Infection

QD Clinic: Gout, Sepsis… or Both? Dr. Mrinalini Dey, London, discusses a complex case. https://t.co/UtncfZgZyL https://t.co/xVTA0LnPpN

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QD Clinic: Gout, Sepsis… or Both? Dr. Mrinalini Dey, London, discusses a complex case. https://t.co/UtncfZgZyL https://t.co/81SyzpWbcl

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Dr. John Cush @RheumNow( View Tweet )
Genetic study of 16 pts w/ Allopurinol-induced severe cutaneous adverse Rxn (SJS/TEN) shows 2 class I alleles to be associated: HLA-B*58:01 (OR, 28.0 [95% CI, 8.6-100.6]) and HLA-A*34:02 (OR, 20.6 [95% CI, 3.3-131.1]). Both explain 80% risk in US pts https://t.co/OxDXuWCbup https://t.co/oky61JImQV

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#THA revisions in 3657 RA vs 446428 OA pts (mean F/U ~7y) find RA has signif incr risk of revision (HR 1.35); espec due to infx (HR 1.48), dislocation (1.87), aseptic loosening (0–3m; 2.81). No diff w/ cemented, cementless, hybrid THA. Age > 65 was main risk factor. https://t.co/iK6pL3QF1W
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The Hidden Cost of Gout

Mrinalini Dey, MBBChir, MA(Hons) Cantab., MRCP, FHEA

For many people, gout is viewed as an episodic disease: a painful flare, a short course of treatment, and then life returns to normal. However, as rheumatologists, we know that recurrent attacks can lead to joint damage and tophi if left untreated. Furthermore, the true burden of gout extends

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Metanalysis of 31 studies (14,548 pts) looked at infection in idiopathic inflamm myopathy (IIMs). Infection prevalence was 24%, primarily Respiratory tract. PJP, aspergillosis, H zoster most prevalent pathogens. Risk factors: older age, male, DM, HTN,MDA5+ (OR 3.41), rapidly https://t.co/GvOvAVRkRv
Dr. John Cush @RheumNow( View Tweet )
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Seronegative RA Disease Activity (7.17.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and Gout features from this past week on RheumNow.com.

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Four Things About Allopurinol Hypersensitivity Syndrome Dr. Robert Terkeltaub discusses allopurinol hypersensitivity syndrome in gout patients. https://t.co/5seiyfVLW1 https://t.co/0A1Rtk9hzS

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Dr. John Cush @RheumNow( View Tweet )
Glucocorticoid use in 1st yr of 574 newly DX RA cases-- 75% recv GC in 1st yr; 313 (55%) Rx at 1st visit. (m GC dose =9.3 mg/day. 1/2 (47%) recv IA GC injx. 20% had 1st yr infx. Risk of infx was NS (RR 1.13; 0.77 to 1.67) for 0-10 mg/d vs no GC https://t.co/s9YaGZsUjr https://t.co/ESHvVK1Egx

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Dr. John Cush @RheumNow( View Tweet )
Metanalysis of 31 studies (14,548 pts) looked at infection in idiopathic inflamm myopathy (IIMs). Infection prevalence was 24%, primarily Respiratory tract. PJP, aspergillosis, H zoster most prevalent pathogens. Risk factors: older age, male, DM, HTN,MDA5+ (OR 3.41), rapidly https://t.co/Go51MUOQlG
Dr. John Cush @RheumNow( View Tweet )
Retrospective study 1420 newly Dx non-tuberculous mycobacterial (NTM) infx (2012-2024) - 66 (4.6%) Dx w/ RA (55 after RA dx). Having RA + NTM incr risk of Resp. death (HR 4.3) w/ lower 5yr survival (75% vs 93%) partly explained by ILD and sytemic inflamm. https://t.co/6sdR7XwwD7
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RZV (Shingrix) response in 76 immunosuppressed SSc & 304 controls (CG) recv two RZV doses. High seroconversion seen in SSc but signif lower than CG (92.6% vs 99.7%, P 0.001), w/ lower concentration but comparable CMI, lower AE (74% vs 86%) https://t.co/ALlnVEZIAt https://t.co/kYYy2JIo2J

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DMARD Efficacy in RA-ILD A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional,

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QD Clinic: Cellulitis Paradoxes Dr. Richard Conway, Dublin, discusses a case of cellulitis and gout. Presented as part of RheumNow's "Gout: More than Flares" campaign during the month of July 2026. https://t.co/ZeYyISJrrE https://t.co/2Ih4QRa7FK

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Dr. John Cush @RheumNow( View Tweet )
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Gout Cavalcade (7.10.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week. July is Gout: More than Flares month.

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JAMA HBV review - Worldwide, HBV affects ~254 million, causing 1.1 million deaths. In 2022, 14k new HBV infx in the US. HBsAg = ongoing infxn; HBsAb indicates immunity; HBcAg=ongoing or past infection. Do HBV DNA for virus-replication activity https://t.co/Yvdx09DrQ5 https://t.co/88VsTEgFev

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Dr. John Cush @RheumNow( View Tweet )
#TB Infection or reactivation is Psoriasis or Psoriatic Arthritis pts taking IL-23 inhibitors is rare, rare. Literature review showed 34 studies of IL-23i in PsO had no new TB, but 1 case of LTBI reactivation. In 8 IL-23i PsA studies there were NO new TB or LTBI reactivations https://t.co/h0oe3WksK1
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Generic Tofacitinib (6.26.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Updates on tofacitinib, CAR-T therapy and AI.

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Do You Zoster Vaccinate? (6.19.2026) Dr. Jack Cush reviews the news, journal reports and best ways to review EULAR 2026. https://t.co/hOfXR39s3H https://t.co/X7skwKrCc3

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Dr. John Cush @RheumNow( View Tweet )
Systematic review of live virus MMR in #JIA had 9 studies (743 pts) showing no flares, good safety & immunogenicity in short term, BUT incomplete or less durable protection in biologic-treated patients, especially for measles & rubella. 5-yrs post MMR, seroprotection was lower if https://t.co/JQhL9o1O4e
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Single center study of 102 pts starting JAK inhibitor (72% >50yrs; 77% RA) shows only 27.5% received at least one RZV vaccination dose (Shingrix) & only 3 recv RZV within 30 daysof a JAK inhibitor. ????? (I vaccinate everyone going on a JAKi w/ Shingrix - don't you?) https://t.co/7HUqGGBeJ8
Dr. John Cush @RheumNow( View Tweet )
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Do You Zoster Vaccinate? (6.19.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and best ways to review EULAR 2026.

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Vaccine2.jpg (keep)

EULAR 2026: Updated Recommendations for Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases

Jack Cush, MD

This update includes new pandemic era evidence, recombinant zoster vaccine data, and new perspectives on vaccination in patients taking novel immunosuppressants. Five overarching principles and 10 vaccine recommendations follow.

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Single center study of 102 pts starting JAK inhibitor (72% >50yrs; 77% RA) shows only 27.5% received at least one RZV vaccination dose (Shingrix) & only 3 recv RZV within 30 daysof a JAK inhibitor. ????? (I vaccinate everyone going on a JAKi w/ Shingrix - don't you?) https://t.co/j2jrBIiuOo
Dr. John Cush @RheumNow( View Tweet )
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EULAR 2026 Rheumatology RoundUp

Jack Cush, MD

It’s time for Rheumatology RoundUp from EULAR 2026 from London, UK. Drs. Artie Kavanaugh and Jack Cush review their choice presentations from the meeting, offering their perspectives on impact and applicability.

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Recent Blogs

Advanced Practice Rheum

Safety of Biologics and Novel Agents

Jack Cush, MD
APR Safety Video Cover
Dr. Jack Cush reviews safety of biologics and novel agents.
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Advanced Practice Rheum

Steroids

Jack Cush, MD
STEROIDS COVER
In this Advanced Practice Rheum, Dr. Jack Cush reviews steroids.
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A Brief History of Rheumatoid Arthritis Mimics

Robert Schoen, MD, MBA
books history
Imagine that 100 years from now, your great granddaughter, an eminent rheumatologist, reviews the history of rheumatoid arthritis mimics.
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