Gout Cavalcade (7.10.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week. July is Gout: More than Flares month.
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Weight loss helps gout, but extreme weight loss (bariatric surgery, ketogenic diets) may trigger gouty attacks. (Not seen with GLP-1 agonist weight loss)
For more gout content, follow our Gout: More than Flares campaign at https://t.co/xnBVBN5IXZ, https://t.co/LGEENexSZ6
Dr. John Cush @RheumNow( View Tweet )
Long term F/U of Gout (CARES) trial (febuxostat vs allopurinol) shows remission increased from 37% (1,593/4,259) 1st Yr to 63% (322/510) at year 6. Over the 6 years, ~60 achieved remission at least once; more likely based on age, race, dz severity, comorbidities, & febuxostat
Dr. John Cush @RheumNow( View Tweet )
EULAR26: GLP-1 Agonist Use in the RISE Registry
At EULAR 2026, McCormick and Curtis et al presented data from the American College of Rheumatology’s (ACR) Rheumatology Informatics System for Effectiveness (RISE) registry on the use of GLP-1 agents in rheumatic diseases (RMD). https://t.co/EqgETKjN1v
Dr. John Cush @RheumNow( View Tweet )
ICYMI: 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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EULAR26: GLP-1 Agonist Use in the RISE Registry
EurekAlert!
At EULAR 2026, McCormick and Curtis et al presented data from the American College of Rheumatology’s (ACR) Rheumatology Informatics System for Effectiveness (RISE) registry on the use of GLP-1 agents in rheumatic diseases (RMD).
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Spotlight on Comorbidities from EULAR 2026
EurekAlert!
Systemic autoimmune diseases are associated with increased cardiovascular morbidity and mortality – possibly through autonomic imbalance, myocardial inflammation, or fibrotic infiltration of the conduction system. A team in Colombia have been looking into the
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20% sample of elder RA Medicare pts (2009-2022) on TNFi who either stopped or tapered TNFi found 38% sustained de-escalation, while 62% re-escalated within a medianof 164. Re-escalation was more likely in Blacks, Hispanic/other, with a lower comorbidity burden. https://t.co/rEB3VdOii2
Dr. John Cush @RheumNow( View Tweet )
Dietary Interventions in PsA
Dr. Peter Nash reports on several abstracts at the 2026 EULAR meeting in London, including: OP069; OP070 and POS0050.
https://t.co/VLldzkbFU3 https://t.co/5w5wstPawk
Dr. John Cush @RheumNow( View Tweet )
Risk of Psoriasis is increased 19% by long-term exposure to Particulate Matter (PM2.5 & PM10; adjHR 1.19), while short-term exposure increases risk of psoriasis exacerbation (adjusted OR 1.03). Stronger in younger, urban, lower SES, ever-smokers, & comorbid allergies https://t.co/pd6S13RG1B
Dr. John Cush @RheumNow( View Tweet )
Do u screen your SLE pts for OP?
In this real-world multicenter study, SLE pts who were likely to be tested for BMD were older, had MSK s/sxs, sSJg & longer GC exposure.
RFs for OP: LN, higher dse. activity, longer GC use, high cumulative GC dose
POS1372 @RheumNow #EULAR2026 https://t.co/pAxhOPGGYs
sheila @RHEUMarampa( View Tweet )
#OP0207 #EULAR2026: SUPERFIBRES trial suggests dietary fibre supplementation may enhance MTX response in RA. Inulin improved EULAR responses and Th17/Treg balance over 30 days, with strongest effects seen in MTX-treated patients. Fascinating microbiome-linked signal. @RheumNow https://t.co/nCvZlooamF
Mrinalini Dey @DrMiniDey( View Tweet )
Beyond the Scale: Do GLP-1RAs Offer More Than Weight Loss in PsA?
Over 70% of patients with psoriatic arthritis (PsA) struggle with excess weight, amplifying synovio-entheseal inflammation and blunting biologic response.
https://t.co/pAIXkdazci https://t.co/vQTn3BWv2r
Dr. John Cush @RheumNow( View Tweet )
CT imaging in RA
Body composition changes beyond BMI
489 RA vs 397 ctrl
RA asso w/
-increased subcutaneous fat
-increased intermuscular adipose tissue -poorer muscle quality
Looks like it represent “hidden obesity” with more by fat redistribution and myosteatosis
#OP0348
Aurelie Najm @AurelieRheumo( View Tweet )
Diet as a DMARD? The Evidence Is Still Hard to Swallow
Dietary interventions are rarely taken as seriously as pharmacological therapies in rheumatology. Yet patients ask about them constantly, and an increasing number of studies suggest that nutrition may influence disease https://t.co/BLrr3CNZMg
Dr. John Cush @RheumNow( View Tweet )
ETA+MTX vs triple therapy after MTX failure in #RA: machine learning-emulated RACAT trial (n=3,472 VA pts) confirms ETA+MTX modestly better overall. But smoking matters: benefit disappears in current smokers. Precision medicine from RWD. @RheumNow #EULAR2026 POS0255
Jiha Lee @JihaRheum( View Tweet )
💉Do GLP-1 agonists improve DMARD persistence in PsA/axSpA?
TriNetX real-world study (n=3,068): YES!
Better b/tsDMARD persistence and lower stroke & mortality risk
#POS0194 #EULAR2026 @rheumnow
Nelly ZIADE 🍀 @Nellziade( View Tweet )
@RheumNow HOT #Obesity session (7)
📢A call for action
Current RMD treatments ignore obesity:
They all target immune response but miss the metabolic-inflammatory loop
Breaking that cycle may be the missing piece
Obesity must be part of every rheumatology plan
#EULAR2026 @rheumnow
Nelly ZIADE 🍀 @Nellziade( View Tweet )
☂️What is an umbrella meta-analysis?
It's a meta-analysis of meta-analyses ☔️
⬇️This one showed the effect of diet supplementation on several RA outcomes
Unfortunately, most studies have low levels of evidence
#umbrella #rainy_London #EULAR2026 @rheumnow https://t.co/kYPchXEexn
Nelly ZIADE 🍀 @Nellziade( View Tweet )
🔥 TOGETHER-PsA (OP069) #EULAR2026 #EULARbest Ixekizumab + Tirzepatide vs IXE alone in PsA with obesity/overweight: ✅ Primary endpoint (ACR50 + ≥10% wt loss at W36): 31.7% vs. 0.8% (p<0.001) ✅ ACR50: 33.5% vs. 20.4% ✅ MDA: 26.3% vs. 15.3% (p=0.026) @rheumnow @DrLauraCoates https://t.co/6wh3S6khXw
Nelly ZIADE 🍀 @Nellziade( View Tweet )
⚖️ Does BMI outrank treatment in early PsA outcomes?
YES - SPEED trial AI analysis:
BMI #1 predictor of PASDAS at 1yr in 192pts
#OP0187 #EULAR2026 @RheumNow https://t.co/9cZG7AWau2
Nelly ZIADE 🍀 @Nellziade( View Tweet )
🦴 What drives enthesophytes in PsA?
SITE-SPECIFIC:
Pelvic driven by disease activity+BMI
Calcaneal by BMI+damage
in a 1596pts cohort
OP0182 #EULAR2026 @RheumNow https://t.co/4RxgjJ2V9u
Nelly ZIADE 🍀 @Nellziade( View Tweet )
@RheumNow WIN Nutrition session #EULAR2026 (4)
🌾 Gluten does NOT influence biologic response in RD, BELIEVE cohort, 197 pts. No need to go gluten-free unless celiac disease
🌱 Plants for Joints trial: plant-based diet + exercise → sustained DAS28&WOMAC improvement @ 2Y, RA/OA
@RheumNow
Nelly ZIADE 🍀 @Nellziade( View Tweet )
@RheumNow WIN Nutrition session at #EULAR2026 (3)
6.🍟 High UPF intake → increased RA risk (HR 1.06/SD), partly mediated by CRP. Not all NOVA-4 foods are equal
7.💊 Vit D supplementation significantly reduces SLE disease activity — MA of 10 RCTs, SMD −0.54 (p<0.00001).
@RheumNow
Nelly ZIADE 🍀 @Nellziade( View Tweet )
WIN Nutrition session at #EULAR2026 (2)
🐟 n-3 PUFAs reduce RA risk by 9–10% per SD increase — especially in genetically high-risk individuals.
🫒 Mediterranean diet reduces RA risk by 25% (HR 0.75) & SLE risk by 39% (HR 0.61) in UK Biobank studies.
@RheumNow
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Therapeutic Updates
Psoriatic arthritis and overweight or obesity
Sponsored by Lilly Medical Affairs
Dr. Merola presenting the results from TOGETHER‑PsA, a phase 3b trial evaluating the concomitant use of an IL‑17A antagonist and an incretin receptor agonist in adults with psoriatic arthritis and overweight or obesity.
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Recent Blogs
The presence of comorbidities naturally complicates treatment choice, patient adherence to medication and patient outcomes, increasing also the risk of making RA ‘difficult-to-treat’.
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Comorbidities can pile up like a stack of blocks for people with rheumatoid arthritis (RA). At the time when RA is diagnosed, they already have more comorbidities than their peers, and after RA diagnosis they accumulate comorbidities faster than their peers.
It’s been reported that approximately one-third to one-half of patients with psoriatic arthritis will try supplements and other complementary and alternative medicinal (CAM) practices without discussing with their rheumatologists. Of those, nearly 90% of PsA patients using CAM report benefits!
Here is your updated review on common supplement data in psoriasis and PsA.
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Podcasts
EULAR 2026 Daily Podcast Day 2a
