General Rheumatology

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Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA

Jack Cush, MD

After the first tumour necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid
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“Success is not final, failure is not fatal: it is the courage to continue that counts.” – Winston Churchill

Dr. John Cush @RheumNow( View Tweet )

Severe thrombocytopenia (TP) assoc w/ severe APS & increased mortality. Retro study of 432 #APS pts - 142 w/ TP (33%): 13% severe TP (<50L G/L). Severe TP assoc w/ ITP & CAP -had higher mortality https://t.co/7f8VpIcEJy

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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 )
NSAIDs in Inflammatory Bowel Disease? At least some patients with inflammatory bowel disease (IBD) can safely use common drugs for musculoskeletal aches and pains, a large study of insurance claims data suggested, contradicting a widespread concern that these products can https://t.co/JeINgTWTK0
Dr. John Cush @RheumNow( View Tweet )
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Follow the Money (4.23.2026)

Jack Cush, MD

Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week. 

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DESIR axSpA inception cohort study of 631 pts (no HTN), found no signif association between NSAID use & incident HTN. Over 10 YRs, 88 developed HTN (HR 1.01, 1.00–1.02) https://t.co/Gs9mPwthEj https://t.co/4sfpHmFTsu

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Chinese study of 371 pts w/ Autoimmune hepatitis (AIH) - extrahepatic autoimmune diseases (EADs) seen in 24% -Sjogren’s & autoimmune thyroid dz (9% each). ANA+ independently assoc w/ EADs (OR 2) https://t.co/NVz8MWbJch https://t.co/tjCzaDcUFI

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Twofold Mortality in SLE

Jack Cush, MD

Despite declining incidence of lupus, mortality for SLE was twice that of controls in this large incident cohort study.

Ethnicity is a strong predictor of incidence and outcomes in systemic lupus erythematosus (SLE) patients. This population study used the UK Clinical Practice

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ACR Endorses New Training Model for Pediatric Subspecialties

ACR

The American College of Rheumatology (ACR) welcomes the recent announcement from the American Board of Pediatrics (ABP) outlining new training models for pediatric subspecialties. Given the collaborative work ACR has engaged in over the years, this is an important step forward in reimagining

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Rheumatology Salaries 2025

Jack Cush, MD

Medscape has published its annual Physician Compensation report with physican salaries up roughly 3% and eight specialties earning more than $500,000 per annum. 

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Do patients with chronic pain have double the rates of smoking compared to those without pain? Take this week's RheumIQ quiz to find out. https://t.co/rmB55KC7Zh https://t.co/ms3G9uBMd5

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Dr. John Cush @RheumNow( View Tweet )
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Aspirin Cardiovascular Prevention in Giant Cell Arteritis

Jack Cush, MD

A retrospective target trial emulations has shown that low-dose aspirin (ASA) given with a giant cell arteritis (GCA) diagnosis is associated with a lower risk of major adverse cardiovascular events (MACE), but a higher risk of GI bleeding.

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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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Adjunctive Prednisolone for Kawasaki Disease An NEJM study has shown that glucocorticoids provide no added benefit when added to standard primary treatment in Kawasaki disease patients. https://t.co/dS1uwufh69 https://t.co/wpxyOYXp8l

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Dr. John Cush @RheumNow( View Tweet )
Leeds study of 63 pts w/ palindromic rheumatism (PR) progressed to Persistent IA (PIA) @ median 13.4 mos, hands predominating across flares. PIA developed in joints involved in PR flares in 71% of pts. @RA Dx, PR onset pts had signif higher swollen joints(4.1 vs 3.2) https://t.co/g2vjfVjDlK
Dr. John Cush @RheumNow( View Tweet )
If I cannot do great things, I can do small things in a great way.” - Martin Luther King, Jr

Dr. John Cush @RheumNow( View Tweet )

Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/rS69epQiif

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Physician Use of Augmented Intelligence has Doubled A 2026 Physician Survey assessing AI and its use in Medical Practice has been published and follows earlier surveys on adoption and use. This is the third in a series of longitudinal surveys (prior waves 2023, 2024), enabling https://t.co/4QoMR17Ure
Dr. John Cush @RheumNow( View Tweet )
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Prescribing Lessons (4.17.2026)

Jack Cush, MD

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

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Modest Benefits with AI Scribes on EHR Documentation Documenting patient visits in the EHR is essential to care, but a major contributor to clinician burnout. AI-enabled ambient documentation (“AI scribes”) can auto-generate draft clinical notes for clinician review. They may https://t.co/6HaUwpFYLC
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Retrospective clinicopathologic review of 170 AORTIC surgical pathology cases (2009-16) - showed 87% w/ atherosclerosis, 13% aortitis/periaortitis and 2.4% atherosclerosis w/ excessive inflammation. Lymphoplasmacytic inflammation was most common w/ aortitis/periaortitis. https://t.co/CuP30dqRQU
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ACR Backs the Provider Reimbursement Stability Act

ACR

The American College of Rheumatology (ACR) today thanked lawmakers in the U.S. House of Representatives for introducing the bipartisan Provider Reimbursement Stability Act of 2025 (H.R. 8163), legislation designed to stabilize Medicare payments for physicians and protect patient access to care

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Physician Use of Augmented Intelligence has Doubled

Jack Cush, MD

A 2026 Physician Survey to assess artificial intelligence and its use in Medical Practice has been published and follows earlier surveys around adoption and use. This is the third in a series of longitudinal surveys (prior waves 2023, 2024), enabling meaningful trend analysis. AI adoption has

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Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/SyhK12KhHY

Links:

Dr. John Cush @RheumNow( View Tweet )

Therapeutic Updates

5-Year Results of an IL-23 Inhibitor in Patients With PsA

AbbVie March 2026
Dr. Alvin Wells and Dr. Shikha Singla share their clinical perspectives on using an IL–23 inhibitor to manage patients with PsA throughout their treatment journey in the context of 5-year data from the KEEPsAKE trial program.
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Recent Blogs

Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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Advanced Practice Rheum

Difficult to Treat Rheumatoid Arthritis

Jack Cush, MD
D2T RA Cover
Dr. Cush addresses the management of difficult-to-treat rheumatoid arthritis (D2TRA).
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Advanced Practice Rheum

Methotrexate

Jack Cush, MD
APR MTX Cover
In this session, Dr. Jack Cush reviews methotrexate.
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Podcasts

  • ACR 2025 Daily Podcasts Day4a
  • ACR 2025 Daily Podcasts Day3a
  • ACR 2025 CAR-T Topic Podcasts Compilation 1
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