Hmmm Really? (7.11.2025)
Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?
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RABBIT (German biologics register) study shows overall small increase in malignancy w/ JAKi vs bDMARDs. Risks greatest in those ≥ 60 yrs, w/ Hi Dz activity, on ≥3 prior csDMARDs. 2285 JAKi vs 4259 bDMARDs: 88 vs 135 malignancies CAs (IRs 11.6 vs 8.9; adj HR 1.40). JAKi risk https://t.co/PRn0G94CB0
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Case–control study RA pts > 65yrs in US. SEER (cancer) database (2014–2019). Overall cancer risk not associated with use of JAKi (adjOR 1.04), TNFi (0.98) or other bDMARDs (0.98). But, JAKi use was assoc w/ incr risk of lung CA (OR 1.40), esp in Males (2.12) & >2 yrs JAKi. Lower https://t.co/u2psafyN1I
Dr. John Cush @RheumNow( View Tweet )
Overview of the VEXAS Syndrome
A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.
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Immunomodulators in the Treatment of Autoimmune Hepatitis
EurekAlert!
Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on histology. With an annual global incidence of 1.37 per 100,000, AIH can lead
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Review of 104 irAE pts rx w/ JAK inhib. (82% tofacitinib). Checkpoint inhib was for Lung (20%), gastric (17%) & melanoma (16%). JAKi indications: myocarditis (70%), myositis (33%), hepatitis (24%). JAKi potentially effective esp in irAE pts unresponsive to cytokine Rx. https://t.co/8ezpAOzpRh
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs
A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (
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ICYMI: AGA Guideline: Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals
The American Gastroenterology Association has published its revised clinical practice guidelines for the prevention and treatment of hepatitis B virus (HBV) reactivation in at-risk patients, particularly those with immune-mediated disease, receiving immunomodulatory therapy and steroids.
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ICYMI: Combination treatments in Psoriatic Arthritis
Despite the advances in the treatment of PsA with biologic (bDMARD) and targeted synthetic (tsDMARD), less than half of patients with this condition achieved remission or low disease activity. Combination DMARD treatment is often used in order to achieve remission or minimal disease activity.
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ICYMI: Axial Involvement in Psoriatic Arthritis
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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JAK Inhibitors: The Latest from the JAK-pot Study
Dr. David Liew reports on abstract POS0150 - Evolution of Janus Kinase Inhibitors (JAKi) Prescriptions Since 2015 In An International Collaboration of Rheumatoid Arthritis Registers (The 'JAK-pot' Study): Effect of Regulatory https://t.co/KiOZuphQTx
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PCR: Prevalence, Cost, & Risk (6.27.2025)
Dr. Jack Cush reviews the news and journal reports from last week on RheumNow.com
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What would it take for JAKs to ROCK the boat?
JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. https://t.co/tgfsU3uFVo
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What would it take for JAKs to ROCK the boat?
JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. Once the https://t.co/JgmfxGa6TY
Dr. John Cush @RheumNow( View Tweet )
Trends and Innovations from Barcelona (6.20.2025)
Dr. Jack Cush reviews highlights, trends and novel studies from EULAR 2025 in Barcelona from last week.
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JAK Safety Update
Dr. Jonathan Kay offers his perspectives on abstracts POS0150, POS0151, and POS0157 presented at the 2025 EULAR meeting in Barcelona, Spain.
https://t.co/F8WzGohCj8 https://t.co/FguBLrmPzZ
Links:
Dr. John Cush @RheumNow( View Tweet )
What would it take for JAKs to ROCK the boat?
JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. So it is an intriguing idea to pair JAK inhibitors with something that might
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Steroids, Not JAKi, Are the Real Infection Risk
Dr. David Liew reporting at EULAR 2025 in Barcelona, Spain.
https://t.co/rLpyo1UNjd https://t.co/bDfdLTEM1N
Links:
Dr. John Cush @RheumNow( View Tweet )
Seronegative Arthritis Breakthroughs
Dr. Janet Pope discusses abstracts POS0015, "Zasocitinib (TAK-279) exhibits high levels of TYK2 inhibition and no inhibition of JAK 1/3 when compared with licensed TYK2 and JAK inhibitors" and POS0016, "Characterization of ORKA-002, a Novel https://t.co/7nmOWw11lb
Dr. John Cush @RheumNow( View Tweet )
EULAR 2025 – Day 4 Report
Saturday was the final day of EULAR, and included several lectures, but mostly late breaking abstracts and new EULAR guidelines - notably on Rheumatoid Arthritis and another on Interstitial Lung disease in connective tissue disorders. My favorite presentations included the following.
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RA Care Should be Guided by Need—Not Age
Dr. Jiha Lee reports on abstract POS0627, "Examination of Clinical Outcomes by Treatment Duration of Biologics and JAK inhibitors in Nonagenarian Rheumatoid Arthritis," at EULAR 2025 in Barcelona, Spain.
https://t.co/zKHXZSVLJy https://t.co/w6CkRy2yIA
Dr. John Cush @RheumNow( View Tweet )
From Domains to Decisions: Personalizing PsA Care with Data
At EULAR 2025, Dr. Laura Coates (Oxford) took the plenary stage to reframe how we think about treating psoriatic arthritis. The message was clear: in 2025, PsA treatment is no longer about following a linear algorithm; it’s about understanding the unique constellation of domains, comorbidities,
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POETYK PsA-1
Deucravacitinib TYK2i RCT Ph 3
ACR 20 DEU 54% vs. 34% PBO wk 16
ACR 50 DEU 23% vs. 14% PBO
also significant diff for HAQ-DI PASI 75 SF-36 PCS and MDA
Less Rx progression
@RheumNow #EULAR2025 LB0001 https://t.co/oRLlHwI4Bh
Aurelie Najm @AurelieRheumo( View Tweet )
Deucravacitinib, the first oral TYK2 inhibitor, delivers in PsA:
✅ ACR20: 54% vs 34% (placebo)
✅ Skin, joints, fatigue, QoL
📉 Post hoc: less radiographic progression
No new safety signals at W16.
LB0001 @RheumNow #EULAR2025
Jiha Lee @JihaRheum( View Tweet )
📊 In POETYK PsA-1, deucravacitinib (TYK2i) significantly improved ACR20 at W16 (54% vs 34% placebo) in bDMARD-naive PsA.
Also improved QoL, skin, and MSK outcomes.
Post hoc: slowed radiographic progression.
Well tolerated & no new safety signals
@RheumNow #EULAR2025 #LB0001
Mrinalini Dey @DrMiniDey( View Tweet )
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