Labs/Biomarkers

Metanalysis looked at neutrophil to Lymph ration (NLR) in SLE - 31 studies, 4,006 SLE pts. NLR signif incr in SLE worldwide. NLR was higher in Active vs inactive SLE, and showed a significant but moderate correlation w/ SLEDAI (CC=0.354, p < 0.001). https://t.co/tA6UBb1wVo https://t.co/XoXrf6HlKL

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Dr. John Cush @RheumNow( View Tweet )
Ro52 Abs in idiopathic inflammatory myopathies (IIM). From 2,126 IIM China/Japan pts, Ro52 positivity was common (46%), esp in MDA5+ DM & anti-synthetase syndr (ASyS) & was assoc w/ high freq of ILD, rapidly progressive ILD, and poor prognosis. https://t.co/TA4gSnZax1 https://t.co/riYs5YJwQV

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Dr. John Cush @RheumNow( View Tweet )
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Treating Obesity is Disease-Modifying (9.4.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  New drugs approved, new drugs halted and some drugs out of control. Ready to test your knowlege? Take this week's quiz!

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Metanalysis looked at neutrophil to Lymph ration (NLR) in SLE - 31 studies, 4,006 SLE pts. NLR signif incr in SLE worldwide. NLR was higher in Active vs inactive SLE, and showed a significant but moderate correlation w/ SLEDAI (CC=0.354, p < 0.001). https://t.co/ROG5L4nfo2 https://t.co/9mqqId45lG

Links:

Dr. John Cush @RheumNow( View Tweet )
Ro52 Abs in idiopathic inflammatory myopathies (IIM). From 2,126 IIM China/Japan pts, Ro52 positivity was common (46%), esp in MDA5+ DM & anti-synthetase syndr (ASyS) & was assoc w/ high freq of ILD, rapidly progressive ILD, and poor prognosis. https://t.co/may6ZTJkvt https://t.co/EuinNbZUm7

Links:

Dr. John Cush @RheumNow( View Tweet )
Cancer.risk_.jpg

EUSTAR Registry - Cancer in Systemic Sclerosis

Jack Cush, MD

Cancer is a major cause of mortality in systemic sclerosis (SSc).  A nested case-control study within EUSTAR registry shows distinct patterns of cancer related temporally to SSc, serologic profiles and traditional cancer risk factors.

Cancers were

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JAK inhibitors work & have a dose dependent effect in severe alopecia areata (AA). Metanalysis of 10 Rxs, 3866 AA pts (used the SALT20 endpoint) showed the best efficacy was deuruxolitinib_12 mg, and baricitinib_4 mg (OR: 2.59, 95% CI: 1.98–3.38). https://t.co/k86f2RvCEJ https://t.co/N1fsrbbmDw

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Dr. John Cush @RheumNow( View Tweet )
Per adult-onset IgA vasculitis guidelines, which agent is now preferred for refractory or relapsing disease? Test your knowledge in this week's RheumIQ at https://t.co/TBlB4pmnKa. https://t.co/7tMcDkoCKH

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Dr. John Cush @RheumNow( View Tweet )
purpura

Guidelines for Adult-Onset IgA Vasculitis

Jack Cush, MD

A EUVAS-sponsored expert panel of 37 specialists across rheumatology, nephrology, dermatology and pathology has published evidence-based guidelines for adult-onset IgA vasculitis (IgAV), which behaves very differently in adults compared to usually self-limited childhood form.

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SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/DIe2OJhZIc
Dr. John Cush @RheumNow( View Tweet )
Misdiagnosis of Still's Disease High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be https://t.co/mCbNBAt9T5
Dr. John Cush @RheumNow( View Tweet )
QD Clinic: A Watched Tophus Never Resolves Dr. Jack Cush discusses his plan to medically manage multiple large volume tophi and a patient who has recently started urate lowering therapy with febuxostat. https://t.co/swfyYEeW0s https://t.co/wyLlcHR4Td

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Dr. John Cush @RheumNow( View Tweet )
Fever,temp,man,HA,thermometer

Misdiagnosis of Still's Disease

Jack Cush, MD

High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be misdiagnosed or mistreated. A current case review by

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SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/Savx5IOTcG
Dr. John Cush @RheumNow( View Tweet )
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Efgartigimod Efficacy in Idiopathic Inflammatory Myopathy

Jack Cush, MD

Today Argenx announced the results of their Phase 3 "ALKIVIA" study; demonstrating efficacy and safety of subcutaneous efgartigimod for Idiopathic Inflammatory Myopathy (IIM, AKA inflammatory myositis).

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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/s1VFhaOYgn
Dr. John Cush @RheumNow( View Tweet )
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Doubting RS3PE (8.14.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.

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Biomarker substudy from SENSCIS trial of nintedanib in SSc-ILD shows higher baseline KL-6 levels >1000 U/mL was assoc w/ greater FVC worsening; & decrease in CA-125 was assoc. w/ nintedanib responses. Epithelial cells are primary source of CA-125 in the lung https://t.co/7VJ2UDOKin
Dr. John Cush @RheumNow( View Tweet )
Sweets.JAMA2026

A Case of Sweet Syndrome

Jack Cush, MD

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

Links:

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
Dr. John Cush @RheumNow( View Tweet )
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

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Dr. John Cush @RheumNow( View Tweet )
RA,polyarticular,black,rheumatoid

Evaluating Inflammatory Joint Pain in Older Adults

Jack Cush, MD

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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tick.jpg

What's New in Lyme Disease

Jack Cush, MD

JAMA has published an overview of new considerations on Lyme disease, focusing on Diagnostics, Vaccines, and Prevention.

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Therapeutic Updates

ILD Treatment and Guidelines

Hinze title card
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

ICYMI: Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
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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Advanced Practice Rheum

Systemic Lupus Erythematosus

Jack Cush, MD
APR SLE VIDEO COVER
Dr. Cush reviews systemic lupus erythematosus.
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Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
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.”
Read Post
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