General Rheumatology

Polymyalgia rheumatica is an inflammatory condition that affects persons >50 years of age and is characterized by pain in both shoulders with or without hip or neck pain (or both) and with pronounced morning stiffness. Learn more about the diagnosis and management: https://t.co/pKCl42dGVX

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NEJM @NEJM( View Tweet )
EULAR 2025 Update for Behçet’s syndrome EULAR has updated its recommendations for the management of Behçet’s syndrome, the last being published in 2018. The current update carries no recommendations from the previous version: seven recommendations have content modifications, https://t.co/QcjVUqlyMU
Dr. John Cush @RheumNow( View Tweet )
phase 3 VALOR trial of 6-valent OspA-based Lyme dz vaccine (LB6V) vs placebo; 4 doses given @ Mos 0, 2, 5-9, & 12 mos later. LB6V reduced Lyme Dz risk by 73.2% @28d after 4th dose. But it was only 15.8% effective (falling short of prespecified 20%) because of fewer than expected https://t.co/TcX0GV05gY
Dr. John Cush @RheumNow( View Tweet )
lumbar,spine,lbp,pain

Who Treats Spondyloarthritis Better?

MedPage Today

European nations may be winning at optimizing care for people with axial spondyloarthritis (axSpA), international survey data indicate. In data collected from physicians and patients in the U.S. and five European countries, American patients reported a greater symptom burden on average after

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Prevalence of fibromyalgia in PsA = 18%. FM-PsA pts have higher scores Dz activity scores from FM, rather than inflammation. Fibromyalgia is assoc w/ worse disease outcomes, including failure to achieve low disease activity state and poorer response to therapy. https://t.co/utQRXPmpDs
Dr. John Cush @RheumNow( View Tweet )
Behcets_disease.jpg

EULAR 2025 Update for Behçet’s syndrome

Jack Cush, MD

EULAR has updated its recommendations for the management of Behçet’s syndrome, the last being published in 2018. The current update carries no recommendations from the previous version: seven recommendations have content modifications, four have minor wording amends, and one is entirely new

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"If you have a great 2nd act; the 3rd act writes itself". - Ron Shelton https://t.co/OFgISgu2qF
Dr. John Cush @RheumNow( View Tweet )
JAMA Patient Education Page on JAMA Eosinophilic Fasciitis (EF). EF is rare, but begins with swelling and redness of the arms and/or legs. Later the skin thickens and develops the peau d' orange appearance. EF does not involve fingers or toes, & doesnt have Raynauds https://t.co/WEFFITtmQC
Dr. John Cush @RheumNow( View Tweet )
You can change what comes to your attention. We can change the external and internal focus by being mindful of the triggers and amplifiers we consume. If you’re not happy with what your attention is bringing you, you can change it. - Seth Godin https://t.co/QsUxTmjX1U

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Dr. John Cush @RheumNow( View Tweet )

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 )
SOLSTICE: phase 3b RCT of IL-23i, guselkumab vs PBO in 451 active PsA pts (GUS q4wk vs q8wk vs PBO). @wk 24 GUS signif better than PBO-ACR20 (59%/62% vs 35%), ACR50 (31%/32% vs 12%), ACR70 (17%/17% vs 2%), PASI 90 (49%/45% vs 12%), MDA (19%/24% vs 5%) ction) https://t.co/QDMCnGdN6J
Dr. John Cush @RheumNow( View Tweet )
Pilot phase I open-label trial of the PPARγ agonist pioglitazone (ACTOS; 45 mg/d) in 13 pts w/ inclusion body myositis (IBM) showed promise. After 32 weeks, no clinical improvement but proteomic muscle metabalomics & PPARGC1A expression improved. https://t.co/MtiTnwRfaE https://t.co/jUthouMSnP

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Dr. John Cush @RheumNow( View Tweet )
Single center prospective cohort study of 137 Takayasu’s arteritis (TAK) pts found the prevalence of coronary arteritis was 13 (9%). TAK coronary arteritis pts were not distinguished by demographics, angiographic patterns. 50% had complications from vascular grafts or stents https://t.co/xRR7TSi5FW
Dr. John Cush @RheumNow( View Tweet )
JAMA Patient Education Page on JAMA Eosinophilic Fasciitis (EF). EF is rare, but begins with swelling and redness of the arms and/or legs. Later the skin thickens and develops the peau d' orange appearance. EF does not involve fingers or toes, & doesnt have Raynauds https://t.co/azH9bMRsOb
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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Dr. John Cush @RheumNow( View Tweet )
Cross-sectional study of 180 PMR pts compared dz activity by PMR-AS to Systemic Immune-Inflammation Index (SII = Plts × PMNs/Lymphs) using CBC.48% had mod-hi dz (PMR-AS >=7). SII had moderate correlation with PMR-AS (r = 0.47), possibly useful in monitoring PMR https://t.co/vG1alSdVRU
Dr. John Cush @RheumNow( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
purpura

Hydralazine and the Rare Risk of Vasculitis

Jack Cush, MD

Since the 1980s, hydralazine has been a notable cause of drug-induced lupus, and inferred to cause vasculitis as well.  A retrospective cohort study from Canada has shown

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A multi-center, retrospective chart review of 82 Still's disease pts (63% female; mean Dx age 6.4 ± 4 yrs; F/U ~2.8 yrs). When analyzing Dz course, 34% were monophasic, 46% polyphasic (higher-than-expected), 19.5% persistent Dz. non-monophasic predicted by active 3 mos from Dx https://t.co/qtONtpeA22
Dr. John Cush @RheumNow( View Tweet )
Poets Know It (3.13.2026) Dr. Jack Cush reviews the news, regulatory decisions and new journal articles. https://t.co/gFToRS2xh4 https://t.co/FUIWlNG5QJ

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Dr. John Cush @RheumNow( View Tweet )
ICYMI: My Cancelled Lecture Slides https://t.co/hHvszC0SFR https://t.co/SRqfM5DsT3

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Dr. John Cush @RheumNow( View Tweet )
lab%20-rheumatoid-factor-testing.jpg

Pitfalls of autoimmune serologic testing

Jack Cush, MD

Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of  serological autoimmune markers. 

A current review focuses commonly used serologies and autoimmune tests to identify

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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 )
Rheumatic Immune-related Adverse Effects with Checkpoint Inhibitor Therapy A retrospective study of patients who developed rheumatic immune-related adverse events (R-irAEs) after receiving immune checkpoint inhibitors (ICIs) at two oncology centers in Spain suggests that early https://t.co/hYf6GiR6TN
Dr. John Cush @RheumNow( View Tweet )
2 RCTs of 699 children Tx in ER for acute limb injury compared 1 dose of oral acetaminophen or hydromorphone to ibuprofen - none significantly reduce self-reported pain scores at 60 minutes. Use of hydromorphone resulted in a 4-fold increase in adverse events. https://t.co/cqddDES9V0
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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