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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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 )
Biomarker substudy from SENSCIS trial of nintedanib in SSc-ILD shows higher baseline KL-6 levels >1000 U/mL was assoc w/ greater FVC worsening; & decrease in CA-125 was assoc. w/ nintedanib responses. Epithelial cells are primary source of CA-125 in the lung https://t.co/7VJ2UDOKin
Dr. John Cush @RheumNow( View Tweet )
What's New in Lyme Disease
JAMA has published an overview of new considerations on Lyme disease, focusing on Diagnostics, Vaccines, and Prevention.
https://t.co/jG09wc6gI8 https://t.co/rQBW6RIz5U
Dr. John Cush @RheumNow( View Tweet )
Study of 364 Japanese myositis (IIM) pts - 42 (11.4%) had cancer-assoc myositis (CAM); 30/42 Dx w/in ±1 yr of IIM. CA risk incr ±3 yrs of IIM (SIR 2.54), highest 1st yr (SIR 8.66). 5 factors predicted CAM: TIF1γ +, ^CRP, dermatomyositis, older age, +FHx CA (AUC 0.86; sensitivity https://t.co/9ojTWTK5kO
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Congratulations to Dr. Edoardo Cipolletta (U Nottingham) - winner of Gout, Urate, and Crystal Deposition Disease Best PhD Thesis Award. Read his insightful interview on his reasearch on #gout. https://t.co/5i3hEV6PJX https://t.co/XV5trvEonW
Dr. John Cush @RheumNow( View Tweet )
Evaluating Inflammatory Joint Pain in Older Adults
Lee, Levinson, and Makris have published an approach to evaluating inflammatory joint pain in older adults in JAMA Internal Medicine. While intended to be a practical guide for primary care clinicians, the tenets and clues ring true for all.
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Wealth and Where you Live Influences Outcomes
EurekAlert!
Patients from wealthier European countries tend to start treatment with biologics earlier but also stop or switch treatment earlier. They also experience lower disease activity at treatment start than patients in middle- and low-income countries.
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What's New in Lyme Disease
JAMA has published an overview of new considerations on Lyme disease, focusing on Diagnostics, Vaccines, and Prevention.
Read Article
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/MHz8mdqDqi
Dr. John Cush @RheumNow( View Tweet )
Best proof of difference betw Seropos vs seroneg RA from TREAT-EARLIER 12 mos study 236 clinically suspect arthralgia pts w/ subclinical Jt inflammation Rx w/ MTX vs PBO. MTX prevented RA only the seroneg RA (9 v 35%); But no protection in seropos RA (58 vs 65%) https://t.co/ufY9ZJmKgf
Dr. John Cush @RheumNow( View Tweet )
U Alberta Rheumatology study of GCAPS score in 62 new onset, suspected GCA referrals. GCA Dx in 39 pts excluded in 23. 50% had a High risk GCAPS (screening) score, 38% Intermediate & 13% had Low risk GCAPs. Intermediate or High risk GCAPS sensitivity 97%, specificity 30%, PPV 70% https://t.co/gKD1Je3QRH
Dr. John Cush @RheumNow( View Tweet )
Best proof of difference betw Seropos vs seroneg RA from TREAT-EARLIER 12 mos study 236 clinically suspect arthralgia pts w/ subclinical Jt inflammation Rx w/ MTX vs PBO. MTX prevented RA only the seroneg RA (9 v 35%); But no protection in seropos RA (58 vs 65%) https://t.co/A5aFUgMPQR
Dr. John Cush @RheumNow( View Tweet )
U Alberta Rheumatology study of GCAPS score in 62 new onset, suspected GCA referrals. GCA Dx in 39 pts excluded in 23. 50% had a High risk GCAPS (screening) score, 38% Intermediate & 13% had Low risk GCAPs. Intermediate or High risk GCAPS sensitivity 97%, specificity 30%, PPV 70% https://t.co/HxHL60VAuO
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In a Cohort of 410 #SLE pts, there were 37 MALES who demonstrated a high prevalence of renal (IV/V lupus nephritis 49%) and a notable incidence of Plaquenil-related retinal toxicity. 62% on HCQ, but 22% D/C HCQ due to retinal toxicity or drug intolerance. https://t.co/FcIFxRoZ6O https://t.co/7OgexLYWge
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Retrospective study, 41 pediatric Behcets Dz pts looked at Inflam. indices (NLR, SII, PIV, CRP/albumin) vs controls. BD systemic involvement in 68%, CNS dz in 10%, Vascular Dz in 12% & major organ dz 46%. Inflamm indices significantly higher in BD w/ systemic, CNS, & Vasc https://t.co/wHiBIaOWWU
Dr. John Cush @RheumNow( View Tweet )
6 mos. RCT of low-dose baricitinib (Bari) plus danazol for refractory ITP (n 216); Pts Rx w/ either Bari+DNZ vs DNZ alone. At 6-mos a durable response was seen in 45% of Bari+DNZ vs 20% in DNZ monotherapy (P < 0.001). AEs were equal (48% vs 45%), More studies needed on this https://t.co/YbF49ZNA0E
Dr. John Cush @RheumNow( View Tweet )
Cerebral atrophy is common in SLE - assoc w/ age (OR 1.1), higher education (0.22), NPSLE (OR 4.6), cognitive impairment & lower dsDNA titers. 70 pts (mean age 40, Dz dur 12yrs). Cerebral atrophy 53% (mostly 76% mild). https://t.co/ewRmNj8zNA https://t.co/yT8TCXZREA
Dr. John Cush @RheumNow( View Tweet )
Gout: Diagnosis
The diagnosis of gout - labs, imaging and polarized microscopy, created by @MithuRheum for RheumNow.
https://t.co/s8gkANFJSB https://t.co/pkUeFLG5if
Links:
Dr. John Cush @RheumNow( View Tweet )
Interferon-α as an Immunologic Driver of Sjögren's Disease
Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and can be elevated a decade before diagnosis. This study assessed the role of type 1 interferon (IFNα) in its onset and https://t.co/Clj9u5COzQ
Dr. John Cush @RheumNow( View Tweet )
Methotrexate Safety Tips (7.31.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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The Wider Implications of Dactylitis
Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis.
https://t.co/HRaIvMHMSV https://t.co/XOcHbFVMsS
Dr. John Cush @RheumNow( View Tweet )
Four Decades of Gout Management
During this month-long campaign on Gout, we have documented many significant changes in our approach to gout, as well as many unmet needs and deficiencies that merit our continued, primary attention. We are all familiar with the famous 1905 quote, “Those who cannot remember the past
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2 T2T RCTs of 383 gout pts starting allopurinol - 31% had tophi. At 12 mos achieving target uric acid (<0.36mmol/L) was same in pts with and without tophi (70.3 vs 73.6), as was the %gout flares in month 11 (71.4% vs 79.7%; p=0.21). Allopurinol T2T success not influenced by https://t.co/zr7K8Y2Bqz
Dr. John Cush @RheumNow( View Tweet )
Therapeutic Updates
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
