Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Global Study of #gout - incidence increased by 158% (from 1990 to 2023), during which mean onset agerose from 58 to 62 years; but % young-onset gout dropped 15.8% to 9.8%. #s due to aging, not younger onset. https://t.co/5pqMwPEnuj https://t.co/414vJHnBYi
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Couldn’t attend https://t.co/4UQlqwujiR 2026?
You can now watch the entire meeting On Demand.
This high-impact program features leading experts discussing:
• RA outcomes and pathogenesis
• Obesity, inflammation, and rheumatic disease
• Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3
Links:
Dr. John Cush @RheumNow( View Tweet )
Worldwide Trends in Hyperuricemia
A Lancet Rheumatology systematic review shows the prevalence of hyperuricaemia has risen markedly over the past two decades in both men and women, owing to population growth, aging, and increasing age-specific rates.
https://t.co/qXx2tLcj8b https://t.co/bQ861Hkcb8
Dr. John Cush @RheumNow( View Tweet )
Worldwide Trends in Hyperuricemia
A Lancet Rheumatology systematic review shows the prevalence of hyperuricaemia has risen markedly over the past two decades in both men and women, owing to population growth, aging, and increasing age-specific rates
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Managing Gout in CKD Patients
A current review article addressed the management of gout patients with chronic kidney disease (CKD). This full read review addresses the epidemiology, challenges, treatment decisions, and outcomes.
https://t.co/ND0cspcmDd https://t.co/HI55D5koZj
Dr. John Cush @RheumNow( View Tweet )
Sodium-glucose cotransporter-2 (SGLT2) inhibitors lower serum uric acid levels, by approximately 0.6 to 1.5 mg/dL. They increase renal uric acid excretion via a uricosuric effect), thereby reducing gout risk by 30% to 50%. https://t.co/weXVOhpiP9 https://t.co/NsCRNi9JI9
Dr. John Cush @RheumNow( View Tweet )
Managing Gout in CKD Patients
A current review article addressed the management of gout patients with chronic kidney disease (CKD). This full read review addresses the epidemiology, challenges, treatment decisions and outcomes.
The prevalence of gout rises with each stage of CKD; from 4%, 6% to 10%, 11%
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US Epidemiologic survey data from NHANES gout prevalence is incr. in RA pts vs controls (10.3% vs. 4.8%, P < 0.001), increasing trend over time. RA is as an independent risk factor for gout (OR: 2.67), strongest in SNRA. Evidence for the converse may not be as strong. https://t.co/hhRT9NCzVG
Dr. John Cush @RheumNow( View Tweet )
UBER Rheumatology Ride (3.6.2026)
Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com
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Metanalysis of 8 articles, 2655 gout pts shows that ELEVATED neutrophil-to-lymphocyte ratio (NLR; SMD: 0.75; 95% CI: 0.48–1.03) and platelet-lymphocyte ratio (PLR; SMD: 0.52; 95% CI: 0.24–0.79) showed significant value in predicting acute gout attacks https://t.co/RaArPdoc2s https://t.co/Qi2WDSPlde
Dr. John Cush @RheumNow( View Tweet )
Treat-to-Target and Cardiovascular Benefits in Gout
A new user cohort study of 109 504 gout patients, achieving a serum urate level less than 6 mg/dL, was associated with a significantly lower risk of cardiovascular events.
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US Epidemiologic survey data from NHANES gout prevalence is incr. in RA pts vs controls (10.3% vs. 4.8%, P < 0.001), increasing trend over time. RA is as an independent risk factor for gout (OR: 2.67), strongest in SNRA. Evidence for the converse may not be as strong. https://t.co/VzDcJ2hTKw
Dr. John Cush @RheumNow( View Tweet )
Comorbidity & Health Management
https://t.co/cSwCEDKL28 https://t.co/WP7yIdWPVY
Dr. John Cush @RheumNow( View Tweet )
Disease Modification, Disparities and the Next Therapeutic Frontier in Gout
Gout management has entered what Dr. Robert Terkeltaub MD from UC San Diego described as its “disease-modifying era,” during his talk at RheumNow Live 2026. In a recent comprehensive review of the past, present, and future of gout therapy, the central message was clear: “We can really apply
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RT @gibson_rheumPAC Gout flares are not benign. Recent flares double MI/stroke risk and markedly increase CV mortality—making flare prevention vital.#RNL26 https://t.co/gKvqo3vFYb
Dr. John Cush @RheumNow( View Tweet )
RT @gibson_rheumPAC
Baseline serum urate >8–9 mg/dL strongly predicts worse flares, hospitalizations, and joint damage over years. Urate level should inform urgency and intensity of therapy. #RNL26 https://t.co/4RBVXZxCCX
Dr. John Cush @RheumNow( View Tweet )
SGLT2 Inhibitors in Gout - Better Outcomes, Fewer Meds
Natalie McCormick, PhD (RACER Center, Mass General Brigham), led a new Diabetes Care study on gout-related medication use after starting SGLT2 inhibitors in patients with gout and type 2 diabetes.
https://t.co/BFJB3OY2L3 https://t.co/63Bu4t6LYM
Links:
Dr. John Cush @RheumNow( View Tweet )
ANA Pollution (2.06.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory news from this past week on RheumNow.com
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SGLT2 Inhibitors in Gout - Better Outcomes, Fewer Meds
EurekAlert!
Natalie McCormick, PhD, of the Rheumatology and Allergy Clinical Epidemiology Research (RACER) Center within the Division of Rheumatology in the Mass General Brigham Department of
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RheumNow Live Preview (1.30.2026)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com - and the top 5 reasons to attend RheumNow Live 2026, which is one week away.
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Treat-to-Target in Gout and Cardiovascular Outcomes
A 5 year JAMA study shows that a treat-to-target (serum urate < 6 mg/dL) study finds that effective urate-lowering treatment (ULT) results in a significantly reduced cardiovascular risk in patients with gout.
These findinds are significant knowing that
QD Clinic: Tophi Tales: Management of Uncontrolled Gout Daric Mueller, PA-C and Andrew Sulich, MD, St. Clair Shores, MI, present this QD Clinic: Tophi Tales: Management of Uncontrolled Gout. This QD Clinic is presented as part of RheumNow's "Mission: APP Partners in Care" https://t.co/7JTbC0223I
Dr. John Cush @RheumNow( View Tweet )
2026 Resolutions (1.9.2026)
Dr. Jack Cush reviews the news, announcements and journal articles from this past week on RheumNow.com. More on Variable bendability, a better way to treat RA, and a novel advance for GLP1a in PsA; and 2026 Resolutions!
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Nordic Registry Study on NSAID use of ~750K, w/ 34-40% under 60 yrs. 48-58% started NSAIDs before Dx of OA. NSAID use incr w/ age from 18 to 55 yrs, then declined. OA pts have a substantial risk of GI complications in all age groups, including those under 60 yrs. Need to consider https://t.co/PLoUVI4Hys
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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Imagine that 100 years from now, your great granddaughter, an eminent rheumatologist, reviews the history of rheumatoid arthritis mimics.
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I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine.
How did we decide which words should perish? And by what criteria? Who has the final say?
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