Labs/Biomarkers

PSS & Biomarkers: Dutch international scleroderma trial of 21 pts showed that cartilage oligomeric matrix protein (COMP), and collagen type IV alpha 1 (COL4A1) significantly correlated with modified Rodnan skin score; COMP were associated with mRSS change (r = 0.013) https://t.co/E7SgmIiYmn
Dr. John Cush @RheumNow( View Tweet )
RHEUM Survey> In RA, seropositivity correlates best with what?

Dr. John Cush @RheumNow( View Tweet )

Simple, low-cost strategy to Dx/Prognose GCA using CBC components NLR & PLR. 119 GCA vs 131 non-GCA pts - All CBC biomarkers signif assoc w/ ESR & CRP, but ESR/CRP did not predict mortality over time; YET mortality signif predicted by PLR, NLR, MLR (P value <  0.044) https://t.co/96Q7jDAiWt
Dr. John Cush @RheumNow( View Tweet )
RHEUM Survey> What is the Sensitivity of the ANA test?

Dr. John Cush @RheumNow( View Tweet )

I agree that multiple assessments are needed to Dx NP-SLE; but my order of preference (for Dx yield) is: A) Hx c/w cerebritis; B) imaging to r/o other causes; C) CSF IgG index w/ Q albumin

Dr. John Cush @RheumNow( View Tweet )

2018 NHANES population survey of 28,040 individuals, 4168 (14.32%) identified with sleep disorders, and 1589 (4.28%) had #RA. Thus, sleep disorders were significantly associated with increased odds of RA (OR = 1.76, 95% CI: 1.46–2.13, P < 0.001). https://t.co/9O2MsLvwVe https://t.co/cBsm8Jt8Ks

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Dr. John Cush @RheumNow( View Tweet )
purpura

B Cell Targeting in Idiopathic Thrombocytopenic Purpura

EurekAlert!

The New England Journal of Medicine  has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune

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British Society of Rheumatology Guideline for Monitoring DMARDs

Jack Cush, MD

The British Society of Rheumatology has published an update to their previous 2017 BSR/BHPR guideline regarding the use and monitoring of DMARDs (disease-modifying anti-rheumatic drugs) used to treat systemic autoimmune rheumatic diseases (SARDs). 

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Hematologic Malignancies Increased in Systemic Sclerosis

Jack Cush, MD

Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.

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CBC & Psoriasis - case–control study 60 pts: 30 PsA & 30 PSO pts showed that PsA showed elevated WBCs, neutrophils, monocytes & inflammatory markers (NLR, MLR, SII, SIRI, & decr PMR (all p < 0.001). NLR 100% Dx accuracy (AUC = 1.000). WBC > 6.7, MLR > 0.17, & PMR ≤ 503 were https://t.co/AB7iFiMuSM
Dr. John Cush @RheumNow( View Tweet )
A New Disease Activity Score for Antiphospholipid Syndrome? APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and https://t.co/G2xGtOPmwb
Dr. John Cush @RheumNow( View Tweet )
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Turkey Tryptophan (11.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

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Subclinical Cardiac Dysfunction in Gout. ECHO study of 202 hyperuricemic (100 gout vs 102 asympt [asymSUA]) pts. VS. asymSUA, Gout pts had signific more LV Diastolic Dysfunc (31% vs 11%), lower LV ejection Fx (60 vs 65); questioning need for tailored CV monitoring in ^SUA pts https://t.co/gCOKKk7H05
Dr. John Cush @RheumNow( View Tweet )
Stills,continuum

Treating Refractory Still's Disease

Jack Cush, MD

A full read systematic review article examined treatment options for difficult to manage systemic juvenile idiopathic arthritis, or Still’s disease. It classified these refractory disease patients as those with either (1) persistent arthritis, (2) recurrent or difficult-to-treat

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Vitamin D and Lupus Outcomes (11.21.2025) Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow. https://t.co/M2e4kMi5H7 https://t.co/wEcAjWJSk7

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Dr. John Cush @RheumNow( View Tweet )
A New Disease Activity Score for Antiphospholipid Syndrome? APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and https://t.co/eouynDPLUX
Dr. John Cush @RheumNow( View Tweet )
Retrospective cohort study adult RA patients shows that TRIPLE Positivity (RF + /ACPA + /ANA +) was consistently associated with higher disease activity at baseline and 12 months of follow-up and lower rates of sustained remission compared to RF + /ACPA + /ANA- https://t.co/l2TQDShFYi
Dr. John Cush @RheumNow( View Tweet )
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Vitamin D and Lupus Outcomes (11.21.2025)

Jack Cush, MD

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

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Organ Involvement with Behçet’s

Jack Cush, MD

A review of patient data from the International AutoInflammatory Disease Alliance (AIDA) Network registry identifying those with mucocutaneous Behçet’s disease (BD) may progres to major organ involvement (MOI)m especially at later stages.

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Retrospective review of 113 AOSD pts, median age 45yrs, ferritin 4626 (IQR 1169–14,239). Advanced Rx (IVIG, IL-1, IL-6) required in 15 (13.3%), NOT predicted by ferritin levels, either measured continuously or by quartiles. Ferritin is not a reliable biomarker in AOSD. https://t.co/pHEPeIf9u2
Dr. John Cush @RheumNow( View Tweet )
Serum IL-1Ra levels are elevated in Lg vessel vasculitis - 21 active, Rx naive LVV pts (13 GCA, 8 TAK), IL-1Ra higher in TAK (465 pg/mL) & GCA (385 pg/mL) vs NLs (170). IL-6 also incr. in LVV, but IL-1β & IFN-γ incr in GCA & ^ IL-17in TAK. IL-1Ra correlate w/ CRP in GCA & https://t.co/TFDpK5DqcJ
Dr. John Cush @RheumNow( View Tweet )
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Seeking Musculoskeletal Care

Jack Cush, MD

A report entitled The Burden of Musculoskeletal Diseases in the United States (BMUS) report was published by the US Bone and Joint Decade (USBJD) with input from rheumatology, orthopedic surgery, physical medicine and rehabilitation regarding musculoskeletal care.

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Retrospective cohort study adult RA patients shows that TRIPLE Positivity (RF + /ACPA + /ANA +) was consistently associated with higher disease activity at baseline and 12 months of follow-up and lower rates of sustained remission compared to RF + /ACPA + /ANA- https://t.co/mLRCzczqXH
Dr. John Cush @RheumNow( View Tweet )
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25-Hydroxyvitamin D levels and Lupus Outcomes

MedPage Today

Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said.

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Hospital Mortality in Dermatomyositis A cohort study reveals that hospitalized patients with dermatomyositis have a higher in-hospital mortality rate in the presence of active rash, interstitial lung disease, and an elevated neutrophil-to-lymphocyte ratio at admission. https://t.co/6WIFVJT9w7
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

rheumthought

CNS Lupus (NPSLE)

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

Unpopular opinion: spinach can be bad for you

Lara El Khoury, MD
pro con unsure opinion thumbs debate
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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