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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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 )
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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Late Breaking abstract from 2025 Amer. Acad. Dermatology (AAD) on the Phase 3 ICONIC-LEAD study showed J&J's oral IL-23 inhibitor (icotrokinra) was superior to deucravacitinib in skin clearance (65% vs 8%) & PASI90 (50% v 4%) at Wk 15 in 684 moderate-to-severe plaque PsO pts… https://t.co/GYK604kJ9u https://t.co/Ao1BpL1Qxt
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).
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
Links:
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 )
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.
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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 )
ICYMI: Sex related differences in PsA
Different factors are known to influence disease characteristics and outcomes in psoriatic arthritis (PsA). Recently, there is new evidence that sex-related differences play a role not only in disease manifestations but also in efficacy and safety of treatments as well as outcomes
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54K Peptic Ulcers Annually (12.13.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com
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Don’t Buy Guitars (12.6.2024)
This year at ACR24, the RheumNow faculty and reporters were prolific, generating >800 Tweets, 56 written articles, 117 Videos and 28 podcasts – all in 4 days! You can best review and learn ACR24 by A) Rheumatology Roundup; b) Topic Panel videos; and c) Topic podcasts.
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ACR24: Rheumatology Roundup
Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.
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Sex related differences in PsA
Different factors are known to influence disease characteristics and outcomes in psoriatic arthritis (PsA). Recently, there is new evidence that sex-related differences play a role not only in disease manifestations but also in efficacy and safety of treatments as well as outcomes
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What is the effect of cs/bDMARDs on weight in #PsA?
⬇️Weight loss seen with:
IL17i
IL23i
csDMARDs
⬆️Weight gain seen with:
TNFi
IL12/23i
Important to consider #comorbidity & #BMI in management decisions in PsA
Ab2639 #ACR24 @RheumNow
Mrinalini Dey @DrMiniDey( View Tweet )
A#2585
PsABIOnd observ cohort study of IL23 (GUS) or IL17i
6 mo interim results of 686 pts
PROs: PsAID-12
High Rx persistence at 6mo -94% on both Rx
Comparable improvement in PsAID-12 - best results skin, discomfort
1/2 with clinically meaningful improvement
#ACR24 @RheumNow https://t.co/TM1jwTRR7C
Links:
Eric Dein @ericdeinmd( View Tweet )
A#2363
Deodhar
Bimekizumab fast time to work:
BE MOBILE 1 and 2 - rapid treatment responses with separation from PBO as early as 1-2 weeks after single dose.
@RheumNow #ACR24 https://t.co/T81Lzyoy7m
Eric Dein @ericdeinmd( View Tweet )
A study investigating weight trends in Psoriatic Arthritis (PsA) and the impact of various medications. Analyzing 1754 patients, it explored multifactorial influences on weight changes
Key findings:
- Significant weight loss after starting IL17i, IL23i, and csDMARDs.
- TNFi &… https://t.co/qOl2ojV9rL https://t.co/Eh2ZNLeKhn
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
📝Bimekizumab 160mg Q4 weeks in r-axSpA and nr-axSpA achieved
substantial reductions in MRI inflammation at Wk 16 maintaining to Wk 52.
-PBO‑switchers (started at week 16) reached similar levels of improvement as continuous BKZ pts at Wk 52.
Abst#1757 #ACR24 @RheumNow https://t.co/m9sdAbFqI9
Links:
Adela Castro @AdelaCastro222( View Tweet )
BE MOBILE 1 & 2: Bimekizumab resulted in improvement of SIJ MRI inflammation & structural lesions particularly after 16 wks of treatment and continued on until wk. 52.
Supports addtl evidence of BKZ's winning streak in #axSpA
@RheumNow #ACR24 abs1757 https://t.co/EUntQIuQC8
sheila @RHEUMarampa( View Tweet )
Exciting early data for new highly selective TYK2i zasocitinib
Improved PASI skin scores (though not as much as IL23i...)
Funky skin-related adverse events at higher doses, not sure what to make of that?
#ACR24 @rheumnow Abstr#1477 https://t.co/CtOFsoHdBh
Links:
Mike Putman @EBRheum( View Tweet )
#1462 🔬Rx persistence in PsA; Guselkumab (GUS) v. IL17Ai
💡 GUS (n=910) persistence @ 12 months (67%) almost 2X IL-17Ai (n=2743) (50%)
⏳ Median time to discontinuation: GUS not reached v 12.3 months for IL-17Ai.
🔴Durable therapy ❓better outcomes
#ACR @RheumNow https://t.co/LfA3WygNVq
Caoilfhionn Connolly @CaoilfhionnMD( View Tweet )
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