Labs/Biomarkers

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

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Dr. John Cush @RheumNow( View Tweet )
Fever,temp,man,HA,thermometer

Misdiagnosis of Still's Disease

Jack Cush, MD

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 )
myositis.jpg

Efgartigimod Efficacy in Idiopathic Inflammatory Myopathy

Jack Cush, MD

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 )
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Doubting RS3PE (8.14.2026)

Jack Cush, MD

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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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 )
Sweets.JAMA2026

A Case of Sweet Syndrome

Jack Cush, MD

This overview appeared in JAMA Dermatology.

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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. https://t.co/jG09wc6gI8 https://t.co/rQBW6RIz5U

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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
Dr. John Cush @RheumNow( View Tweet )
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

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Dr. John Cush @RheumNow( View Tweet )
RA,polyarticular,black,rheumatoid

Evaluating Inflammatory Joint Pain in Older Adults

Jack Cush, MD

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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tick.jpg

What's New in Lyme Disease

Jack Cush, MD

JAMA has published an overview of new considerations on Lyme disease, focusing on Diagnostics, Vaccines, and Prevention.

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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/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
Dr. John Cush @RheumNow( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
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
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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

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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

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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 )

Therapeutic Updates

ILD Treatment and Guidelines

Hinze title card
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

Augurex Front End Image
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

ICYMI: Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
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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Advanced Practice Rheum

Systemic Lupus Erythematosus

Jack Cush, MD
APR SLE VIDEO COVER
Dr. Cush reviews systemic lupus erythematosus.
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Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
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.”
Read Post
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