GI/Liver

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/AEaoucfT13 https://t.co/7UVQpkj3cn https://t.co/PuCjh5LQc5

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Dr. John Cush @RheumNow( View Tweet )
antibody (Keep)

Clinical Associations with Anti-RNA Polymerase III Antibodies

Jack Cush, MD

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 outcomes.

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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

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Dr. John Cush @RheumNow( View Tweet )
GALAXI-2 and GALAXI-3 published showing the efficacy of IL-23 inhibitor, Guselkumab in a 48 week study in adults with moderately to severely active Crohn's disease. https://t.co/pWolec25cX https://t.co/e2fdcMxEro

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Dr. John Cush @RheumNow( View Tweet )
Immunomodulators in the Treatment of Autoimmune Hepatitis Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on https://t.co/KgzjNvrZ7v
Dr. John Cush @RheumNow( View Tweet )
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Immunomodulators in the Treatment of Autoimmune Hepatitis

EurekAlert!

Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on histology. With an annual global incidence of 1.37 per 100,000, AIH can lead

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Hepatitis B (Keep)

ICYMI: 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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The ‘iron fist’ of haemochromatosis arthropathy, and other key features: Patrick Kiely #EULAR2025 @RheumNow https://t.co/grs1Tq3GAk

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David Liew @drdavidliew( View Tweet )
EULAR,poster

EULAR 2025 – Day 2 Report

Jack Cush, MD

Day 2 was a full agenda for those attending EULAR 2025 in Barcelona with sessions on the management of RA, Behcets, Lupus and Hand Osteoarthritis. Clinical overviews on MAS, Ehlers-Danlos, Difficult to treat RA and PsA offered a wide variety of options to rheumatologists. Here are a few

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GI symptoms in axSpA -Cohort of 370 pts with axSpAfrom New Zealand -Elevated fecal calprotectin ➡️ positive correlation with GI symptoms and high disease activity -Bowel symptoms associated with reduced quality of life. -Use of TNFi improved bowel symptoms over time. https://t.co/wA37G3HWyi

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Adela Castro @AdelaCastro222( View Tweet )
IL-40 is elevated in systemic sclerosis (SSc). Study of serum (90 SSc vs controls/HCs), Skin Bx (5 SSc v 5 HCs). IL-40 signific. upregulated in the skin & correl. w/ ESSG (r = 0.37), GI dz; also w/ serum IL-8, TGF-β1. IL-40 functionally linked to activated B cells, PMNs, T https://t.co/XsSFXgBxuD
Dr. John Cush @RheumNow( View Tweet )
IL-40 is elevated in systemic sclerosis (SSc). Study of serum (90 SSc vs controls/HCs), Skin Bx (5 SSc v 5 HCs). IL-40 signific. upregulated in the skin & correl. w/ ESSG (r = 0.37), GI dz; also w/ serum IL-8, TGF-β1. IL-40 functionally linked to activated B cells, PMNs, T https://t.co/2sIgMYK7xo
Dr. John Cush @RheumNow( View Tweet )
Biologic.choice.MD_.jpeg (keep)

Biologics in Pregnancy Patients With Autoimmune Disease

Jack Cush, MD

A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients than those with rheumatoid arthritis (RA), psoriasis (PsO) or psoriatic

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Single center study of 2741 ANA tests: 65% ANA negative, 31% ANA+ w/ nuclear staining patterns, & 2.0% ANA+ w cytoplasmic staining. Cytoplasmic - most were reticular, dense fine speckled next. Reticular assoc w/ primary biliary cholangitis (w/ Abs against M2). Dense fine https://t.co/SfBY9BShax
Dr. John Cush @RheumNow( View Tweet )
Vitamin D Headlines (5.9.2025) Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy. https://t.co/i9OJrYR59T https://t.co/PQ3fAR5teR

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Dr. John Cush @RheumNow( View Tweet )
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Vitamin D Headlines (5.9.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy. 

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67 systemic sclerosis pts w/ mod-to-severe lower GI Sxs were Rx in phase 2, RDBPCT of placebo or fecal transplants at wks 0 and 2, with no signif change in GI sxs by week 12 (bloating or diarrhoea). https://t.co/vWq2c8d4Kn https://t.co/PpPsAQbj5M

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Dr. John Cush @RheumNow( View Tweet )
67 systemic sclerosis pts w/ mod-to-severe lower GI Sxs were Rx in phase 2, RDBPCT of placebo or fecal transplants at wks 0 and 2, with no signif change in GI sxs by week 12 (bloating or diarrhoea). https://t.co/vWq2c8d4Kn https://t.co/EZGgVYpxAl

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Dr. John Cush @RheumNow( View Tweet )
Pairwise Network Metanalysis suggests that JAKi use may NOT be assoc w/ Gastrointestinal perforation (GIP), as suggested by the PI. 23 RCTs, (20,023 pts) followed for 24 wks. Incidence of JAKi GIP=0.19%. compared to csDMARDs this was not signif increased (RR 1.02; CI: 0.41-2.56). https://t.co/lLD9Tj6a9F
Dr. John Cush @RheumNow( View Tweet )
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Rheumatology: Believe It or Not (4/25/2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?

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Osteoarthritis Risky Business (4.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com.  Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.

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In a murine model of Kawasaki Dz vasculitis- depleting gut microbiota reduces KD like vasculitis. CV lesions were assoc w/ decrease in Akkermansia muciniphila and Faecalibacterium prausnitzii. Replacement attenuated these findings. https://t.co/uAfInA5MAq https://t.co/3AjMRQnmts

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Dr. John Cush @RheumNow( View Tweet )
Anti-muscarinic 3 Abs are assoc w/ severe GI Dz in systemic Sclerosis. 132 SSc pts (enrich for GI Sxs) - 39% had anti-M3R Abs; 25% high-titer M3R+. Hi titer M3R+ pts had more diffuse Dz (44% vs 23%), GI severity (91% vs 70%), RNPC3+ (18% vs 6%), U1RNP+(21 vs 2%) https://t.co/j8ZWFY4fgx
Dr. John Cush @RheumNow( View Tweet )
In a murine model of Kawasaki Dz vasculitis- depleting gut microbiota reduces KD like vasculitis. CV lesions were assoc w/ decrease in Akkermansia muciniphila and Faecalibacterium prausnitzii. Replacement attenuated these findings. https://t.co/Hnij8TWkYy https://t.co/wEuVcuAZ5j

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Dr. John Cush @RheumNow( View Tweet )
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An Epidural Letdown (4.4.2025)

Jack Cush, MD

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

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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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