ERA, APPs, & Alpha GAL (3.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Listen in for 2 new case questions - Ask Cush Anything.
Read Article
The FDA has approved guselkumab(Tremfya) for both subcutaneous (SC) and intravenous (IV) induction therapy treatment of adults with moderately to severely active Crohn’s disease (CD). It is the only IL-23 inhbitor available for SC and IV use in CD https://t.co/ekXRVOwNnS https://t.co/6zveRR5WjD
Dr. John Cush @RheumNow( View Tweet )
Alpha-gal syndrome (AGS) is a (Lone Star) tick-borne allergy to the galactose-α-1,3-galactose carbohydrate, found in mammalian meat/products; Sxs (hives, itching, swelling, and GI issues) present 2-8 hrs after meat & be life-threatening. Time to Dx has dropped considerably, w/… https://t.co/p1M9Qaf1jz https://t.co/jTJzq7YtVJ
Dr. John Cush @RheumNow( View Tweet )
A Case of IgA Vasculitis Presenting as Duodenal Perforation
Presentation by Dr. Audrey Liu, at the Rheumatology Winter Clinical Symposia - Feb 2025
https://t.co/kZWgy1S0Wh https://t.co/9mJAzVRVpl
Dr. John Cush @RheumNow( View Tweet )
Are Combination Biologics Safe?
Although package inserts commonly warn against combining the use of biologic or targeted therapies, there is growing interest in such combination therapy for patients with problematic immune-mediated inflammatory diseases (IMID).
Crohn’s Microbiome may Predispose to Axial Spondyloarthritis
Researchers at Weill Cornell Medicine found that people with Crohn’s disease and related joint inflammation have distinct gut bacteria, with Mediterraneibacter gnavus as a potential biomarker.
https://t.co/SI03wAJ3UU https://t.co/dlt3VxBDLw
Dr. John Cush @RheumNow( View Tweet )
Crohn’s Microbiome may Predispose to Axial Spondyloarthritis
EurekAlert!
People with Crohn’s disease and related joint inflammation linked to immune system dysfunction have distinct gut bacteria or microbiota, with the bacterium Mediterraneibacter gnavus being a potential biomarker, according to new study by Weill Cornell Medicine researchers.
Read Article
From Bellyache to Bloodstorm - a Mesenteric Sclerosis case with Macrophage Activation Syndrome
Presentation by Dr. Anjali Nidhaan at the Rheumatology Winter Clinical Symposia - Feb 2025
https://t.co/pXwav5f2BI https://t.co/0Faao7zhbV
Dr. John Cush @RheumNow( View Tweet )
UK MRCP exam makeup:
Cardio 15%
Pharm 15%
Resp 10%
GI 10%
Neuro 10%
ID 8%
Endo 8%
RHEUM 6%
Heme 5%
Renal 5%
Derm 4%
Eye 2%
Psych 2% https://t.co/WG7X3B8a0Y https://t.co/9VF5LkLJjs
Dr. John Cush @RheumNow( View Tweet )
Do infections lead to Kawasaki Dz (KD)? Swedish registry study of 1774 KD vs 17 731 controls. +Hx of Infx incr risk of KD (OR 2.3; 2.0 to 2.5) - mostly Resp, skin, GU & GI Infx. Infxns usually clustered before KD Dx (OR 5.1 15–28d; OR 1.3 6-12 mos prior KD. More infx = more KD… https://t.co/V9zbcmJdKv https://t.co/Evl3rtCxUO
Dr. John Cush @RheumNow( View Tweet )
Optimal Management of Rheumatoid Arthritis Patients and Liver Disease
https://t.co/4JfUueF55o https://t.co/hBkgYU1Mye
Dr. John Cush @RheumNow( View Tweet )
Srudy of 558 #RA pts finds GERD symptoms were significantly w/ higher TJC28 and VAS scores and lower use of MTX (but not related to NSAID or steroid use). GERD Sxs may impact MTX dosing and Dz activity measures in RA https://t.co/2H8RUNywlG https://t.co/ZBSlTL1ZA3
Dr. John Cush @RheumNow( View Tweet )
Optimal Management of Rheumatoid Arthritis Patients and Liver Disease
https://t.co/29CG4bwlYR
Dr. John Cush @RheumNow( View Tweet )
Optimal Management of Rheumatoid Arthritis Patients and Liver Disease
https://t.co/KpdY1MEM1w https://t.co/vETGMJgHf3
Dr. John Cush @RheumNow( View Tweet )
The Cartel is Coming for Rheumatology
"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.
Read Article
AGA Guideline: Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals
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.
Read Article
Celecoxib Lowers Colon Cancer Recurrence Risk
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
Read Article
Weak Data (1.24.2025)
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.
Read Article
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 )
Fallen Angels (1.17.2025)
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.
Read Article
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
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
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
Dr. John Cush @RheumNow( View Tweet )
54K Peptic Ulcers Annually (12.13.2024)
https://t.co/18FiQx1YQA https://t.co/32UZi9XafS
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
Links:
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
