Immunology

RA Prevention through Deep Immunophenotyping Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for RA. They have found the expansion of specific T cell subtypes, in the at-risk group, and postulate this could lead to https://t.co/AEo0GOr7Kn
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Immunophenotyping, JCI

RA Prevention through Deep Immunophenotyping

Jack Cush, MD

Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for rheumatoid arthritis (RA). They have found the expansion of specific T cell subtypes, in the at-risk group, and postulate this could lead to future immunospecific prevention

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pediatric eye uveitis

Uveitis Risk with Slow Adalimumab Weaning

MedPage Today

Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.

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yoga, mindfulness

Mindfulness and CBT improve chronic low back pain

EurekAlert!

Behavioral interventions were associated with reduced pain and daily opioid use and improved function and quality of life for up to 12 months among adults with opioid-treated chronic low back pain, according to a new randomized clinical trial.

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Vamorolone: a New Steroid on the Horizon?

Jack Cush, MD

Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases. It is a dissociated steroidal compound with reduced side effects, and in an animal model of inflammation has shown effective antiinflammatory properties and reduced systemic

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Stillsnow, Stills, podcast

1st Line Biologics vs csDMARDs in Adult Still's Disease

Jack Cush, MD

A German multicentre, retrospective study assessed the first-line efficacy of biologics and conventional synthetic DMARD therapy in patients with adult-onset Still's disease and found biologic agents were significantly better with sustained, event-free remissions and fewer complications.

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If COVID was responsible for causing autoimmune Dz (AD), it is possible that Molecular mimicry was in play. Study shows 10nsequence homology between SARS-CoV-2 & AD epitopes; 2) similar MHC binding; 3) of high empirical immunogenicity. https://t.co/WO3gjxhVBw https://t.co/QdqtQMHcpL

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Dr. John Cush @RheumNow( View Tweet )
Researchers have developed a machine learning model capable of predicting rheumatoid arthritis progression from seronegative undifferentiated arthritis. In the KURAMA cohort of 210 SN patients, 57 (27%) progressed to RA. The FNN model excelled with an AUC of 0.924 and 81% https://t.co/b8G2AzMZ7m
Dr. John Cush @RheumNow( View Tweet )
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Cancer Survival with TNF Inhibitors (3.28.2025)

Jack Cush, MD

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

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A comprehensive examination of the pathogenesis and recent advancements in Familial Mediterranean Fever (FMF). This condition results from autosomal recessive mutations in the MEFV gene, which codes for Pyrin, a crucial component of the NLRP3 inflammasome. These genetic https://t.co/XNV89LW893
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A study in mice shows that JAK inhibition In mice model of status epilepticus (SE) didnt prevent initial SE but when did effect chronic phase of Sz weeks after SE induction of SE, suppressing seizures, and epilepsy-associated histopathological alterations. Sz suppression lasted https://t.co/GMIPCtoc7x
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ACPA specificity and recognition motifs examined in 6,907 patients with RA from 5 Scandinavian cohorts. ACPA targeting non-glycine citrulline motifs assoc. more strongly w/ HLA-SE; ACPA to glycine citrulline motifs assoc. w/ smoking and IgA ACPA A&R https://t.co/PmKv3dZLc4 https://t.co/NdPG4Orfj4

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ACR_Journals @ACR_Journals( View Tweet )
#Thrombocytopenia is common in #antiphospholipid syndrome (APS), and is likely associated with more severe disease. Although the pathophysiology underlying thrombocytopenia in APS has yet to be definitively revealed, mechanisms that play a role (at least in subsets of patients) https://t.co/pUXmb1irbw

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Alberto Giraldo @alb_giraldo( View Tweet )
55 myositis (IIM) pts studied Nailfold Capillaries, MSAbs, cytokines & IFN genes. MDA5(+) pts signif more dilated (DIL), giant & abnl morphology caps, w/ microhemorrhages (MH) vs ARS (+) pts. MH & DIL assoc w/ MX1, IFI27, IP-10, RANTES, GROα. Giant caps assoc w/ IFI27, SDF-1α, https://t.co/3WQL8Sw0rq
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Autoimmune Disease Impact Report

Jack Cush, MD

Integrated Benefit Institute, a nonprofit independent research organization, has published its 2025 Autoimmune Disease Impact Report, which examines the health and productivity impacts of five prevalent and costly autoimmune conditions: rheumatoid arthritis, multiple sclerosis,

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Targeting Obesity in Rheumatic Disease Patients

Jack Cush, MD

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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Mizoribine Effective in Lupus Nephritis A randomized clinical trial has shown that oral mizoribine, a common immunosuppressant in Japan, was noninferior to intravenous cyclophosphamide (CTX) as induction therapy in patients with active lupus nephritis. https://t.co/OWnGly4TUX https://t.co/zbPPH1n4lU

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Dr. John Cush @RheumNow( View Tweet )
617 seropos ARTHRALGIA pts - 34% got inflamm. arthritis (avg time ~20mos). Arthritis risk factors: high ACPA (HR 4.7) or double positive(HR 6.8); 1st degree relative (1.5); intermittent Sxs(1.6); <12 mos Sxs (HR 0.71); AM stiff ≥1hr (1.6); joint swelling (1.5). IF > 2 https://t.co/tHL19ro5C8
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Large GWAS study of smokers, shows that polygenic risk scores (PRS) for RA & ILD were assoc w/ their intended phenotypes in whites (OR 1.32 & 1.88, respectively) but no in blacks https://t.co/FflF2f1orq https://t.co/NlxcASrj9K

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Spatial transcriptomic profiling on pre- and post-Rx synovial tissue Bxs from RA - Tx naive pts on DMARDs or adalimumab. Rx refractory patients had high expression of COMP, and fibroblast TGFβ signaling driving synovial tissue fibrosis https://t.co/1xFVvoddCD https://t.co/kYvhyX8VuS

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Dr. John Cush @RheumNow( View Tweet )
Mizoribine Effective in Lupus Nephritis A randomized clinical trial has shown that oral mizoribine, a common immunosuppressant in Japan, was noninferior to intravenous cyclophosphamide (CTX) as induction therapy in patients with active lupus nephritis. https://t.co/OS3yaJlEm7 https://t.co/1YcyfarF09

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Dr. John Cush @RheumNow( View Tweet )
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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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2024 Rheumatology Year in Review

Jack Cush, MD

2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians.  While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list

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syringe, pill, DMARD, Treatment, therapy

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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Crohn’s Microbiome may Predispose to Axial Spondyloarthritis Researchers at Weill Cornell Medicine found that people with Crohn’s disease and related joint inflammation have distinct gut bacteria, with Mediterraneibacter gnavus as a potential biomarker. https://t.co/SI03wAJ3UU https://t.co/dlt3VxBDLw

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Unpopular opinion: spinach can be bad for you

Lara El Khoury, MD
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PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives.  Read Post

What Goes Wrong with the Immune System in PMR?

Kornelis van der Geest, MD, PhD
PMR,pathogenesis.JIM2022
Polymyalgia rheumatica (PMR) is a common inflammatory rheumatic disease. The exact trigger for PMR onset remains unknown. However, immunology studies and clinical trials with biological DMARDs now shed light on the immune pathways involved in PMR. Read Post
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