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IL-23

Immunosuppression Increasing (2.23.2024)

Feb 23, 2024

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.




  1. 2021 NHIS Survey data suggests the prevalence of immunosuppression in the USA is

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Oral IL-23 Inhibitor Effective in Psoriasis The NEJM has published the results of the FRONTIER 1 trial demonstrating the efficacy of JNJ-77242113, an oral interleukin-23 (IL-23) receptor antagonist peptide, in patients with psoriasis (PSO). https://t.co/NRK8LnM5zp https://t.co/FnWEze976O
Dr. John Cush @RheumNow( View Tweet )
Feb 19, 2024
"It's hard not to be jealous of the dermatologists." @JointMD discussing the results of JNJ 77242113, po IL-23R, the Frontier 1 trial. #RWCS24 @RWCSmtg @RheumNow https://t.co/1zQ6bu5TM2
Dr. Rachel Tate @uptoTate( View Tweet )
Feb 16, 2024
Combo IL-23 and TNFi synergistic benefit in UC in the proof-of-concept VEGA trial. More data to come! #RWCS24 @RWCSmtg @RheumNow https://t.co/FgLTR2PBYJ
Dr. Rachel Tate @uptoTate( View Tweet )
Feb 16, 2024

Pre-Treatment Testing with Biologics Falls Short

Feb 01, 2024

US commercial insurance claim analysis of laboratory screening and monitoring practices in chronic inflammatory skin disease (CISD) patients shows that < 60% received the recommended pretreatment testing when starting systemic immunomodulatory treatment.

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2023 Rheumatology Year in Review

Jan 12, 2024

Dr. Jack Cush reviews highlights, advances and hot topics in rheumatology from 2023 and the RheumNow website.  



2023 was a year of growth and new horizons while returning to operational and practice standards (in care and education) established before the pandemic.  



Below is

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Enthesitis, Synovitis, and Tenosynovitis in Psoriatic Arthritis

Jan 04, 2024

An ultrasound study suggests that enthesitis is associated with both synovitis and tenosynovitis in patients with Psoriatic arthritis (PsA).

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Best of 2023: Does Biologic Treatment in Psoriasis Reduce the Risk of Psoriatic Arthritis?

Dec 29, 2023

Retrospective claims analysis shows that psoriasis patients treated with either an IL-12/23 inhibitor or an IL-23 inhibitor had a lower risk of developing incident psoriatic arthritis, compared to TNF inhibitors or IL-17 inhibitors.

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ICYMI: Bimekizumab is Coming…in Third Place

Of the many exciting advancements for patients with psoriatic arthritis at ACR Convergence, one upcoming therapy stood out: the dual IL-17A/F inhibitor bimekizumab. Nearly two dozen bimekizumab abstracts will be featured at this year’s meeting and it recently received authorization in Europe and

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UK Dermatology Registry of 13 699 Psoriasis pts on biologics (25K biologic exposures) found 1% risk of paradoxical eczema. Biologics included inhibitors of TNF, IL-17, IL12/23, IL-23. Lowest risk w/ IL-23i (0.56/100kPY), and higher w/ IL-17i (1.22) https://t.co/fOX6VGJQLk https://t.co/u1p1sidCte
Dr. John Cush @RheumNow( View Tweet )
Dec 10, 2023
#ACR23 Late-Breaking Abstr#L14 Which team are you on? IL5-i or IL5-receptor-i #EGPA. Phase 3 H2H RCT showed similar efficacy btw Mepolizumab and Benralizumab, with more pts fully tapering off GC at WK52 favouring BENRA. Rapid reduction in Eosinophils too @RheumNow #ACRBest https://t.co/cXhSS80mA2
Md Yuzaiful Md Yusof ( View Tweet )
Nov 14, 2023
Systemic anti-inflammatory treatments for PsO and PsA including methotrexate and biologics provided cardioprotective effects Potential cardiovascular benefits of IL-17i and IL-12/23i compared to TNFi @RheumNow #ACR23 Abs#0498 https://t.co/Np7PSNvFd6
Robert B Chao, MD ( View Tweet )
Nov 12, 2023

Bimekizumab is Coming… in Third Place

Of the many exciting advancements for patients with psoriatic arthritis at ACR Convergence, one upcoming therapy stood out: the dual IL-17A/F inhibitor bimekizumab. Nearly two dozen bimekizumab abstracts will be featured at this year’s meeting and it recently received authorization in Europe and

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Pizza and Rheumatoid Arthritis (8.11.2023)

Aug 11, 2023

Dr. Jack Cush reviews the news and journal reports from the wonderful wide world of Rheumatology. This week:




  1. Swedish study of 325 #AAV pts saw CVA in 35 pts (8%); CVA incidence=11.3/1000 PYs - this was higher than gen population [SIR 1.85). AAV CVA risk factors included age

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IL-23 Inhibitor Performance in Psoriatic Disease A single center real-world observational study shows three commercially available IL-23 inhibitors have high and similar drug survival and effectiveness in difficult-to-treat psoriasis and PsA. https://t.co/J3HIDBguj1 https://t.co/uqYf0Bdh0n
Dr. John Cush @RheumNow( View Tweet )
Jul 31, 2023

IL-23 Inhibitor Performance in Psoriatic Disease

Jul 27, 2023

IL-23 inhibitors are approved for the treatment of psoriasis and psoriatic arthritis; a single center real-world observational study shows three commercially available IL-23 inhibitors have high and similar drug survival and effectiveness in difficult-to-treat psoriasis and PsA.

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Double blind RCT of 101 active AS patients with BASDAI ≥4 showed the IL-23 inhibitor, tildrakizumab was not superior to placebo after 24 weeks (ASAS20: 74% on tildrakizumab 200 mg vs 80% on PBO). Study was terminated after wk 24 interim analysis https://t.co/zZxiAk6A5o https://t.co/P1tNX8BN6C
Dr. John Cush @RheumNow( View Tweet )
Jul 25, 2023

Prevalence of Psoriatic Arthritis, Spondyloarthritis and Rheumatoid Arthritis in Norway

May 25, 2023

Recent reports have suggested a rising and unrecognized number of patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) compared to rheumatoid arthritis (RA). This has implications on diagnosis and population care.  A recent analysis of Norway registry data answers this

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Disappointing Secondary Use of Newer Therapies in Psoriatic Arthritis

May 12, 2023

Analysis of patient data from five Nordic registries shows that the uptake of newer biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in psoriatic arthritis (PsA) was mainly in biologic-experienced patients. The use of newer b/tsDMARD was hampered by limited

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Lillys IL-23 inhibitor (Mirakizumab) has suffered a minor setback receiving a "complete response letter" from the FDA regarding MIRA application (BLA) for use in ulcerative colitis. The CRL hold up is related to the manufacturing issues (not data/safety) https://t.co/Xs93pFNFAp https://t.co/vlVP8qiqGr
Dr. John Cush @RheumNow( View Tweet )
Apr 17, 2023

Night Splinting for Carpal Tunnel (3.24.2023)

Mar 24, 2023

Dr. Jack Cush reviews the news and journal articles from the past 2 weeks on RheumNow.com.  This week reviews clinical associations with SS-A, a new biomarker for SSc-ILD and cancer screening for myositis patients.




  1. 29 pts w/ PsA Sine Psoriasis: 16F/13M, mean age 45 yrs w/

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Open-label trial of Guselkumab (IL-23 inhib) in 20 moderate-to-severe hidradenitis suppurativa (HS) pts saw 65% with HiSCR response at wk 16. Yet phase IIB NOVA PBO-RCT showed GUS HiSCR response 45–51% (vs 39% PBO). GUS may only benefit subgroup of HS https://t.co/OxtFfyRMFk https://t.co/hnQyU0VWxg
Dr. John Cush @RheumNow( View Tweet )
Mar 16, 2023
Does Biologic Treatment in Psoriasis Reduce the Risk of PsA? Retrospective claims analysis shows that psoriasis patients treated with an IL-12/23 inhibitor or an IL-23 inhibitor had a lower risk of developing incident PsA. https://t.co/j73V7zMnkn https://t.co/EhGUXDNNlS
Dr. John Cush @RheumNow( View Tweet )
Mar 09, 2023

Does Biologic Treatment in Psoriasis Reduce the Risk of Psoriatic Arthritis?

Mar 07, 2023

Retrospective claims analysis shows that psoriasis patients treated with either an IL-12/23 inhibitor or an IL-23 inhibitor had a lower risk of developing incident psoriatic arthritis, compared to TNF inhibitors or IL-17 inhibitors.



There has been considerable debate whether

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NSAIDs in Pregnancy (3.3.2023)

Mar 03, 2023

Dr. Jack Cush reviews the lastest journal articles, news, and FDA announcements from the past week on RheumNow.  This week, the importance of IFNa, Subclinical PsA and NSAID safety during Pregnancy.




  1. Study of 87 pts with isolated Nail Psoriasis noted that 11% went on to have

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