Nutrition/Obesity

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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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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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 )
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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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Adult co-twin study of 1261 pairs, 1/2 Rx w/ metformin. Although metformin Rx Twin had higher BMI, they had significantly less incident peripheral OA (adjusted HR 0.60; 0.44–0.82). @ 10 yrs, 6.7% of treated twins, vs 9.7% of non-treated twins had incident OA, with difference of https://t.co/7KpiGssFSo
Dr. John Cush @RheumNow( View Tweet )
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Obesity and Low Back Pain

EurekAlert!

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. 

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Best of 2025: Targeting Obesity in Rheumatic Disease Patients Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese. https://t.co/aPGuYFCWLo
Dr. John Cush @RheumNow( View Tweet )
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Best of 2025: Targeting Obesity in Rheumatic Disease Patients

Jack Cush, MD

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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Best of 2025: Vitamin D for Prevention of Disease JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults. https://t.co/PFHO7x5nxH https://t.co/fvwzLgYGJe

Links:

Dr. John Cush @RheumNow( View Tweet )
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Best of 2025: Vitamin D for Prevention of Disease

Jack Cush, MD

JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults.

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Lilly announced phase 3 RCT TRIUMPH-4, where Retatrutide, a new GIP, GLP-1 & glucagon recpt agonist, was given to obese (BMI >35), knee osteoarthritis pts *without diabetes*. Wt loss at 68 wks was 28.7% with reduced WOMAC pain scores of -4.5 points (75.8%) https://t.co/73yIyvwRtL
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MEDISPO study of 38 mild-mod psoriasis pts, 16-wk Mediterranean diet vs low-fat diet. Mediterranean diet did much better w/ PASI change −3.4 vs 0, more pts achieving a PASI 75 reduction (47.4% vs none) https://t.co/ZJU58VanGr https://t.co/x6juAT672B

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Dr. John Cush @RheumNow( View Tweet )
Retrospective EHR study of 38,327 COVID-19 infx pts & 1,143 whodeveloped post Covid Syndrome (PCC). PCC risk was signif higher in women & obese. Pre-COVID, psoriasis (OR 1.41) & RA (OR 1.64) had incr risk of PCC. Post COVID, more Sjögren’s (OR 4.05) among PCC. https://t.co/0Z48Hy43XY
Dr. John Cush @RheumNow( View Tweet )
Medical Cannabis for Pain Management Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients. https://t.co/kxTDqbzpgg https://t.co/fBumEAgISU

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Dr. John Cush @RheumNow( View Tweet )
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Reefer Madness (12.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com.  B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.

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Dr, Tuhina Neogi writes its time for a new understanding of OA; its not just wear n tear. Based on preclinical and clinical evidence, OA is a systemic, whole-body disease and that this should change future research and treatment of #OA. https://t.co/HQWI14WSXg https://t.co/5bIWgqaETU

Links:

Dr. John Cush @RheumNow( View Tweet )
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APPs in the News (12.5.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.

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WHO recommendations on GLP-1 agonists: 1) conditional recommendation - GLP-1 drugs can be used for for long-term obesity treatment by adults, except pregnant women; 2) GLP-1a use should be paired with a healthy diet and physical activity. Access to these drugs is a problem. https://t.co/jMa7rbJPby
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
A person indoors raises one arm in a flexed pose while holding the elbow with the opposite hand, with a sofa and light curtains in the background
Obesity is common in PsA and may worsen disease activity and reduce treatment effectiveness through shared inflammatory pathways. Weight intervention may improve outcomes and support achievement of targets of disease control.
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