IL-23

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Osteoarthritis Risky Business (4.18.2025)

Jack Cush, MD

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

Jack Cush, MD

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)

Jack Cush, MD

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)

Jack Cush, MD

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

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Dr. John Cush @RheumNow( View Tweet )
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ERA, APPs, & Alpha GAL (3.21.2025)

Jack Cush, MD

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

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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 )
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Axial Involvement in Psoriatic Arthritis

Jack Cush, MD

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.

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World Changers (3.14.2025)

Jack Cush, MD

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 )
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Are Combination Biologics Safe?

Jack Cush, MD

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).
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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 )
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Drug Naming Games (2.7.2025)

Jack Cush, MD

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 )
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Weak Data (1.24.2025)

Jack Cush, MD

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

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Dr. John Cush @RheumNow( View Tweet )
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ICYMI: Sex related differences in PsA

Adela Castro, MD

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)

Jack Cush, MD

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)

Jack Cush, MD

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

Jack Cush, MD

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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men and women

Sex related differences in PsA

Adela Castro, MD

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

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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

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Eric Dein @ericdeinmd( View Tweet )

Recent Blogs

Best of 2022: The Enthesitis Challenge in Psoriatic Arthritis

Robert Chao, MD
heel enthesitis spur calcaneal
A colleague of mine once told me an interesting story of how her father, who was a doctor, misdiagnosed his wife with fibromyalgia when she actually had psoriatic arthritis with enthesitis all along. I would venture out and say that the average physician would have trouble evaluating enthesitis because even we, as rheumatologists do!  Read Post

Best of 2022: Toss of a Coin - How do You Choose PsA Medication?

M. Elaine Husni, MD, MPH
Coin toss
When balancing all these disease domains, individual phenotypes, and comorbidities, sometimes treatment decisions can feel like tossing a coin. Fortunately, numerous guidelines have been published to help us do better than tossing a coin…or do they?  Read Post
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