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Labs/Biomarkers

A Case of Sweet Syndrome

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
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.

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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
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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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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
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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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Gout: Diagnosis The diagnosis of gout - labs, imaging and polarized microscopy, created by @MithuRheum for RheumNow. https://t.co/s8gkANFJSB https://t.co/pkUeFLG5if
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
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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 )

New Avacopan Analysis Sent to FDA

MedPage Today

After data manipulation allegations, the FDA has been calling for the vasculitis drug to be pulled from the market since January.

Amgen has submitted a third-party review of avacopan's (Tavneos) pivotal trial data and other analyses to the FDA in a bid to keep the embattled drug for

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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/0BDDvR5cUB
Dr. John Cush @RheumNow( View Tweet )

Uricase-Targeted Therapies in Gout

In most mammals, uricase catalyzes the oxidation of uric acid to allantoin, a highly soluble compound easily excreted by the kidneys. But humans lack functional uricase, leaving xanthine oxidase inhibitors (allopurinol/febuxostat) as first-line urate-lowering therapy (ULT). Uricase-based

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