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Labs/Biomarkers

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

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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
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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 )
Pitfalls of autoimmune serologic testing Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of serological autoimmune markers. https://t.co/QDWTRgdlOh https://t.co/3hvM1OBcMC
Dr. John Cush @RheumNow( View Tweet )

Rheumatology Pitfalls (3.20.2026)

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

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Prospective multinational cohort of 1180 lupus pts, followed ~2.7 yrs. 37% had renal biopsies (Class III/IV 56%). They achieved mCRR 46%, mPERR 53%, LLDAS 60%, & REMission 46% at least once. renal response highest @ 2 yrs. New organ damage 11% @ 1yr; 33% by 5yr. https://t.co/ugh60M08Xf
Dr. John Cush @RheumNow( View Tweet )

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. 

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Urinary biomarkers improve w/ anifrolumab in TULIP-LN (lupus nephritis) trial; 112 pts, 197 uriniary proteins assessed. Urinary CD163 and MCP-1 signif improved as early as wk 12. Anifrolumab reduced the proteomic inflammatory signature, regardless of responder status https://t.co/n6fIJVDCN1
Dr. John Cush @RheumNow( View Tweet )
Pitfalls of autoimmune serologic testing Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of serological autoimmune markers. https://t.co/VKosO3bVL2 https://t.co/4FTvTcrGJa
Dr. John Cush @RheumNow( View Tweet )
Cross-sectional study of 180 PMR pts compared dz activity by PMR-AS to Systemic Immune-Inflammation Index (SII = Plts × PMNs/Lymphs) using CBC.48% had mod-hi dz (PMR-AS >=7). SII had moderate correlation with PMR-AS (r = 0.47), possibly useful in monitoring PMR https://t.co/vG1alSdVRU
Dr. John Cush @RheumNow( View Tweet )

Pitfalls of autoimmune serologic testing

Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of  serological autoimmune markers. 

A current review focuses commonly used serologies and autoimmune tests to identify

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Worldwide Trends in Hyperuricemia

A Lancet Rheumatology systematic review shows the prevalence of hyperuricaemia has risen markedly over the past two decades in both men and women, owing to population growth, aging, and increasing age-specific rates

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Metanalysis of calcineurin inhib. in RA - 11 RCTs, 1793 RA pts. Cyclosporin (CSA( (RR 1.6 & Tacrolimus (TAC (RR 2.1) signif improved ACR20 responses. CSA was dose dependent, less so w/ TAC. Both require serum Creat. monitoring consistent increase in s-Cr https://t.co/OxNGYbupnt https://t.co/F08vDCMYtr
Dr. John Cush @RheumNow( View Tweet )
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