Immunology

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/kvrAqc529V
Dr. John Cush @RheumNow( 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

Links:

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
Dr. John Cush @RheumNow( View Tweet )
Medical.costs.RMD

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,

Read Article
obesity.back_.jpg

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.

Read Article
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

Links:

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
Dr. John Cush @RheumNow( View Tweet )
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

Links:

Dr. John Cush @RheumNow( View Tweet )
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

Links:

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

Links:

Dr. John Cush @RheumNow( View Tweet )
RheumNow Podcast square

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.

Read Article
2024.year.review

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

Read Article
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).
Read Article
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

Links:

Dr. John Cush @RheumNow( View Tweet )
SOCS1 Insufficiency - a Rare Inborn Error of Immunity Lancet Rheumatology has published a population study of the rare suppressor of cytokine signalling 1 (SOCS1) insufficiency - an inborn error of immunity affecting the negative regulation of cytokine and growth factor… https://t.co/I0muoIk5GL https://t.co/jbcuAZivci
Dr. John Cush @RheumNow( View Tweet )
Blood labs

Normalizing Serologies Enhances Remission in SLE

Jack Cush, MD

Analysis of five phase III belimumab (BEL) trials reveals that normalizing serologies affords protection against severe and renal SLE flares, supporting the concept of treat-to-target to minimize risk in SLE.

Several measures of SLE outcomes (DORIS, Lupus Low Disease Activity State

Read Article
Selective mutation of Traf1/cIAP2 (V196) interaction attenuates inflammatory responses that may contribute to rheumatoid arthritis activity. THis may lead to a new class of therapies for RA https://t.co/kYqAqGsSEA https://t.co/JWUN6iTvxa

Links:

Dr. John Cush @RheumNow( View Tweet )
AI,genes

SOCS1 Insufficiency - a Rare Inborn Error of Immunity

Jack Cush, MD

Lancet Rheumatology has published a population study of the rare suppressor of cytokine signalling 1 (SOCS1) insufficiency - an inborn error of immunity affecting the negative regulation of cytokine and growth factor signalling.

Read Article
Schnitzler Syndrome: A Rare Autoinflammatory Disorder A credible, quick overview Chronic Urticaria Monoclonal Gammopathy ( Recurrent Fever Bone & Joint Pain Elevated CRP &ESR https://t.co/sQ22t8Z46m https://t.co/nJOVCghoFa

Links:

Dr. John Cush @RheumNow( View Tweet )
RheumNow Podcast square

Opioid Deaths are Down (2.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  Opioid deaths are down, IL-33 levels are up and Weight loss is in the news again this week!

Read Article
RNA-seq analysis of human chondrocytes (HTC) shows Osteoarthritis has more HTC-1 (w/ more cell apoptosis & PD-1 genes) & proliferate fibrochondrocytes (ProFC2) w/ heightened inflammatory response, & increased cytokine signalling https://t.co/FZ72CnWk20 https://t.co/sx4NB2C8h3

Links:

Dr. John Cush @RheumNow( View Tweet )
175px-Dermatitis2015.jpg

Misdiagnosis of Dermatomyositis

Jack Cush, MD

JAMA Dermatology reports a retrospective cohort study from Johns Hopkins reviewing mimic of dermatomyositis (DM), suggesting that DM and especially clinically amyopathic DM (CADM) are commonly and initially misdiagnosed as inflammatory skin disease (ISD).

The study was undertaken to

Read Article
AI,genes

Diagnoses via Immune ‘Fingerprints’

Jack Cush, MD

Science and researchers at Stanford Medicine have reported the use of Mal-ID (machine learning for immunological diagnosis) to analyze B and T cell receptors sequences from human blood, showing the ability to predict health status (healthy vs diseased) and discriminate between distinct

Read Article
ACPA+ linked to nodule progression. 208 #RA pts w/ Chest CT studied. Lung nodules seen in 1/3; 10% before RA Dx (10.4 mos before). Positive ACPA (not RF) was assoc w/ nodule progression (OR 3.69). csDMARDs & b/ts-DMARDs NO affect on nodule progression. https://t.co/GO1wLRIl9j https://t.co/pfFGbPv2DG

Links:

Dr. John Cush @RheumNow( View Tweet )
Increased L-33 linked to SLE. Study of 120 #SLE vs 60 controls. IL-33 levels signif higher in SLE (258.7 vs 78.3, p < 0.001) & correlated w/ SLEDAI (r = 0.68, p < 0.001) & organ damage (r = 0.45, p < 0.01) & renal dz (p < 0.01). https://t.co/8dbH6u2s1r https://t.co/SzKWy5Xbv1

Links:

Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Unpopular opinion: spinach can be bad for you

Lara El Khoury, MD
pro con unsure opinion thumbs debate
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
×