A Patient’s Plea for a New Paradigm in Autoimmune Disease
A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?
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24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/pAEqYJIKaw
Dr. John Cush @RheumNow( View Tweet )
Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis
Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.
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By @RheumattDoc
#Psoriasis and nail changes
#PsA #PsoriaticArthritis #enthesitis #dactylitis https://t.co/rxH2zrGBwC
Dr Gurdeep S Dulay @gurdeep_dulay( View Tweet )
More Comorbidity in Difficult to Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
RCT 120 mod-severe hip OA (KL 2-4) pts Rx w/ THA +rehab or exercise. @12 mos. THA had signif. better pain, function & HRQoL vs exercise program alone (WOMAC total -30.9 vs -3.7). (38% of exercise/conservative grp needed THA) https://t.co/6vvRAr6isf https://t.co/VOYgS3PPwr
Dr. John Cush @RheumNow( View Tweet )
“Almost always, the creative dedicated minority has made the world better. “
-Martin Luther King, Jr.
Dr. John Cush @RheumNow( View Tweet )
Knee pain: JAMA review
- 5% PCP visits knee pain
- Knee OA ~654 million worldwide
- Patellofemoral pain: <40 yrs & physically active; pain on squat
- Meniscal tears in 12% adults (McMurray 61% sensitive; 84% specific; Joint line tender 83% sensitive; 83% specific) https://t.co/2fdpl464mb
Dr. John Cush @RheumNow( View Tweet )
Prospective study of 305 Consecutive newly diagnosed axSpA pts (55% male; Dx delay 6 yrs; 75% B27+). 56% w/ r-axSpA more male w/ hi CRP. nr-axSpA had more inflam LBP, +FHx SpA. SpA Dx made without sacroiliitis in 12%; only 2/38 later developed sacroiliitis https://t.co/xPlGwZ7Kjk https://t.co/2TBQALvxsG
Dr. John Cush @RheumNow( View Tweet )
Which autoimmune condition carries the highest relative risk for lymphoma? Test your knowledge in the latest RheumIQ quiz at https://t.co/TBlB4pmnKa https://t.co/sx8fpdHgHN
Dr. John Cush @RheumNow( View Tweet )
EULAR Recommendations for Physical Activity in Arthritis
EULAR has published a 2025 update for physical activity recommendations for patients with osteoarthritis (OA) and rheumatoid arthritis (RA).
https://t.co/RFECflCUgf https://t.co/Da7D6KpN6q
Dr. John Cush @RheumNow( View Tweet )
Great Lectures; Great Presentations
Dr. Jack Cush lectures on giving a great presentation; based on 40 years of lecturing in Rheumatology.
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A man spends 50 years teaching at MIT.
He knows his time is running out.
So he records one last lecture — everything he knows, distilled into a single hour.
He died 5 months later.
This is that lecture.
The most important hour you'll watch this week. 👇
Bookmark it for later https://t.co/tRUH05ysSt
Suryansh Tiwari @Suryanshti777( View Tweet )
FDA Targeting the Safety of Avacopan
The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market.
The FDA’s concern is that the data, orginally
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EULAR Recommendations for Physical Activity in Arthritis
EULAR has published a 2025 update for physical activity recommendations for patients with osteoarthritis (OA) and rheumatoid arthritis (RA).
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Sun Pharma buys out Organon w/ $11.75 billion buyout. Both generated $6.2 billion in 2025 sales. Organon spun off from Merck in 2021, specializes in women’s health and is top 7 in biosimilars. Sun is into dermatology, ophthalmology and oncology-dermatology. https://t.co/zb4hucTqCJ
Dr. John Cush @RheumNow( View Tweet )
Presented at AACE Annual Meeting, FREEDOM Real-World Study looked atypical femoral Fxs & found a low AFF risk - 24 AFFs w/ denosumab (0.89/1KPY) vs 397 AFFs w/ bisphosphonates (0.82/1KPY) but no active comparators & excluded pts w/ comorbidities. https://t.co/vRwkfHSXxh https://t.co/xzgC0D5ZTu
Dr. John Cush @RheumNow( View Tweet )
Neoplasia and Autoimmune Disease
Malignancy rivals cardiovascular disease as a leading cause of death in patients with systemic autoimmune diseases. Chronic inflammation and immune dysregulation can drive oncogenesis, while antitumor immune responses can trigger autoimmune phenomena (paraneoplastic syndromes, checkpoint
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Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA
After the first tumour necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid arthritis (RA) responded by switching to upadacitinib, compared to cycling to a second TNFi, adalimumab.
Obesity is more than comorbidity—it’s a driver of inflammation.
At #RheumNowLive 2026, Dr. Uzma Haque breaks down weight management strategies that actually move the needle in rheumatology care.
🎧 Listen here: https://t.co/A6fbPvV2tD
#Rheumatology #Inflammation #Obesity https://t.co/RLxV44SrUB
Dr. John Cush @RheumNow( View Tweet )
“Success is not final, failure is not fatal: it is the courage to continue that counts.”
– Winston Churchill
Dr. John Cush @RheumNow( View Tweet )
Rheumatology Salaries 2025
Medscape has published its annual Physician Compensation report with physican salaries up roughly 3% and eight specialties earning more than $500,000 per annum.
https://t.co/DNe42EsxRW https://t.co/aegcNm8Pla
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
Links:
Dr. John Cush @RheumNow( View Tweet )
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 )
Therapeutic Updates
5-Year Results of an IL-23 Inhibitor in Patients With PsA
Sponsored by AbbVie Medical Affairs + Health Impact
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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Poster Hall
Recent Blogs
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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Podcasts
ACR 2025 Daily Podcasts Day4a-
ACR 2025 Daily Podcasts Day3a
ACR 2025 CAR-T Topic Podcasts Compilation 1
