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Labs/Biomarkers

3 x IL-23 = IL do Better (11.6.2026)

Jack Cush, MD

Dr. Jack Cush reviews the FDA approvals and news reports from this past week on RheumNow.com. This week we discuss playing the numbers in rheumatology, playing the long game with stem cell transplants, and a=the Positive spin on seronegative RA. 

Dr. John Cush
@RheumNow
The Concern about Seronegative RA A current review of seronegative RA (SNRA) by D’Onofrio, et al in npj Autoimmunity shows the diverse fate of seronegative RA - which can resolve, persist or become refractory. Clearly dedicated trials of SNRA are needed to better predict. https://t.co/98VDKucMgX

The Concern about Seronegative RA

Jack Cush, MD

A current review of seronegative RA (SNRA) by D’Onofrio, et al in npj Autoimmunity shows the diverse fate of seronegative RA - which can resolve, persist or become refractory. Clearly dedicated trials of SNRA are needed to better predict.

Dr. John Cush
@RheumNow
Exagen studies 192 established RA pts (383 controls) for Abs: CCP2, RF IgA, RF IgM, PAD4 (IgA, IgG). RA signif assoc w/ CCP2+ (OR 110), RF (>7), PAD4 (3.5-5.9). In CCP neg - only PAD4 IgG (2.87) & RF (2.2) assoc w/ RA, w/ only small Dx gain (ΔAUC 0.02–0.04). https://t.co/isf7aMf24O
sheila
@RHEUMarampa
Prof. AHoi presented their study on ESR as potential source of risk info in SLE 48% discordance bet ESR & conv. serology Isolated ⬆️ESR levels showed ⬆️ assoc with dse activity and flare; risk increases further if combi ⬆️ESR+low c3/4+antidsDNA @RheumNow #APLAR2026 https://t.co/BvC0OZFjd5
Dr. John Cush
@RheumNow
Boston study of 25 systemic sclerosis pts has shown spatial frequency domain imaging (SFDI) is a noninvasive evaluation of skin, but only has weak-to-moderate correlation w/ mRSS (r −0.38 to −0.48); somewhat better w/ histology/fibrosis (r −0.35 to −0.52) https://t.co/N1uSWjNEcl
Dr. John Cush
@RheumNow
REVEAL study enrolled 418 early microscopic polyangiitis pts - High baseline (Pre-Rx) neutrophil-to-lymphocyte ratio (NLR > 10) was assoc w/ signif higer Dz activity (BVAS), alveolar hemorrhage, poor renal function, reduced survival & higher infection-related mortality (P = https://t.co/wYBOz00GGB

Treat-to-Target has Excellent 10-Year Outcomes in RA

MedPage Today

Most patients with rheumatoid arthritis (RA) whose initial treatment used a stringent treat-to-target strategy in a clinical trial were in remission 10 years later, with only modest radiographic progression over that time, researchers said.

Dr. John Cush
@RheumNow
REVEAL study enrolled 418 early microscopic polyangiitis pts - High baseline (Pre-Rx) neutrophil-to-lymphocyte ratio (NLR > 10) was assoc w/ signif higer Dz activity (BVAS), alveolar hemorrhage, poor renal function, reduced survival & higher infection-related mortality (P = https://t.co/vXuRwXP9gc

Joint Disease in SLE Reconsidered

Jack Cush, MD

A new Frontiers in Immunology review from Ong, Wincup and colleagues, shows that lupus arthropathy is not a single uniform entity and it is biologically under-studied and clinically mismeasured, Moreover, the biology of lupus arthritis may shed light on choosing the best therapy for MSK

Dr. John Cush
@RheumNow
Single center study of Probiotics in #PsA showed no benefit. 66 moderately active PsA pts (PASDAS>3.2) on stable Tx: Rx probiotic vs PBO x 12 wks. 56 pts analyzed, PASDAS <3 responders: 43% probiotic vs 65% PBO (P 0.167), w/ no change in gut permeability markers or stool https://t.co/0JUZ8SrRuw
Dr. John Cush
@RheumNow
Study of Prognostic Nutritional Index (PNI) in 984 RA pts shows PNI is independently inversely corelated w/ RA dz activity, esp. PNI <45. PNI = ser albumin & lymphocyte count calculation (10 × s albumin [g/dL]) + (0.005 × lymphocyte count/mm³]). Other studies have shown modest https://t.co/AV3AGXwSfg
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