Nutrition/Obesity

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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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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uricacid.jpg

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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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
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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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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 )
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SATISFACTION (2.27.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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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/YySGDHX9KO
Dr. John Cush @RheumNow( View Tweet )
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Referral Rules to Live By (2.20.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Highlights include referral rules, combination biiologics in psoriasis and don't use JAK inhibitors in pregnancy.

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Together PSO Trial - Combination Ixekizumab and Tirzepatide Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over https://t.co/YWCjN2NyGM
Dr. John Cush @RheumNow( View Tweet )
Slim,waist,obese,obesity

Together PSO Trial - Combination Ixekizumab and Tirzepatide

Jack Cush, MD

Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over IXE alone.

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Obesity, Surgery, and Optimizing Patient Care Rheumatologic care requires a multidisciplinary approach and collaboration with other specialties to treat complex systemic diseases. While many Pods at RheumNow Live are disease-specific, the Pod II focused on Advancing Practice on https://t.co/hvSY5yHZmd
Dr. John Cush @RheumNow( View Tweet )
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&lt;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 &gt;27 + 1 wt related co-morbidity -Endpts - ACR and &gt;10% weight reduction -ACR50 improved 33.5% compared to 20% IXE alone (p&lt;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 &amp; obesity is expensive" Adipose tissue - active endocrine organ -&gt; 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 )

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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