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Infection

Wait! FDA approved the Chikungunya Virus Vaccine 2 yrs ago, but just pulled the vaccine, Ixchiq, citing serious safety concerns (specifically CBER reports of >20 serious adverse events, including 21 hospitalizations, 3 deaths, w/ 1 fatality directly linked to vaccine-derived https://t.co/aaC38VX7rF
Dr. John Cush @RheumNow( View Tweet )
Recombinant zoster vaccine effective in #SLE without flare. Retrospective Medicare & commercial claims data on pts given 2 RZV doses, matched 1:4 to unVAX. 3592 pts F?u ~1.5 yrs. Vax effectiveness 70% in Medicare; 54% commercial. SLE flare rates HR 0.91& 0.94. https://t.co/WCBOQhb4Ad
Dr. John Cush @RheumNow( View Tweet )

ILD Begins (8.29.2025)

Dr. Jack Cush reviews the news and journal reports from RheumNow.com. This week news on vaccines, safety of acetaminophen and more.

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Antibiotics are not linked to Autoimmune disease in kids The global incidence of autoimmune diseases among children has increased over the past few decades. A study published August 21st in the open-access journal PLOS Medicine by Ju-Young Shin at Sungkyunkwan University, https://t.co/46Q0GFZQiw
Dr. John Cush @RheumNow( View Tweet )
Wait! FDA approved the Chikungunya Virus Vaccine 2 yrs ago, but just pulled the vaccine, Ixchiq, citing serious safety concerns (specifically CBER reports of >20 serious adverse events, including 21 hospitalizations, 3 deaths, w/ 1 fatality directly linked to vaccine-derived https://t.co/k5wBtsGVIs
Dr. John Cush @RheumNow( View Tweet )
What Is Lyme Disease? JAMA Patient education handout. Lyme disease is the most common tick-borne infection in the US. A bite from infected Ixodes scapularis ticks can transmit the bacterium Borrelia burgdorferi, which causes Lyme disease. https://t.co/a8eMdAy0bi https://t.co/Jrj4Eiuy24
Dr. John Cush @RheumNow( View Tweet )
Recombinant zoster vaccine effective in #SLE without flare. Retrospective Medicare & commercial claims data on pts given 2 RZV doses, matched 1:4 to unVAX. 3592 pts F?u ~1.5 yrs. Vax effectiveness 70% in Medicare; 54% commercial. SLE flare rates HR 0.91& 0.94. https://t.co/bcEwtzFDvy
Dr. John Cush @RheumNow( View Tweet )
Cardiovascular Sequelae in Adults After Kawasaki Disease A long-term cohort study of children diagnosed with Kawasaki disease (KD) shows evidence of future adult cardiovascular complications and hospitalizations. These severe cardiovascular events clustered during the young KD https://t.co/zbo64gAV1H
Dr. John Cush @RheumNow( View Tweet )
Antibiotics are not linked to Autoimmune disease in kids The global incidence of autoimmune diseases among children has increased over the past few decades. A study published August 21st in the open-access journal PLOS Medicine by Ju-Young Shin at Sungkyunkwan University, https://t.co/siIDGezw9W
Dr. John Cush @RheumNow( View Tweet )
Study of 90 Still's Dz pts w/ lung disease from AIDA network - mean age 36 yr; 36% male (13% from pediatrics). Lung findings: pleuritis 72%, parenchymal 34%, ARDS 9.5% & pulm HTN 2.3%. Parenchymal involvement assoc w/ sore throat, pericarditis, higher systemic score, but not https://t.co/4YIx2BwADe
Dr. John Cush @RheumNow( View Tweet )
Claims data study of 82 399 PsA pts - 542 on combo targeted Rx >3 mos (200 > 6mos). 2 most common combos of apremilast w/ TNFi or IL-17i. Use of combo targeted Tx was not assoc. w/ more serious infxn (RRs 0.53; 0.17-1.63) or opportunistic infx (RR 1.00; 0.09-11.02) @ 3 or 6 mos https://t.co/mkvq1lqt9Y
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Rheumatic Dz & HIV - Arthralgia: self limiting - HIV-assoc arthritis: mimics RA - Occurs w/ HIV: SpA, ReA, PsA - Less : IIM, vasculitis, opportunistic infxn https://t.co/Yf7jZ0icZw https://t.co/6FuJgvDYRF
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There's a transient (1 yr) increase in New Abx Rx among 399 PsA pts after starting a TNF inhibitor. Pre-TNFi, PsA pts were more likely to recv Abx vs controls (1.26 vs. 0.60/yr; p<0.001). Post TNFi Abx use incr to 1.64/yr (p<0.001) but returned to baseline thereafter. https://t.co/LHXn5d7oC9
Dr. John Cush @RheumNow( View Tweet )

Teaching You How to Think… (8.15.2025)

Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and  aphorisms to live by.

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Systematic review of 47 studies covering 1.5 million cases found that Dx of Crohns, SLE, Type I DM positively associated w/ incr risk of pancreatic, esophageal, colon, liver, and hepatobiliary cancers. MS assoc w/ lower risk of pancreatic, esophageal, rectal, & colorectal CA https://t.co/g0N5eHhJYj
Dr. John Cush @RheumNow( View Tweet )

Biologic Switching in Psoriasis

A systematic review and meta-analysis found that biologic switching was effective in a significant number of psoriasis patients; but there may be a price to pay. 

Patients with psoriasis may be required to switch therapies, for a variet of reasons (

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Advances in Still's disease Rx: - using IL-1 or IL-6 inhibitors 1st line - New FDA approval of emapalumab (IFNg) for MAS - unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/qefCt5b7qh
Dr. John Cush @RheumNow( View Tweet )
French OL trial of PCV13 vaccination in 248 early, DMARD Naive RA pts starting MTX @ same time or after 1 month delay. 1 mo delay in MTX resulted in significantly higher responses (46%, 65%) vs. pts vax while taking MTX. Signif responses seen 1 yr later. RA activity equal betw. https://t.co/AnqK89ZJtE
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RA leads to ILD: but ILD does not lead to RA New research sheds light on the link between rheumatoid arthritis (RA) and idiopathic pulmonary fibrosis (IPF). A team from Taizhou Hospital used advanced multi-omics methods to explore the causal relationship between these two https://t.co/QbY6GC0KBZ
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Retrospective study of FDG-PET scans at Int. Medicine tertiary hosp (2015-2020), included 260 adult IM pts - indications: infx 42%, inflammation 35%, suspected CA 17%. 80% were helpful; 40% Rx changed. 23% neg. results; 9% made the Dx; 43% PET superior to other imaging. Less https://t.co/2UG2npJgRg
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Danish childhood vaccination registry study (1997-2020) found among 1,224,176 children w/ vaccination before age 5, w/ aluminum containing vaccines against an DPT, poliovirus, Hib (DTaP-IPV/Hib), PCV, etc found no increased risk of autoimmune dz by 8 yrs of https://t.co/9IR6AmlIT9
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Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer. https://t.co/i3FMOCbyNg
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CKD & Osteoporosis Rx Revisited (7.25.2025)

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

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New CDC report confirms a record number of Measles cases in the USA, now at 1,319 (in 39 states), the highest since 1992. National cases are more than 4.5 times higher than the entirety of last year, which had an estimated 285 cases reported. https://t.co/KkqQu9C4cO https://t.co/bND6hPDUNA
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RA Lung Disease Portends Poor Outcomes A retrospective Harvard affiliates study shows that rheumatoid arthritis (RA) patients with lung disease have higher mortality, especially respiratory and infection-related mortality than those without lung disease (LD). https://t.co/13h2u26ecb
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