IL-23

Biologic survival study of British Assoc. of Dermatologists Biologics Register (11/07-6/23) looked at 19,034 Rx courses (median F/U 2.3 yrs), of TNFi, IL-12/23i, IL-17i, & IL-23i. IL-23i (GUS & RIS) had best survival (~1.93yrs) for efficacy & safety (broadalumab the least) https://t.co/uhomYmiUZy
Dr. John Cush @RheumNow( View Tweet )
GALAXI-2 and GALAXI-3 published showing the efficacy of IL-23 inhibitor, Guselkumab in a 48 week study in adults with moderately to severely active Crohn's disease. https://t.co/pWolec25cX https://t.co/e2fdcMxEro

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Dr. John Cush @RheumNow( View Tweet )
Biologic survival study of British Assoc. of Dermatologists Biologics Register (11/07-6/23) looked at 19,034 Rx courses (median F/U 2.3 yrs), of TNFi, IL-12/23i, IL-17i, & IL-23i. IL-23i (GUS & RIS) had best survival (~1.93yrs) for efficacy & safety (broadalumab the least) https://t.co/aAULb0e3o9
Dr. John Cush @RheumNow( View Tweet )
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Cancer Survival Outcomes in Autoimmune Skin Disease Patients

Jack Cush, MD

Patients with autoimmune skin diseases (ASDs) with cancer had significantly better cancer survival outcomes than those without ASD, suggesting coexistant autoimmune or inflammatory disease does not adversely affect a cancer prognosis.

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Early DMARD Initiation Benefits in Psoriatic Arthritis

Jack Cush, MD

Mease et al has published the results of a cohort study showing early initiation of disease-modifying antirheumatic drugs (DMARDs) in patients with psoriatic arthritis (PsA) resulted in better outcomes compared to late initiation.

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ICYMI: 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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PCR: Prevalence, Cost, & Risk (6.27.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from last week on RheumNow.com

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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

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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

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
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Imaging and Early Detection in Psoriatic Arthritis

Antoni Chan, MD, PhD

At EULAR 2025, there have been new developments in imaging in PsA. Two key poster presentations (POS0104 and 

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Panacea of Prednisone & Cannabis (5.16.2025)

Jack Cush, MD

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

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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 )
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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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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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