Imaging and Early Detection in Psoriatic Arthritis
At EULAR 2025, there have been new developments in imaging in PsA. Two key poster presentations (POS0104 and
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APEX study showed significant inhibition of structural damage progression with both dosing regimens (Q4W and Q8W) of GUS (IL-23i) in biologic-naïve pts with active PsA.
Abstract #LB0010
#EULAR2025
@RheumNow https://t.co/QxYAPGB67v
Adela Castro @AdelaCastro222( View Tweet )
In the APEX Phase 3b RCT (N=1020), guselkumab (IL-23p19 inhibitor) significantly reduced radiographic progression (ΔvdH-S 0.55 & 0.54 vs 1.35 PBO; p≤0.002) and improved ACR20 (67–68% vs 47%) at W24 in biologic-naïve PsA. Safety consistent with prior data. Abstract LB0010 https://t.co/mFDsBsCg6m
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Panacea of Prednisone & Cannabis (5.16.2025)
Dr. Jack Cush reviews the news, journal and regulatory reports from this week on RheumNow.com. Interesting trends and results with prednisone in lupus, cannabis in RA and opioid deaths too!
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J&J announced results of Phase 3 ICONIC-TOTAL study of qd icotrokinra, an oral IL-23 receptor inhibitor, in 311 ps w/ difficult scalp and genital psoriasis (PSO) -success in 57%; skin clearance in 66% & genital psoriasis resp in 77% treated https://t.co/WftyEcDh8u https://t.co/Ydy37Eo0jX
Dr. John Cush @RheumNow( View Tweet )
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 )
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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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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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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