Early RA Referral Clinics Work!
An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals.
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Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/JDvVZ1KEIY
Dr. John Cush @RheumNow( View Tweet )
True or False: In a Leeds study of idiopathic inflammatory myopathy patients treated with rituximab, responders had lower memory B cells and plasmablasts at 2 weeks.
See if you got it right in this week's RheumIQ quiz at https://t.co/UaXqHKWizt. https://t.co/zRJOMeLn8M
Dr. John Cush @RheumNow( View Tweet )
Dutch single center study of ANCA tests (n 5518) betw 2012-2023; 286 (5.2%) were positive: 63% did not have AAV. ANCA+ Non-AAV pts had other CTD, neoplasia, infxn, or used specific drugs. IIF and ELISA 1st test - good negative predictive values. Performing a second test increased https://t.co/0oAhOg10VL
Dr. John Cush @RheumNow( View Tweet )
A Day of Infamy (9.11.2026)
Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz
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Difficult PsA is called ‘difficult-to-manage’ (D2M) or ‘treatment-refractory’ dz (TRD). Data from 5 Nordic PsA registries 14,362 ps, D/Cs of ≥2/≥3/≥4 b/tsDMARDs in 36%/18%/10%. Freq of D2M low 2%/3%/3%, & TRD was 1.2%/1.2%/0.8%. Female #s, depression, & opioids incr w/ # of https://t.co/FkQU5BVRn2
Dr. John Cush @RheumNow( View Tweet )
JAMA: Review of Adult Rheumatoid Arthritis
Smolen, Kerschbaumer, Aletaha, and Robinson have published a comprehensive review article of rheumatoid arthritis (RA) in JAMA, noting significant changes to our understanding and treatment guidelines.
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Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/HTxOIxkezs
Dr. John Cush @RheumNow( View Tweet )
Metanalysis looked at neutrophil to Lymph ration (NLR) in SLE - 31 studies, 4,006 SLE pts. NLR signif incr in SLE worldwide. NLR was higher in Active vs inactive SLE, and showed a significant but moderate correlation w/ SLEDAI (CC=0.354, p < 0.001). https://t.co/tA6UBb1wVo https://t.co/XoXrf6HlKL
Dr. John Cush @RheumNow( View Tweet )
Ro52 Abs in idiopathic inflammatory myopathies (IIM). From 2,126 IIM China/Japan pts, Ro52 positivity was common (46%), esp in MDA5+ DM & anti-synthetase syndr (ASyS) & was assoc w/ high freq of ILD, rapidly progressive ILD, and poor prognosis. https://t.co/TA4gSnZax1 https://t.co/riYs5YJwQV
Dr. John Cush @RheumNow( View Tweet )
Treating Obesity is Disease-Modifying (9.4.2026)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. New drugs approved, new drugs halted and some drugs out of control. Ready to test your knowlege? Take this week's quiz!
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Metanalysis looked at neutrophil to Lymph ration (NLR) in SLE - 31 studies, 4,006 SLE pts. NLR signif incr in SLE worldwide. NLR was higher in Active vs inactive SLE, and showed a significant but moderate correlation w/ SLEDAI (CC=0.354, p < 0.001). https://t.co/ROG5L4nfo2 https://t.co/9mqqId45lG
Dr. John Cush @RheumNow( View Tweet )
Ro52 Abs in idiopathic inflammatory myopathies (IIM). From 2,126 IIM China/Japan pts, Ro52 positivity was common (46%), esp in MDA5+ DM & anti-synthetase syndr (ASyS) & was assoc w/ high freq of ILD, rapidly progressive ILD, and poor prognosis. https://t.co/may6ZTJkvt https://t.co/EuinNbZUm7
Dr. John Cush @RheumNow( View Tweet )
EUSTAR Registry - Cancer in Systemic Sclerosis
Cancer is a major cause of mortality in systemic sclerosis (SSc). A nested case-control study within EUSTAR registry shows distinct patterns of cancer related temporally to SSc, serologic profiles and traditional cancer risk factors.
Cancers were
JAK inhibitors work & have a dose dependent effect in severe alopecia areata (AA). Metanalysis of 10 Rxs, 3866 AA pts (used the SALT20 endpoint) showed the best efficacy was deuruxolitinib_12 mg, and baricitinib_4 mg (OR: 2.59, 95% CI: 1.98–3.38). https://t.co/k86f2RvCEJ https://t.co/N1fsrbbmDw
Dr. John Cush @RheumNow( View Tweet )
Per adult-onset IgA vasculitis guidelines, which agent is now preferred for refractory or relapsing disease?
Test your knowledge in this week's RheumIQ at https://t.co/TBlB4pmnKa. https://t.co/7tMcDkoCKH
Dr. John Cush @RheumNow( View Tweet )
Guidelines for Adult-Onset IgA Vasculitis
A EUVAS-sponsored expert panel of 37 specialists across rheumatology, nephrology, dermatology and pathology has published evidence-based guidelines for adult-onset IgA vasculitis (IgAV), which behaves very differently in adults compared to usually self-limited childhood form.
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SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/DIe2OJhZIc
Dr. John Cush @RheumNow( View Tweet )
Misdiagnosis of Still's Disease
High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be https://t.co/mCbNBAt9T5
Dr. John Cush @RheumNow( View Tweet )
QD Clinic: A Watched Tophus Never Resolves
Dr. Jack Cush discusses his plan to medically manage multiple large volume tophi and a patient who has recently started urate lowering therapy with febuxostat.
https://t.co/swfyYEeW0s https://t.co/wyLlcHR4Td
Dr. John Cush @RheumNow( View Tweet )
Misdiagnosis of Still's Disease
High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be misdiagnosed or mistreated. A current case review by
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SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/Savx5IOTcG
Dr. John Cush @RheumNow( View Tweet )
Efgartigimod Efficacy in Idiopathic Inflammatory Myopathy
Today Argenx announced the results of their Phase 3 "ALKIVIA" study; demonstrating efficacy and safety of subcutaneous efgartigimod for Idiopathic Inflammatory Myopathy (IIM, AKA inflammatory myositis).
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Study of 154 anti-Ku Ab+ pts (51 IMMM, 46 SLE, 30 Sjögrens, 27 Sc) = 60 (39%) had ILD - 75% progressed; more rapidly in males. BUT Ku+ is rare <4%, not specific, without clear clinical implications. Ku is a myositis-assoc Ab (like Ro52/Ro60, U1-RNP, PM/Scl) https://t.co/s1VFhaOYgn
Dr. John Cush @RheumNow( View Tweet )
Doubting RS3PE (8.14.2026)
Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.
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Watch our 11-video series on ILD Treatment and Guidelines including videos on assessing ILD, guidelines caveats and concerns, and more.
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Biomarkers in RA
Sponsored by Augurex
Rheumatologist Dr. Walter Maksymowych discusses the role of biomarkers in RA care, with a focus on 14-3-3eta as a modifiable marker for diagnosis and monitoring disease progression.
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Recent Blogs
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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Podcasts
EULAR 2021 - Day2d00:23:12
