Labs/Biomarkers

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ICYMI: Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs

Jack Cush, MD

A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (

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In >228k CTD patients across France, ILD increased mortality risk across all CTDs. Proportion of incident CTD with ILD highest in IIM (37%). Up to 34% of CTD-ILD pts had progressive pulm fibrosis. Supports earlier ILD screening & vigilance in CTDs. @RheumNow #EULAR2025 #OP0033 https://t.co/nEiTWQEqsP
Dr. John Cush @RheumNow( View Tweet )
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ICYMI: TNF Inhibitor Drug-Induced Lupus

Jack Cush, MD

A study from the FDA's adverse event reporting system (FAERS or Medwatch) database identified cases of drug induced systemic lupus erythematosus (SLE) in patients receiving tumor necrosis factor-α (TNF-α) inhibitors - a paradoxical reaction to common antiinflammatory biologic agents.

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ICYMI: Is Rheumatoid Arthritis Becoming Milder?

Jack Cush, MD

A 24 year, prospective study analyzing very early rheumatoid arthritis (RA) in three consecutive eras suggests that RA has evolved since 2005, demonstrating less seropositivity, inflammation, and erosions but is characterized by more comorbidity, smoking and corticosteroid use.

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HLA-B27 Testing in Practice A single center study shows HLA-B27 testing is often performed by both by rheumatologists and nonrheumatologists for a wide array of reasons and often along with other serologic tests. Optimal use of HLA-B27 testing has yet to be defined. https://t.co/oq7GNhzwZd
Dr. John Cush @RheumNow( View Tweet )
JAMA Clinical Challenge - 34-yoF with Forearm Pain and Stiffness. 1 yr of progressive skin tightening over forearms, tibia, LOM of fingers & elbows. Denied DM, Raynauds. Worse after tennis, better w/ steroids. Increased ANA, eosinophils, CRP, aldolase - your Dx? https://t.co/5VrE4OpZ4N
Dr. John Cush @RheumNow( View Tweet )
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ICYMI: Axial Involvement in Psoriatic Arthritis

Jack Cush, MD

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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PCR: Prevalence, Cost, & Risk (6.27.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from last week on RheumNow.com

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Prospective KORAIL study of 138 RA pts w/ ILD on chest CT -60% had UIP ILD. After F/U of 2.9 yrs, 35% had RA-ILD progression. Baseline predictors of progression = UIP, ILD >10 %, DLCO %pred, CCP+, KL-6 levels, RA Dz activity. Useful to ID high-risk RA-ILD pts.

Dr. John Cush @RheumNow( View Tweet )

Aortic aneurysms w/ GCA. TriNetX study of 7,294 Bx-proven GCA vs 265,948 controls w/ tension HA. GCA had signif higher 5-yr risk of aortic aneurysms (3.59%; aHR 1.98), including thoracic thoracoabdominal & abdominal. Carotid A stenosis also incr in GCA (aHR 1.59) https://t.co/15fwlHa0FG
Dr. John Cush @RheumNow( View Tweet )
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HLA-B27 Testing in Practice

Jack Cush, MD

A single center study shows HLA-B27 testing is often performed by both by rheumatologists and nonrheumatologists for a wide array of reasons and often along with other serologic tests. Optimal use of HLA-B27 testing has yet to be defined.

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A Review of Intracranial GCA

Jack Cush, MD

A comprehensive review in Rheumatology on intracranial giant cell arteritis (icGCA) stresses that GCA is both an intracranial and extracranial large vessel vasculitis, with the former having unique presentations, and outcomes.

A systematic review included 102

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Several studies have shown predictive value to monocyte counts in RA responses. UK study of 246 #RA pts showed pretreatment absolute monocyte count [ORadj 9.56; 1.61-59.86, p = 0.01) predicted bDMARD nonresponse @ 6 mos. Replicates other reports! https://t.co/GqGj8R0wq1 https://t.co/HJ7wFBoxGE

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Dr. John Cush @RheumNow( View Tweet )
#EULAR2025 Abstr#OP0265 Do we have convenient biomarkers to help predict new ANA+ referral who would progress to #SLE #Sjogren at 12 mths? Proteomics analysis identified IFN and B-cell markers. Validation is needed and to incorporate clinical items into prognostic model @RheumNow https://t.co/TWClLTKQ0b

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
#EULAR2025 Abstr#POS0318 Single timepoint assessment may not show true picture of #SLE control. Data from BILAG-BR registry using machine learning showed 6 trajectories with clinical meaning: -Nonresponse with high activity: dsDNA-ve & RNP+ -Response-flare: active MSK @RheumNow https://t.co/VrI8e4ONtM

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Is there an association btwn ⬆️ CRP & cardiovascular dysfunction in #axSpA? 🔹️245 pts 🔹️CRP recorded for past 5y 🔹️sustained high CRP in 40% 🔹️associated with ⬆️ cardiovascular risk factors, ⬇️endothelial function & subclin atheroslerosis POS0714 #EULAR2025 @RheumNow https://t.co/jAlj3sr95H

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
Despite the evolution of anti-synthetase antibodies, there’s a clear need for better ways to define the disease. Enter the ACR/EULAR CLASS initiative - classification criteria for anti-synthetase syndrome ⬇️ see the next tweet #EULAR2025 @RheumNow https://t.co/Z3rPOt1vlx

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David Liew @drdavidliew( View Tweet )
1st #recommendations for #Hemochromatosis #arthropathy #psuedogout #CPPD #calcium #pyrophosphate #arthritis #EULAR2025 #Recommenadations II @RheumNow @eular_org https://t.co/AnE4T2wYoa

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Janet Pope @Janetbirdope( View Tweet )
Procalcitonin can be used in the monitoring of infection, but is also high in Stills disease. 89 AOSD pts showed pts w high PCT had more pleuritis, MAS,^LFTs, & correlated w/ Dz activity, CRP, LDH, hi ferritin & normalized w bDMARD Rx. #EULAR2025 abstr #POS1118 https://t.co/NpRA9optd3
Dr. John Cush @RheumNow( View Tweet )
KORAIL cohort: new RA-ILD progression model (inc. DLCO, ILD pattern/extent, anti-CCP, ± KL-6) stratified risk with high sensitivity & specificity. Adding KL-6 boosted AUC to 0.75. A step toward personalised care in RA-ILD. @RheumNow #EULAR2025 #OP0328 https://t.co/AHqNFw40gk

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Mrinalini Dey @DrMiniDey( View Tweet )
Prediction of PsA in PSO pts: does it work? First predictive model using mainly clinical data and labs extracted from primary care Performs well in the cohort it was trained w/ but not in validation cohort. Often an issue with prediction models! Needs more granularity than https://t.co/5cVgqfd4fX

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Aurelie Najm @AurelieRheumo( View Tweet )
🔍MRI lesions in early axSpA vs non axSpA with chronic back pain: -Data from SPACE cohort -n 318 (214 axSpA vs 108 non-axSpA). -Baseline imaging (CR and MRI) and at 2y f/u -Minimal progression on CR in both early axSpA and non-axSpA CBP. -On MRI, significant increase in the https://t.co/m5YOAiFUz1

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Adela Castro @AdelaCastro222( View Tweet )
In 1314 PsA patients, cumulative methotrexate dose was not associated with liver fibrosis (OR 0.99). Instead, higher BMI (OR 1.03) & diabetes (OR 5.03) were key drivers. MASLD, not MTX, may underlie fibrosis risk in PsA. APRI >0.7 used for fibrosis detection. Abstract#POS0111 https://t.co/zsX7NUOT9m

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Rheumatoid nodules are fascinating. If methotrexate nodulosis is a factor, why has their rate gone down when MTX use has gone up? Environmental factors? Something else? It’s still a bit of a mystery - we still don’t know why Christopher Edwards #EULAR2025 @RheumNow https://t.co/8LJYNRybve

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David Liew @drdavidliew( View Tweet )
Acute Dactylitis in #Psoriatic_Arthritis 🔹️1216 patients Canada 🇨🇦 🔹️52% had at least one episode of acute dactylitis in a median 12 years 🔹️Positive association with HLA-B27 and HLA-B27/C02 🔹️No association with HLA-B51 #EULAR2025 @RheumNow OP0180 by Kharouf et al. https://t.co/oNNMBcvVb4

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Nelly ZIADE 🍀 @Nellziade( View Tweet )

Recent Blogs

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Cush RhTh CNS
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose? Read Post

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PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives.  Read Post
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