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Labs/Biomarkers

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 )

Vitamin D and Lupus Outcomes (11.21.2025)

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

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 )

Seeking Musculoskeletal Care

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 )

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 )
+ANA's are common in pregnancy. Study of 2159 Chinese 1st trimester pregnant women found ANAs positivity in 14.7 % (1:100 most common titer; speckled most common pattern). ANA+ assoc w/ smoking, age 30-34 yrs, multiparity, thyroid Dz & hypertension https://t.co/mRQGajVe3g https://t.co/DqE1KC4Kgo
Dr. John Cush @RheumNow( View Tweet )
SLE Prospect. Observational Study of 826 SLE pts over 3 yr for outcomes& IFN signature (IFNGS). 71% were IFNGS-high. IFNGS-high pts were younger. on GC w/ Hi SLEDAI-2K. SLEDAI-2K decreased over time, regardless of IFNGS. By 36mos, 45% had ≥1 flare; higher in IFNGS. https://t.co/CT70CvnOQ9
Dr. John Cush @RheumNow( View Tweet )
Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/JfcycqHvhl
Dr. John Cush @RheumNow( View Tweet )

Treating During Pregnancy (11.14.2025)

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

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Hospital Mortality in Dermatomyositis

A cohort study shows that hospitalized patients with dermatomyositis have higher in-hospital mortality in the presence of active rash, interstitial lung disease, and elevated neutrophil to lymphocyte ratio at admission.

Dermatomyositis (DM) has significiant

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Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/HepyZrYW5L
Dr. John Cush @RheumNow( View Tweet )
Mesothelin as a biomarker and potential therapeutic target in rheumatoid arthritis? Mesothelin is elevated in RA & animal models & promothes osteoclast differentiation & bony destruction. Blocking mesothelin has the potential to reduce bone destruction. https://t.co/WRXG91AqmJ https://t.co/hMgddPXhxG
Dr. John Cush @RheumNow( View Tweet )

IL-1 Inhibition in CPPD

Controlled clinical trials in patients with calcium Pyrophosphate Deposition Disease (CPPD) are scant. Now a metanalysis provides evidence that anakinra, an interleukin-1 inhibitor, is a promising alternative for patients with acute CPPD flares.

The purpose of this analysis is
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NHANES study of 4,622 adults, including 296 w/ RA, shows volatile organic compounds (VOCs) & metabolites (mVOCs) exposures increases the risk of #RA (OR: 1.23 - 1.37), especially in females. https://t.co/pBNLTRkyLn https://t.co/L6nVbYlBhD
Dr. John Cush @RheumNow( View Tweet )

New ACR 2025 Guidelines for Non-Renal Lupus

MedPage Today

Written by Lisa Sammaritano, MD, of the Hospital for Special Surgery in New York City, and a committee of nearly 50 other experts, the new guideline also stipulates that corticosteroids are OK for gaining symptom control in newly diagnosed patients and when flares erupt, but the duration should

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The Decade Ahead: Predicting Long-Term Proteinuria Risk in SLE Lupus nephritis affects almost half of patients with SLE and conveys a mortality rate of up to 30% at 10 years, with at least 10-22% of patients developing end-stage kidney disease. Early detection and diagnosis are https://t.co/ggoA2KsqXg
Dr. John Cush @RheumNow( View Tweet )

Deucravacitinib and Renal Function: Insights from the PAISLEY Trial

In the phase 2 PAISLEY trial, deucravacitinib met its primary and secondary endpoints, demonstrating efficacy across multiple clinical and patient-reported outcomes. However, the impact on renal function has remained unclear. An abstract presented at ACR provides new insights.

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Cellular Biomarkers of Rheumatoid Arthritis Dr. Jeffrey Sparks reports on four abstracts at #ACR25. https://t.co/ZO259DXIcW https://t.co/HOpgiXfYvM
Dr. John Cush @RheumNow( View Tweet )
B Cell Depletion: Check the Lymph Node Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25. https://t.co/BjgIC3Kng0 https://t.co/flfyLZYW8q
Dr. John Cush @RheumNow( View Tweet )
This and other reports on palindromic rheumatism show that PR is a pre-clinical RA state, both having same predictive factors for progression to RA! https://t.co/jfpraGfe72

Dr. John Cush @RheumNow( View Tweet )

Taking a closer look: B-Cell depletion beyond the blood

Following the landmark case series by the Erlangen group, multiple cellular therapies have entered the race—each with unique targets, constructs, and mechanisms. Yet, a fundamental question remains: How deep is the B-cell depletion? In clinical practice, peripheral blood counts often serve as

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