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JAK/TYK2

JAK-pot: 46913 Rx courses on JAKi, TNFi, other MOA. Rx D/Cs for AEs: - TNFi = JAKi (HR 1.0) - Other MOA > JAKi (HR 1.11) - TNFi < tofacitinib (0.81) - TNFi > baricitinib (1.15) - TNFi < JAKi; if >65yrs w/ CV risk (0.79) https://t.co/jCtLG3SNvP https://t.co/FN5U5Z1M9M
Dr. John Cush @RheumNow( View Tweet )
JAK inhibitors maybe an option in refractory Juvenile Dermatomyositis. Metanalysis of 26 reports (195 pts) JDM Rx w/ JAKi (median 5 rys); most Rx w/ tofacitinib (57%), ruxolitinib(27%), baricitinib (15%), w/ Improvement in 90%, 69%, 93%, respectively. https://t.co/tfISYVtwUN https://t.co/zv88Vdy6c0
Dr. John Cush @RheumNow( View Tweet )

Ides of March (3.15.2024)

Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.





  1. Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory

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US Trends in RA DMARD Use 2017-2021

A trend analysis of DMARDs shows that only half of rheumatoid arthritis (RA) patients are taking DMARDs, and that the COVID-19 pandemic substantially affected DMARD use. Despite numerous DMARD advances and evolving treatment guidelines since 1990, older therapies are still commonly used and

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JAMA Review of DMARD Use in Rheumatoid Arthritis

JAMA has reviewed the "2022 EULAR Recommendations for the Management of Rheumatoid Arthritis With Synthetic and Biological Disease-Modifying Antirheumatic Drugs". 

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Immunosuppression Increasing (2.23.2024)

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.





  1. 2021 NHIS Survey data suggests the prevalence of immunosuppression in the USA

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Five Takeaways in PsA/SpA at RNL 2024

Continuing with the theme of clinical pearls, the PsA and SpA speakers also provided a wealth of information. Here are my five key takeaways and clinical pearls. 

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Vasculitis Pearls

Once again RheumNow Live 2024 really delivered with high impact learning packed into short sessions. As someone with an interest in vasculitis it was fantastic to see four of my favorite speakers in the Vasculitis Mavens and STEP talks. They gave us what we really want from these talks –

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Brazilian registry of 1316 RA pts on bDMARDs or JAKi-Added use of antimalarials reduced SAEs & total AEs, & incr survival. 19% were on HCQ, & had signif less SAEs (mIRR: 0.49); AEs (0.68); serious infections (0.53); hepatic AEs (0.21); & mortality (P=.003) https://t.co/bAZ8m3OBo2 https://t.co/SlneyfbJIh
Dr. John Cush @RheumNow( View Tweet )

Sex Disparities in PsA/SpA

Dr. Eder delivered an illuminating talk at RheumNow Live 2024 on sex differences in psoriatic arthritis; the disease may manifest differently in men and women, and therapeutic responses may differ between the sexes.

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JAKi Rx pts w/ H.Zoster who continue JAKi are not at higher risk for recurrent HZ. 3947 (RA>UC pts on JAKi, 611 had HZ (8.38/100PY). 460 continued JAKi, 78 D/C. Recurrent HZ reactivation. after median 1.1 yrs was 5.3/100 vs. 5.9/100 PY; P = 0.52) https://t.co/FH0ysEkGiA https://t.co/lOHyaXzAn3
Dr. John Cush @RheumNow( View Tweet )

Favorable Survival w/ MDA-5 Ab+. 154 pts w/ MDA5+DM; 40 died (26%) Rx induction (mostly resp. failure). 114 survived, w/ 5-yr survival of 97% & relapse-free survival 77%. Survival improved w/ JAKi use (P=.03). 8% achieved complete drug-free remission. https://t.co/QkqM9IztEG https://t.co/yBCH85CpUN

Dr. John Cush @RheumNow( View Tweet )

Co-management of Psoriatic Disease

It is a common clinical scenario to see someone with both severe psoriatic arthritis and skin psoriasis. In an ideal world this would involve a combined clinic with our local friendly dermatologist. For many of us, however, this is not practical for many reasons. The excellent Saturday morning

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VITAL Info on Autoimmune Disease (2.9.2024)

Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".





  1. Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts

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Full read, great review of JAK/STAT signaling and JAK inhibitors published in Ann Rheum Dis.-- Selectivity, efficacy and safety of JAKinibs: new evidence for a still evolving story (Authored by JAK mavens) https://t.co/xen1Htkv2o https://t.co/5hX9hhuK77
Dr. John Cush @RheumNow( View Tweet )

Pre-Treatment Testing with Biologics Falls Short

US commercial insurance claim analysis of laboratory screening and monitoring practices in chronic inflammatory skin disease (CISD) patients shows that < 60% received the recommended pretreatment testing when starting systemic immunomodulatory treatment.

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Some takeways from JAK inhibitors in dermatology talk by Bruce Strober. Great talk. #RNL2024 @RheumNow https://t.co/fuRsSnnsha
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
Dermatology colleagues are using JAKis with success for wide range of dermatological diseases. Note the beauty of this slide with further elaboration on domain inhibition, cool stuff 🤓 Bruce Strober #RNL2024 @RheumNow https://t.co/2yHHcOgTC8
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
JAK toxicity of interest. Eric Ruderman #RNL2024 @RheumNow https://t.co/qdlJFKTUR8
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
I am jealous of the derms who have topical JAKi! Dr. Strober flaunts all the different JAKi he has at his disposal to treat derm diseases #RNL2024 @rheumnow https://t.co/qdMWCSA5I1
TheDaoIndex @KDAO2011( View Tweet )
JAK and TYK2 signaling pathways. Eric Ruderman #RNL2024 @RheumNow https://t.co/WxoZGCEL0z
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
JAKinib negatives. Eric Ruderman #RNL2024 @RheumNow https://t.co/vVzSQMVa5a
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )