Nutrition/Obesity

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Vitamin D in Rheumatic Disease - is it Good Enough?

Jack Cush, MD

Vitamin D deficiency or insufficiency of is highly prevalent and has been often associated with inflammatory rheumatic diseases, raising the question of whether inadequate vitamin D status contributes to immune dysregulation, incipient disease, increased disease activity, or poor skeletal
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U.S. spending on prescription drugs in 2025 jumped 13% to $915 billion=projected to surpass $1 trillion in 2026, according to ASHP/USA today. One major reason– the popularity of the weight-loss and diabetes drugs tirzepatide and semaglutide. https://t.co/EQ9yFCCdBp https://t.co/cig1jNp6NF

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Dr. John Cush @RheumNow( View Tweet )
Review of GLP-1 Receptor Agonists in Psoriasis Psoriasis is a chronic immune-mediated inflammatory disease plaqued by systemic comorbidities that increase morbidity, mortality, and treatment complexity. Obesity is a significant contributor to psoriatic disease. https://t.co/R1Uutdjcvz
Dr. John Cush @RheumNow( View Tweet )
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Review of GLP-1 Receptor Agonists in Psoriasis

Jack Cush, MD

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed cardiometabolic medicine and are now attracting intense interest in inflammatory disorders.

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Weight-loss drugs may affect joints directly A new study from Aarhus University shows that the hormone GLP-1, which is mimicked in medication for diabetes and weight loss, is present in joint fluid. In the long term, this may open up new treatments for arthritis. https://t.co/HkcPUQp05H
Dr. John Cush @RheumNow( View Tweet )
Weight-loss drugs may affect joints directly A new study from Aarhus University shows that the hormone GLP-1, which is mimicked in medication for diabetes and weight loss, is present in joint fluid. In the long term, this may open up new treatments for arthritis. https://t.co/xKm8Ng7fXO
Dr. John Cush @RheumNow( View Tweet )
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Weight-loss drugs may affect joints directly

EulrekAlert!

A new study from Aarhus University shows that the hormone GLP-1, which is mimicked in medication for diabetes and weight loss, is present in joint fluid. In the long term, this may open up new treatments for arthritis.

Rsearchers from the Department of Biomedicine at Aarhus

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NHIS 10yr survey of 195,600 Americans shows Chronic pain assoc w/ double rates of smoking & vaping. Smoking decr over time, but always higher in chronic pain pts (17.7% 2014, 13.1% in 2023) than w/o pain (12.5% 2014, 7.5% 2023). E-cigs incr over time, more w/ chronic pain https://t.co/iW7IDwHyJa
Dr. John Cush @RheumNow( View Tweet )
Global Study of #gout - incidence increased by 158% (from 1990 to 2023), during which mean onset agerose from 58 to 62 years; but % young-onset gout dropped 15.8% to 9.8%. #s due to aging, not younger onset. https://t.co/5pqMwPEnuj https://t.co/414vJHnBYi

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Dr. John Cush @RheumNow( View Tweet )
Couldn’t attend https://t.co/4UQlqwujiR 2026? You can now watch the entire meeting On Demand. This high-impact program features leading experts discussing: • RA outcomes and pathogenesis • Obesity, inflammation, and rheumatic disease • Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3

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Dr. John Cush @RheumNow( View Tweet )
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JAMA Guideline on the Management of Crohn Disease

Jack Cush, MD

JAMA has published a current Clinical Guidelines Synopsis on the Management of Crohn Disease (CD) in Adults.

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CDC: In 2023, age-adjusted prevalence of U.S. adults (>20 yrs) with obesity was 40.3% (9.7% with severe obesity; 31.7% overweight). BMI data from NHANES, & the National Center for Health Statistics https://t.co/kH9ajbUJ2m https://t.co/utbGWf4D12

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Dr. John Cush @RheumNow( View Tweet )
A new review of the GLP-1 receptor drugs @NEJM https://t.co/PK03jApZWB surprisingly, the word inflammation only appears once, in this diagram https://t.co/1PeBakBAQb

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Eric Topol @EricTopol( View Tweet )
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What’s New PsA? (4.3.2026)

Jack Cush, MD

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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Ixekizumab With Tirzepatide Efficacy in Obese Psoriatic Arthritis The TOGETHER-PsA trial has demonstrated the efficacy and safety of ixekizumab (IXE) administered with tirzepatide (TZP) in adult active psoriatic arthritis (PsA) patients who were overweight or obese. https://t.co/KFwfi9FaAh
Dr. John Cush @RheumNow( View Tweet )
Slim,waist,obese,obesity

Ixekizumab With Tirzepatide Efficacy in Obese Psoriatic Arthritis

Jack Cush, MD

The TOGETHER-PsA trial has demonstrated the efficacy and safety of ixekizumab (IXE) administered with tirzepatide (TZP) in adult active psoriatic arthritis (PsA) patients who were overweight or obese.

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New Dyslipidemia (Cholesterol) Guidelines from AHA/ACC: A) Check during childhood; B) Lower Targets: if 10-year ASCVD risk =10%, aim for LDL <70; if you have ASCVD/MI/CV, aim for 55; C) chk lipoprotein(a) once; D) supplements dont lower cholesterol - statins do. https://t.co/tRwdg6GHm8
Dr. John Cush @RheumNow( View Tweet )
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. https://t.co/qXx2tLcj8b https://t.co/bQ861Hkcb8

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Dr. John Cush @RheumNow( View Tweet )
Is BMI a risk factor for Palindromic rheumatism (PR)? Study of 147 PR patients and 294 matched HCs. No significant difference was observed in mean BMI between PR patients and HCs and overweight or obesity was not associated with an increased risk of PR. https://t.co/W7XehFVCTR https://t.co/YRPOeqR04j

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Dr. John Cush @RheumNow( View Tweet )
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Worldwide Trends in Hyperuricemia

Jack Cush, MD

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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International Osteoporosis Foundation (IOF) has developed a self-management website for people living with osteoporosis. The website focuses on providing education and resources for exercise, nutrition, home safety, and advice for care partners. https://t.co/T8TllaIipU https://t.co/V7ifRaTWZY

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Dr. John Cush @RheumNow( View Tweet )
Sodium-glucose cotransporter-2 (SGLT2) inhibitors lower serum uric acid levels, by approximately 0.6 to 1.5 mg/dL. They increase renal uric acid excretion via a uricosuric effect), thereby reducing gout risk by 30% to 50%. https://t.co/weXVOhpiP9 https://t.co/NsCRNi9JI9

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Dr. John Cush @RheumNow( View Tweet )
Prebiotic fibre improves knee OA. Study of 117 older adults w/ KOA Rx w/ 6wks of inulin (fibre) or Physiotherapy exercise (PSE) or both vs PBO. Both Inulin & PSE signif improved pain & PSE vs PBO ( −1.11 to -2.5; p <0.045); inulin also improved pain sensitivity & grip strength https://t.co/Efic4mru1i
Dr. John Cush @RheumNow( View Tweet )
Osteoporosis: Thinking outside the box Osteoporosis care keeps evolving. We have newer agents, newer sequencing strategies, and an increasing number of patients asking for “less medicinal” options that go beyond a prescription. https://t.co/1mGIrx8tm5 https://t.co/QVjeIwXESr

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Dr. John Cush @RheumNow( View Tweet )
GLP-1s are known to improved knee OA. Using a mouse OA model w/ obesity, semaglutide yielded less pain, osteophytes & had strong chondroprotective effects, fia a wt loss-independent way. Changing from glycolysis to oxidative phosphorylation resulted in cartilage restoration. https://t.co/8zs34ys9o9
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Comorbidities in RA: Focus on Difficult-to-Treat Disease

Elena Nikiphorou, MD, PhD
Puzzle pieces
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 in Rheumatoid Arthritis: A Precarious Stack of Blocks

Cynthia S. Crowson, PhD
stack of blocks

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.

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Complementary and Alternative Therapies in Psoriasis and Psoriatic Arthritis

Rachel Tate, DO
turmeric CAM
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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