Rheumatology: Believe It or Not (4/25/2025)
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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TriNetX EMR ulation study of CV risk w/ biologics in Psoriasis pts shows signifcant reduced CV events in PsO pts taking r\TNFi (HR 0.886), IL-17i (HR 0.724), IL-23i (HR 0.739); not anti-IL-12/23 (HR 0.915); Risk reduction applied to all subgroups (age, comorbidity, Wt) https://t.co/67c5yqK80h
Dr. John Cush @RheumNow( View Tweet )
IL-17 inhibitors increase risk of IBD. TriNetX database study of PsO & AS pts starting IL-17i vs apremilast. 13,216 matched pts per group, 142 developed IBD w/ IL-17i vs. 60 with apremilast (aHR = 2.50, 95% CI: 1.85–3.39). https://t.co/sSPqKsfbZ4 https://t.co/YCqDUzX9xq
Dr. John Cush @RheumNow( View Tweet )
2025 BSR Guideline for Treatment of Axial Spondyloarthritis
The British Society of Rheumatology has published its 2025 Guidelines for the Treatment of Axial Spondyloarthritis (axSpA); addressing axial and extra-musculoskeletal manifestations including acute anterior uveitis, psoriasis and IBD. They address the effectiveness and safety of
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Osteoarthritis Risky Business (4.18.2025)
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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The Increasing Cost of First-Line Biologics for Plaque Psoriasis
A national commercial claims analysis of first-line use of biologics in biologic−naive plaque psoriasis patients found a near doubling of net treatment costs from 2007 to 2021 ($21 236 to $47 125). Despite the increasing costs, the 2021 average cost could have been 44% lower if the lowest-
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Phase 2, DBRPCT of nanobody anti-IL-17, izokibep in 172 Psoriatic arthritis pts, showed higher ACR50 rates for izokibep 80mg vs PBO at wk 16 (52% vs 13%; p=0.0006) w/ 40mg=48%. Other arthritis, psoriasis, enthesitis, dactylitis, QOL outcomes also improved.https://t.co/CQn9EVjr9g https://t.co/vVnTo2FPV6
Dr. John Cush @RheumNow( View Tweet )
The IL-17A inhibitor, secukinumab, is in late-stage development forthe treatment of giant cell arteritis and polymyalgia rheumatica. https://t.co/JzzqS7bSjd https://t.co/9Qm0YsJmOL
Dr. John Cush @RheumNow( View Tweet )
In our latest episode, @deodhara takes us behind the scenes of his research on IV secukinumab in #AxSpA. Discover key findings from the INVIGORATE-1 study, how it’s shaping treatment options, & what’s next in AxSpA research. LISTEN NOW → https://t.co/2IBixQSdpO @ACR_Journals https://t.co/HzcJw0pzWI
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American College of Rheumatology @ACRheum( View Tweet )
EMR Messaging Woes (4.11.2025)
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com
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An Epidural Letdown (4.4.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Review article shows that in psoriasis pts, adding #MTX to TNFi increases efficacy, but there is limited data on adding MTX to either IL-17 or IL-23. But in Psoriatic Arthritis (PsA), adding MTX provides no added efficacy compared to biologic monotherapy https://t.co/FiSFIjpsXo https://t.co/ComFg253u9
Dr. John Cush @RheumNow( View Tweet )
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.
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Ontario study of 11 641 older psoriasis pts & hospitalized serious infx in those on b/tsDMARDs. IL-12, IL-23, and IL-17 inhibitors were assoc w/ 35% lower rates of SIE, while MTX, other older systemic meds, TNFi were not incr/decr. But JAK inhibitors had signif 3 fold incr in… https://t.co/ffFdHjme65 https://t.co/DkTsadUNx2
Dr. John Cush @RheumNow( View Tweet )
Axial Involvement in Psoriatic Arthritis
Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.
World Changers (3.14.2025)
Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.
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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).
Valentine RNL 2025 Review (2.14.2025)
Dr. Jack Cush reviews highlights from RheumNow Live 2025 held in Dallas, TX on Feb. 8-9, 2025.
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#Benralizumab vs #Mepolizumab
both work for #EGPA
Which to use? 🤷♀️
perhaps some advantage of more steroid sparing w
Benralizumab?
? JAKi ?long acting #IL5i
#RNL2025 @RheumNow https://t.co/UkthHpNRIq
Janet Pope @Janetbirdope( View Tweet )
New for HS
- Bimekizumab is 3rd FDA approved therapy based on BE HEARD 1&2
- Other approved ADA (2015, PIONEER 1&2), SEC (2023, SUNRISE/SUNSHINE)
Clinical trials:
IL23 failed, ILalpha failed
Brodulamab (IL17a) clinically meaningful response
TNF trials
@RheumNow #ACR2025 https://t.co/BfzwNQ1wUB
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Eric Dein @ericdeinmd( View Tweet )
Drug Naming Games (2.7.2025)
Dr. Jack Cush reviews the news, regulatory and journal reports from the past week on RheumNow.com.
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Is IL-23i better than IL-17i at lowering PsA risk? Retrospective, real-world EHR data study from TriNetX shows that among 4580 adult psoriasis pts (2,273 on IL23i vs 2,307 on IL17i), IL23i had signif lower PsA incidence (HR 0.60; 0.44–0.82, P 0.001), esp if 41-65 yrs (HR 0.42) &… https://t.co/ZuCAiOTIke https://t.co/8PkDCugYy0
Dr. John Cush @RheumNow( View Tweet )
North American Real-world EHR data of PsA & axSpA pts (n 2200 Ea.) found no higher rates of CVD (acute MI, CVA or revascularization) or solid cancers (breast, colorectal, lung, prostate) when comparing JAKi to either TNFi or IL-17i use (over 3 years). https://t.co/macjpWxdnY https://t.co/9gXiomU3YD
Dr. John Cush @RheumNow( View Tweet )
Antiviral prophylaxis is essential for HBsAg+ patients receiving cytokine inhibitors, given the high risk of reactivation. Metanalysis of 10 studies shows reactivation in 21% of HBsAg+ patients without prophylaxis vs 4.4% in HBsAg−/HBcAb+ patients. https://t.co/eHzIeA8uJK https://t.co/CmZw8C8ibn
Dr. John Cush @RheumNow( View Tweet )
Best of 2024: ASLeap: Higher Dose Secukinumab in Ankylosing Spondylitis
Ankylosing spondylitis (AS) patients not responding to usual dosing with secukinumab (150 mg) after 16 weeks were dose escalated to secukinumab (SEC) 300 mg, but failed to show improvement by week 52.
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