Nutrition/Obesity

SGLT2i use in gout reduces use of gout meds. Study of 26,739 gout pts w/ NIDDM (mean 66 yrs), 67% w/ polypharmacy. SGLT2i (vs DPP-4i) user had less Allopurinol starts (HR 0.62;0.52–0.73), also lower use of steroids (,78), NSAID (.85), colchicine (.87) & diuretics (.87) https://t.co/1dW27YzSvg
Dr. John Cush @RheumNow( View Tweet )
GI dz & malnutrition in scleroderma (SSc) is common, assessed by BMI. Among 450 SSc (F/U 5.3 yrs), lower BMI were significantly assoc w/ pseudoobstruction, smaller oral aperture, higher Medsger vascular severity scores. Defines those at risk https://t.co/w45OhUOUTh https://t.co/hWuIaS6OUe

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Dr. John Cush @RheumNow( View Tweet )
Gout in Minority Populations Recent research has revealed substantial racial and ethnic disparities in both who develops gout and the care patients receive. These differences reflect not only genetic susceptibility but also the substantial influence of social determinants of https://t.co/SKEsQVZPw6
Dr. John Cush @RheumNow( View Tweet )
ACP Position Paper on Dietary Supplements More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law allows supplements to reach the market without a premarket safety evaluation, unlike https://t.co/gwLG4ElfCq
Dr. John Cush @RheumNow( View Tweet )
Why Do Gout Flares Start at Night? The striking propensity for gout flares to initiate at night has been recognized for centuries. More recent epidemiological research supports this observation, indicating that the risk of a gout flare is more than twice as high in the early https://t.co/FbCUmXEl2y
Dr. John Cush @RheumNow( View Tweet )
EULAR meeting room

Psoriatic Arthritis: EULAR 2026 Recap

Jack Cush, MD

Years of IL-17 vs. IL-23 debate in PsA finally got tested head-to-head: bimekizumab outperformed risankizumab on joint outcomes in the BE BOLD trial, while a GLP-1 combination study suggests weight and metabolic status are active drivers of PsA — not just comorbidities. This recap also digs into

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ACP Position Paper on Dietary Supplements

Jack Cush, MD

More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives. The paper notes that under DSHEA, dietary

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Gout Cavalcade (7.10.2026)

Jack Cush, MD

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

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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 )
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ICYMI: 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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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

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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

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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

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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

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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 )

Therapeutic Updates

Psoriatic arthritis and overweight or obesity

Sponsored by Lilly Medical Affairs
Lilly RX Update
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

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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Podcasts

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