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Three B-cell targeting anti-CD20 mAbs in clinical use: - Rituximab (1997) for RA, GPA, CLL, NHL, Pemphigus Vulgaris - Ofatumumab (2020) for relapsing MS - Obinutuzumab (2013) for Follicular lymphoma & CLL OFA & OBIN may be better than RTX in membranous GN pts w/ anti-RTX Abs… https://t.co/ZhUbXFXjSR https://t.co/vUHkS76PK7
Dr. John Cush @RheumNow( View Tweet )
Optimal Management of Rheumatoid Arthritis Patients and Liver Disease https://t.co/KpdY1MEM1w https://t.co/vETGMJgHf3

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Dr. John Cush @RheumNow( View Tweet )
JAMA Review on Dx & Rx of Monoclonal Gammopathy of Undetermined Significance. MGUS has NO Sxs or organ damage. MGUS & Dz associations (OP, Autoimmune) were likely overestimated; M protein testing should be done if malignancy or MGCS is suspected. Risk of progression to malignancy… https://t.co/Jikc5q3BJL https://t.co/hxhcD4bJ2X
Dr. John Cush @RheumNow( View Tweet )
That's not my problem - or is it? Multimorbidity in RA RA can look so easy on the television commercials where patients appear young, healthy, and vibrant on the advertised treatment. https://t.co/4lSVKeRtyx https://t.co/Xa1UGbJigy

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Dr. John Cush @RheumNow( View Tweet )
Prevalence of Systemic sclerosis–associated interstitial lung disease (SSc-ILD) was 49.8% - Chinese study of 223 SSc (F/U 8.1 yrs). Among SSc-ILD, 64% had progressive disease w/ elevated CRP at Dx as predictor. Overall mortality rate = 24.2% (pneumonia) w/ predictors of age,… https://t.co/Lb98KziPOj

Dr. John Cush @RheumNow( View Tweet )

Full read review of association betw #RA & Chikungunya fever (viral infxn transmitted by Aedes mosquitoes). Theres no true link betw RA & CHIKV; but incidence of RA after CHIKV is 13.7% (based on 16 reports, 2879 pts, 449 RA postCHIKV) https://t.co/8fxIS846Nd https://t.co/YD1aLIVrrI

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Dr. John Cush @RheumNow( View Tweet )
cost.price_.drugs_.pills_.jpg

The Cartel is Coming for Rheumatology

Eric Dein, MD

"What Do Blockbuster Drugs & The Black Market All Have in Common?" asked Dr. Madelaine Feldman at RheumNow Live 2025. They thrive, she explained, on market exclusivity "... until they don't." At first glance, the pharmaceutical marketplace may not appear like a crime drug ring, but Dr.

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TheDaoIndex @KDAO2011 80% #hydradenitis suppurativa pts are smokers or former smokers, smoking can predate #HS by 4-5 years. Other associations: DM-2, Spa, obesity, SAPHO, PCOS eval for SCC (squ. cell CA) #RNL2025 https://t.co/XHrFseiAMK
Dr. John Cush @RheumNow( View Tweet )
Janet Pope @Janetbirdope #Disease #activity in #axSpA #ASDAS - a crude measure of activity in #ankylosing #spondylitis Is related to #radiographic #progression 👇 ⬆️ CRP May be more predictive #ClinicalPearl⁩ #RNL2025 https://t.co/34wrMuz9mO
Dr. John Cush @RheumNow( View Tweet )
Eric Dein @ericdeinmd Active Morphea: - MTX +/- steroids. If not effective, MMF/RTX/ABA - Topicals for circumscribed - Phototherapy Most pts achieve remission in active in 1 year Inactive morphea - Can address with PT, pain rx, psychological support, plastic surgery fat… https://t.co/OMGt8feO0z https://t.co/yWAgY2Z4Ng
Dr. John Cush @RheumNow( View Tweet )
Eric Dein @ericdeinmd How do you know if Morphea is active? -Erythema -Peripheral induration -New lesions in the past few month Non-active damage? - Dermal atrophy -SQ atrophy -Hyperpigmentation -Skin thickness center #RNL2025

Dr. John Cush @RheumNow( View Tweet )

Eric Dein @ericdeinmd #RNL2025 Treatment of sclerosing skin conditions: Active inflammation? Sclerotic? Atrophic? Target based on activity, depth of involvement and other disease involvement

Dr. John Cush @RheumNow( View Tweet )

MD Survey: Who should manage patients with hidradentis supprativa?

Dr. John Cush @RheumNow( View Tweet )

Full read, comprehensive review of Hidradenitis Supprativa in Lancet Feb 1, 2025 Common assn; DM, IBD, Smoking, Obesity, metabolic syndr, NASH, SpA, RA FDA approved Rx: Adalimumab, Secukinumab, Bimekizumab https://t.co/5Tb8on21E0 https://t.co/BLu6Zaejj5

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Dr. John Cush @RheumNow( View Tweet )
Janet Pope @Janetbirdope #ClinicalPearl Insights into #fibrosing #skin conditions Inflammatory Fibrotic Atrophy We treat the #inflammation but need to determine if lesions are active or not Bx May not discern #dx Heidi Jacobe ⁦ #RNL2025 https://t.co/dG1k4fm4aO https://t.co/5TowCCDiTt

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Dr. John Cush @RheumNow( View Tweet )
TheDaoIndex @KDAO2011 @drcharitydean on emerging public health threats including H5N1 & communicable dz. We need to be monitoring for human to human disease transmissions. There is a high level of concern by large business as they recognize this will affect the supply chain.… https://t.co/T3TZ7LtHQi https://t.co/Ar85A0EcW4
Dr. John Cush @RheumNow( View Tweet )
Eric Dein @ericdeinmd B England 75% of RA pts have multi-morbidity Pts develop multi-morbidity BEFORE the onset of RA Should we have different goals: Prioritize LDA over remission in pts w multimorbidity Collaborate w PCP: one size doesn't fit all, do something better than… https://t.co/RIe7BhSgvJ https://t.co/4dVdR088XF
Dr. John Cush @RheumNow( View Tweet )
TheDaoIndex @KDAO2011 A practical clinic-based approach to assessing CVD, CA screening, lung disease, infections for rheums by Dr Bryant England who offers us menus.. start by asking about symptoms. #RNL2025 https://t.co/AcQDJS870I https://t.co/UCyDOF2GRZ

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Dr. John Cush @RheumNow( View Tweet )
Adela Castro @AdelaCastro222 Multimorbidity in Rheumatoid Arthritis: -Affects >75% of pts -Reduces quality of life and increases mortality -Highly associated w/ D2T RA -Requires multidisciplinary care teams (PCP, specialists, case management, PT) -Management should start early… https://t.co/Sshm8CUWOA https://t.co/W9dojZT99T
Dr. John Cush @RheumNow( View Tweet )
Will AI put me out of a job? The advent of artificial intelligence (AI) continue to amaze us in this changing world and in multiple areas of medicine. As an evolving science, rheumatology has also been introduced to AI where interesting applications seem to enhance patient… https://t.co/W0ysHzxiRg https://t.co/rPOcjC2lyR
Dr. John Cush @RheumNow( View Tweet )
Adela Castro @AdelaCastro222 Are your patients aging with RA, or are they diagnosed with Late Onset RA (LORA)? -LORA pts tend to present acutely -High inflammatory markers~PMR Like -Seronegative/Decreased titers of RF/CCP @UnaMakris #RNL2025 https://t.co/tLrGBV6P1i https://t.co/53HVvUmrG4

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Dr. John Cush @RheumNow( View Tweet )
TheDaoIndex @KDAO2011 Late onset RA (LORA) aka RA diagnosed at an older age — pts have higher inflammatory markers, presents like PMR; they also have polypharmacy, comorbidities, frailty, etc that can complicate management @UnaMakris #RNL2025 @RheumNow #GeriRheum… https://t.co/E2WFwfCsWD https://t.co/tKF0OnUFQH
Dr. John Cush @RheumNow( View Tweet )
#Benralizumab vs #Mepolizumab both work for #EGPA Which to use? 🤷‍♀️ perhaps some advantage of more steroid sparing w Benralizumab? ? JAKi ?long acting #IL5i #RNL2025 ⁦@RheumNow⁩ https://t.co/UkthHpNRIq

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Janet Pope @Janetbirdope( View Tweet )
Adela Castro @AdelaCastro222 How can AI be useful for RA pts and rheumatologists? -AI models have the potential for improving diagnosis, management and outcomes in RA pts. -Can also improve efficiency and clinic workflow. -Not so perfect as it sounds (hallucinations, limited… https://t.co/YA4A990p2v https://t.co/YnHtbP83Nm
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Treatment of sclerosing skin disease: -Progression: inflammation➡️sclerosis➡️ atrophy -Existing therapies target inflammation not sclerosis-poorly developed ttx for sclerosis -First aspect is determining disease state, depth of involvement, extracutaneous manifestations… https://t.co/lYQRW2yDRG https://t.co/DQZjYKS2Ks

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Adela Castro @AdelaCastro222( View Tweet )

Recent Blogs

Overlap Syndrome with ILD

Jack Cush, MD
Cush RheumThought ILD

How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?

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Gangsin: 갱신 Korean: refresh, renew, updated

Kathryn H. Dao, M.D.
change,future,lens,clarity
Remaining status quo requires less effort than making a change. Over the last 20+ years, I have listened to thousands of patients confide their personal stories. Some remained paralyzed in their current state of distress, fearing new situations may be worse. I was one of them, until recently. In this final blog of my trilogy on self-discovery, I reveal my new life. Read Post
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