Influential Rheumatoid Factors (5.8.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com
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ANCA assoc. pachymeningitis (AAP) is rare. 230 systemic vasculitis, from 177 reports (108 MPO+, 71 PR3+); age~60; HA & cranial neuropathy (hearing/visual loss, diplopia) common. 89% w/ systemic Sxs (ENT, lungs, orbits, kidneys). Look for abnl ESR/CRP, CSF https://t.co/bHQegYYl5V https://t.co/hpfu8iaIkx
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Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/8VnmVsuU2h
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True or False: HLA-B27 positivity in psoriatic arthritis is associated with earlier disease onset and a higher prevalence of axial involvement. Put your knowledge to the test in this week's RheumIQ quiz at https://t.co/KVK8J2iaFQ https://t.co/SZZqaNvO2Z
Dr. John Cush @RheumNow( View Tweet )
Gout Control Lowers Cardiovascular Events
A large target emulation trial suggests that gout patients prescribed urate-lowering treatment who achieve a serum urate level lower than 6 mg/dL significantly lower their risk of cardiovascular events.
Cohorts were derived from the Clinical Practice Research
Review of Toll-like Receptor Research
EurekAlert!
A new review on Toll-like receptors (TLRs) systematically summarizes forty years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding
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HLA-B27 in PsA: assoc w/ earlier onset, axial Dz, enthesitis, systemic inflammation. Study of 333 CASPAR PsA pts - 12% HLA-B27 positive--earlier onset (43 v 49), axial (46 v 24%), enthesitis (33 v 18%). No signif differences in sex, dactylitis, uveitis, Rx responses, https://t.co/ALP6AnygSf
Dr. John Cush @RheumNow( View Tweet )
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/TmoodnuJTe
Dr. John Cush @RheumNow( View Tweet )
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
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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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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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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
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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
Links:
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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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
