A Patient’s Plea for a New Paradigm in Autoimmune Disease
A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?
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Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis
Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.
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Among 1074 #PsA tested annually, RF positivity was found in 16.1% overall (5.1% RF+ at baseline). RF+ rediced odds of MDA (OR 0.53) w/ incr risk of bDMARD discontinuation (OR 2.65) https://t.co/AmG6hkWABW https://t.co/MYhkfxAh0r
Dr. John Cush @RheumNow( View Tweet )
Study of 216 RA pts - Serum IL-8 independently assoc w/ RA Dz activity. CRP & IL-6 significantly associated w/ higher IL-8 levels, but RF & CCP did not. IL-8 also correlated w/ CV risk (SCORE2) & carotid intima media thickness https://t.co/aqUoAeXFFP https://t.co/ZW7OAx8YGK
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Dr. John Cush @RheumNow( View Tweet )
Dental study from India assessed periodontal Dz (PD) in 170 RA vs 170 non-RA pts. RA had more PD, ^ESR, more mild PD (39% v 29%). DAS-28 correlated w/ PD severity. Pts w/ periodontitis had 3X ods of RA (OR = 2.9) /https://t.co/bvOnFzbRcd https://t.co/cSxfiIR4iS
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Dr. John Cush @RheumNow( View Tweet )
Arthralgia w/ HIGH ACPA level >3x ULN) has a 30–50% probability of being diagnosed with RA within 3–5 years https://t.co/iJTyMQM480
Dr. John Cush @RheumNow( View Tweet )
Severe thrombocytopenia (TP) assoc w/ severe APS & increased mortality. Retro study of 432 #APS pts - 142 w/ TP (33%): 13% severe TP (<50L G/L). Severe TP assoc w/ ITP & CAP -had higher mortality https://t.co/7f8VpIcEJy
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Dr. John Cush @RheumNow( View Tweet )
Severe thrombocytopenia (TP) assoc w/ severe APS & increased mortality. Retro study of 432 #APS pts - 142 w/ TP (33%): 13% severe TP (<50L G/L). Severe TP assoc w/ ITP & CAP -had higher mortality https://t.co/p0bvLKupUe
Dr. John Cush @RheumNow( View Tweet )
Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Still's Disease Update
Arthritis Research & Therapy has published an overarching review of Still's disease - claiming it to be a single acquired and complex autoinflammatory disease in which both pediatric and adult forms share core pathogenic mechanisms, genetic associations and clinical presentations, with minor
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Potential new mechanism of MTX Effx - MTX polyglutamates accumulates in monocytes by D5, modulates transcriptional signature “non-classical monocyte”-assoc genes by Wk4, & predicts MTX responses https://t.co/g14GONKgvq https://t.co/oyoua9xAN4
Dr. John Cush @RheumNow( View Tweet )
Screening High Risk Myositis Patients for Cancer
An Italian retrospective study of 411 idiopathic inflammatory myopathies (IIM) patients applied IMACS criteria to assess the risk of cancer and found significantly more cancers in those at high risk.
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Top Four and More (4.10.2026)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.
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JAMA Guideline on the Management of Crohn Disease
JAMA has published a current Clinical Guidelines Synopsis on the Management of Crohn Disease (CD) in Adults.
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Machine learning predicts macrophage activation syndrome in adult Still's disease - 312 AOSD - XGBoost model had 5 predictors: ferritin, splenomegaly, Plt#, cholesterol, & ESR (AUC 0.839, sensit 0.824, specificity 0.710. https://t.co/QrogaCYPCT https://t.co/Z6WgCnFTfx
Dr. John Cush @RheumNow( View Tweet )
"When there are conflicting diagnostic possibilities, trust your excellent history and physical examination more than laboratory testing and imaging."
- Arthur Weinstein, MD
Dr. John Cush @RheumNow( View Tweet )
What’s New PsA? (4.3.2026)
Dr. Jack Cush reviews the news and major articles from this week, including FDA safety warnings, reports from AAD, PsA trials.
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Advanced Practice Rheum: Rheumatoid & Inflammation Testing
In this review, we'll be talking about labs, inflammation, and tests for rheumatoid arthritis.
https://t.co/UbEoBz37hT https://t.co/V9WzfRtbFQ
Dr. John Cush @RheumNow( View Tweet )
FDA Safety Warning: Avacopan and Serious Liver Injury
Yesterday the FDA issued a Drug Safety Communication alerting patients and health care professionals about postmarketing identification of serious (drug induced) liver injury, including fatal cases, associated with the use of avacopan (Tavneos) in patients with ANCA- associated vasculitis.
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Review: Rheumatoid Arthritis–Associated Interstitial Lung Disease
RA-ILD represents the most severe extra-articular manifestation of rheumatoid arthritis, affecting an estimated 1% of the adult population in the US and Northern Europe. Prevalence estimates vary widely (up to 58%), reflecting different diagnostic criteria, imaging modalities, and study
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Advanced Practice Rheum: Rheumatoid & Inflammation Testing
In this review, we'll be talking about labs, inflammation, and tests for rheumatoid arthritis.
https://t.co/UlBuUhtB01 https://t.co/09OEk1OLs2
Dr. John Cush @RheumNow( View Tweet )
A retrospective cohort study of 195 renal Bx from 135 Lupus Nephritis pts, Mod-Severe interstitial fibrosis and tubular atrophy (IFTA) strongly assoc w/non-renal response & ESRD progression (HR 8.9) (also w/ age, SLE duration, prior LN flares, higher chronicity index) https://t.co/773xsk6IHZ
Dr. John Cush @RheumNow( View Tweet )
Moral Distress (3.27.2026)
Dr. Jack Cush reviews the journal reports and news from RheumNow.com. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
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Predictors of Response in Lupus
A systematic review suggests that traditional measures (serologies and disease activity) are superior to biomarkers in predicting response to biologics in systemic lupus erythematosus (SLE) patients.
https://t.co/7YuYpoDctR https://t.co/J5VLrkDQ6G
Dr. John Cush @RheumNow( View Tweet )
A retrospective cohort study of 195 renal Bx from 135 Lupus Nephritis pts, Mod-Severe interstitial fibrosis and tubular atrophy (IFTA) strongly assoc w/non-renal response & ESRD progression (HR 8.9) (also w/ age, SLE duration, prior LN flares, higher chronicity index) https://t.co/3JGLi5R5Fs
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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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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Master the dos and don'ts of ordering RF, CCP (ACPA), and inflammatory markers that could transform your diagnostic accuracy.
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Podcasts
EULAR 2021 - Day2d00:23:12
