nutrition and more.
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Pregnancy Management in Inflammatory Bowel Disease: A Global Consensus
Consensus guidance on the management of pregnancy in patients with inflammatory bowel disease (IBD) was simultaneously published in six international journals, including The American Journal of https://t.co/F6er2mpUoV
Dr. John Cush @RheumNow( View Tweet )
MSK Manifestations in Pediatric IBD
Arthritis and musculoskeletal (MSK) symptoms may accompany pediatric-onset inflammatory bowel diseases (pIBD) as an extra-articular intestinal manifestation, but may vary in presentation and clinical course.
https://t.co/VoU3itr0EM https://t.co/ar19JdrsHH
Dr. John Cush @RheumNow( View Tweet )
Pregnancy Management in Inflammatory Bowel Disease: A Global Consensus
Consensus guidance on the management of pregnancy in patients with inflammatory bowel disease (IBD) was simultaneously published in six international journals, including The American Journal of Gastroenterology.
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MSK Manifestations in Pediatric IBD
Arthritis and musculoskeletal (MSK) symptoms may accompany pediatric-onset inflammatory bowel diseases (pIBD) as an extra-articular intestinal manifestation, but may vary in presentation and clinical course.
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Eating Crow (10.10.2025)
Dr. Jack Cush reviews the news, FDA approvals, and journal articles. In this episode: HMGCR Abs, FDA approvals and Cush eats crow.
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Guselkumab (Tremfya) 1st IL-23 inhibitor to be FDA approved for subcutaneous induction in adults with ulcerative colitis https://t.co/KaZVzyomeY
Dr. John Cush @RheumNow( View Tweet )
Equal Safety of JAK Inhibitors and TNF Inhibitors
JAMA has published a systematic review and meta-analysis of head-to-head studies showing there was no meaningful difference in safety events observed when taking either JAK inhibitor (JAKi) vs TNF antagonist (TNFi) therapies for the treatment of immune-
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