Nutrition/Obesity

RT @ericdeinMD #RNL26 Haque Effect of GLP1 on Pts with RA Retrospective study Significant reduction is RA disease activity (P=0.03), VAS pain (p<0.001), weight, cholesterol and A1c But 1/3 stopped due to side effects (mostly GI) https://t.co/SNHTcRFmAX
Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinMD #RNL26 Haque TOGETHER-PsA -P3B study of IXE v IXE + Tirzepatide BMI >27 + 1 wt related co-morbidity -Endpts - ACR and >10% weight reduction -ACR50 improved 33.5% compared to 20% IXE alone (p<0.05) https://t.co/KCpqbg3fHs https://t.co/zktIkdumDk

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Dr. John Cush @RheumNow( View Tweet )
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Maui Potpourri (2.13.2026)

Jack Cush, MD

Dr. Jack Cush reviews the hot item takeaways from last week's RheumNow.Live 2026.

  1. Diet & Obesity Management in Rheumatology - Uzma Haque, MD
  2. Mitigating risk for Rheum patients undergoing orthopedic surgery - Susan Goodman, MD
  3. Paradoxical skin reactions – Joseph
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Incretins/GLP-1s are being investigated widely. @RWCSmtg #RWCS26 https://t.co/57JzRJfK8l
Dr. John Cush @RheumNow( View Tweet )
Most inhibition of inflammation is via the brain. More GLP1 and GIP1 receptors are in the brain, more than the gut. @RWCSmtg #RWCS26 https://t.co/CNzUqteBLg
Dr. John Cush @RheumNow( View Tweet )
The hx and timeline of GLP1a development. @RWCSmtg #RWCS26 https://t.co/7tPgcRy4Ze
Dr. John Cush @RheumNow( View Tweet )
Dr. Willa Tsueh taking on hx of GLP-1 agonists. The first ones, Victoza and Tulicity go back to 2010. @RWCSmtg #RWCS26 https://t.co/cKiDCM5xw6
Dr. John Cush @RheumNow( View Tweet )
#RNL26 Haque @HopkinsRheum 1/2 of Americans will be obese by 2030 "Obesity is common & obesity is expensive" Adipose tissue - active endocrine organ -> cytokines, chemokines, adipokines Leads to inflamm axis - risk factor similar to 🚬, higher activity, worse response https://t.co/yQLTpE7reY
Dr. John Cush @RheumNow( View Tweet )
RT @Gibson_RheumPAC GLP-1 receptor agonists do more than promote weight loss. They impact insulin resistance, inflammation, cardiovascular risk—and may influence musculoskeletal disease. #RNL26 https://t.co/ypKnOJojAm
Dr. John Cush @RheumNow( View Tweet )
RT @Gibson_RheumPAC Obesity doesn’t just increase risk of rheumatic diseases-it worsens outcomes. Patients with obesity have higher disease activity, poorer biologic response, and 20–25% lower remission rates in inflammatory arthritis. #RNL26

Dr. John Cush @RheumNow( View Tweet )

Haque and Goodman

Obesity, Surgery, and Optimizing Patient Care

Eric Dein, MD

Rheumatologic care involves multidisciplinary approaches and collaboration with specialties to treat complex, systemic diseases. While many Pods at RheumNow Live are disease specific, the Pod II focused on Advancing Practice on important and emerging areas affecting rheumatologic patients. This

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RT @Gibson_RheumPAC Nearly 50% of U.S. adults may meet criteria for obesity by 2030. For rheumatologists, it directly impacts disease activity, outcomes, and treatment response. #RNL26 https://t.co/cpy4LBBPHc
Dr. John Cush @RheumNow( View Tweet )
Semaglutide ameliorates osteoarthritis via wt loss-independent mechanism. GLP-1R agonist exhibits OA chondroprotective effects in a mouse model of obesity by changing chondrocyte metabolism from glycolysis to oxidative phosphorylation via the “GLP-1R-AMPK-PFKFB3” axis.

Dr. John Cush @RheumNow( View Tweet )

Factors that may augment future development of SLE - includes Vitamin D levels, poor sleep, EBV reactivation & social determinants of health. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/2J1JBjeXKU
Dr. John Cush @RheumNow( View Tweet )
Factors that may augment future development of SLE - includes Vitamin D levels, poor sleep, EBV reactivation & social determinants of health. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/e3TKATcxXB
Dr. John Cush @RheumNow( View Tweet )
Gout pills injection

SGLT2 Inhibitors in Gout - Better Outcomes, Fewer Meds

EurekAlert!

Natalie McCormick, PhD, of the Rheumatology and Allergy Clinical Epidemiology Research (RACER) Center within the Division of Rheumatology in the Mass General Brigham Department of

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Physical activity (PA) is assoc w/ reduced all-cause mortality in RA pts. Study of 1493 NHANES & 1724 UK Biobank RA cohorts showing robust inverse association between PA and all-cause mortality (HR: active = 0.48, highly active = 0.61) https://t.co/K6ALzqP3QQ https://t.co/2XJ0zD7FA3

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Dr. John Cush @RheumNow( View Tweet )
DARWIN study ADHD med use among children and adults in Europe (Belgium, Germany, Netherlands, Spain, UK) more than doubled betw 2010 to 2023. IN UK use went up 20X in females, 15X males. (Ed. note: ADHD meds-->poor sleep-->fibromyalgia-->MSK pains) https://t.co/KlvUF1vhhj https://t.co/yEWXwM0WBL

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Dr. John Cush @RheumNow( View Tweet )
gout target T2T

Treat-to-Target in Gout and Cardiovascular Outcomes

Jack Cush, MD

A 5 year JAMA study shows that a treat-to-target (serum urate < 6 mg/dL) study finds that effective urate-lowering treatment (ULT) results in a significantly reduced cardiovascular risk in patients with gout. 

These findinds are significant knowing that

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2025

The 2025 Rheumatology Year in Review

Jack Cush, MD

The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.

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GLP-1 Agonist plus IL-17 Inhibition in Obese Psoriatic Arthritis Lilly announced the topline results from its phase 3b "TOGETHER PsA" trial, showing that the combination use of ixekizumab (Taltz) and tirzepatide (Zepbound) was superior to IXE alone, yielding both significant https://t.co/8fOXWULH7w
Dr. John Cush @RheumNow( View Tweet )
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2026 Resolutions (1.9.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, announcements and journal articles from this past week on RheumNow.com. More on Variable bendability, a better way to treat RA, and a novel advance for GLP1a in PsA; and 2026 Resolutions!

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Plenty of evidence that toxic environmental exposures increase #RA risk. Full read, intelligent report from Stanhope et al showing how (healthy environmental) green space exposures are protective & capable of preventing RA!! Lifestyle is gigantically important in your https://t.co/LUWmHhUT7F
Dr. John Cush @RheumNow( View Tweet )
obese.waist_.jpg

GLP-1 Agonist plus IL-17 Inhibition in Obese Psoriatic Arthritis

Jack Cush, MD

Lilly announced the topline results from its phase 3b "TOGETHER PsA" trial, showing that the combination use of ixekizumab (Taltz) and tirzepatide (Zepbound) was superior to IXE alone, yielding both significant weight loss and ACR50 disease control in adults with active psoriatic arthritis (PsA

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Obesity and Low Back Pain A large patient population study finds weight gain, increases risk for low back pain - the risk increased 7% for every BMI unit or 10 pounds over ideal weight. https://t.co/EZQwhLpNjg https://t.co/tIlEQmedp7

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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’. Read Post

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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Rx Updates (filtered for Topic)

Therapeutic Updates

The Impact of Obesity on Psoriatic Arthritis

Sponsored by Lilly Medical Affairs
Lilly February RX Update Revised Image
Image alt text: A person indoors raises one arm in a flexed pose while holding the elbow with the opposite hand. Is obesity common in your patients with PsA? Learn more about the intersection of disease pathogenesis between PsA and obesity and how weight intervention can affect PsA outcomes.
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