Outcomes

RA outcomes according to onset: typica RA vs undifferentiated inflam arthritis (UIA) or palindromic rheumatism (PR). Progress to RA = RA > UIA > PR. PR has more +FHx & ACPA; UIA more females w/ Knee Sxs. Best remission rates w/ PR onsets. https://t.co/JJRCdKcs1u https://t.co/n385f6EF59

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Dr. John Cush @RheumNow( View Tweet )
Methotrexate intolerance in rheumatoid arthritis A current large rheumatoid arthritis (RA) cohort study from Cairo assessed methotrexate (MTX) use and found over half were MTX intolerant and a third of patients were noncompliant with MTX. https://t.co/PDUv2YRFIq https://t.co/2DuBXjNqec

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Dr. John Cush @RheumNow( View Tweet )
RA,polyarticular,black,rheumatoid

ALTO: Long-Term Abatacept Outcomes in At-Risk RA

Jack Cush, MD

Lancet Rheumatology has published the ALTO results - long term outcomes of the APIPPRA trial, demonstrating that treatment with abatacept (ABA) in at risk patients can delay progression to rheumatoid arthritis (RA) for up to 4 years.

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artangiogca.jpg

Giant Cell Arteritis Outcomes in Canada

Jack Cush, MD

A retrospective cohort study of patients with giant cell arteritis (GCA) demonstrates relapses are common and seen in nearly half of patients, were common after treatment is stopped and is not effectively averted by methotrexate (MTX).

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Long term outcomes study of 22 pts w/ adult Stills. 16 (72.7%) completed LTE w/ mean observation 168.9 wks. 3/22 had serious adverse events, Tx efficacy ACR70=68% and 95% reduced in glucocorticoid doses w/ 41% in GC-free remission https://t.co/h0MvDLWGhD https://t.co/HDIKF7VMwA

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Dr. John Cush @RheumNow( View Tweet )
2016 ARTIC trial tested T2T w/ MTX & "bridging" tapered Prednisolone (15 mg --> 0mg over 7wks) in 237 new DMARD naive RA pts. PRED discontinuation successful in 84% @7wks, 89% @3mos, 95% @ 24 mos. Only 5% require Pred @ every visit for 2 yrs. You can D/C pred! https://t.co/O23PHq81YP
Dr. John Cush @RheumNow( View Tweet )
Retractions in Rheumatology Retractions in rheumatology are rising. An analysis of Retraction Watch data found 381 retracted articles (1989–2024), driven by misconduct or data errors. 68.5% originated in Asia, over half from China (50.7%). https://t.co/I6WmceNi2m https://t.co/6z0jHPaiaR

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Dr. John Cush @RheumNow( View Tweet )
Notch and TGFβ Signaling in Refractory Rheumatoid Arthritis Spatial transcriptomic profiling of rheumatoid arthritis (RA) synovial biopsies (pre- and post-treatment) has revealed new insights into the pathobiology or treatment resistent RA. https://t.co/vCvFpnIOvS https://t.co/EV6OihT0br

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Dr. John Cush @RheumNow( View Tweet )
TOPKAT Trial: Partial vs Total Knee Replacement Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little bit https://t.co/SsTXAqs4Xr
Dr. John Cush @RheumNow( View Tweet )
Pain,FM,fibromlyalgia,Trigger

Which Fibromyalgia Drugs are Cost-Effective?

Jack Cush, MD

A cost-effectiveness analysis compared FDA approved fibromyalgia drugs (pregabalin, duloxetine, milnacipran) with amitriptyline and found duloxetine was the preferred strategy across perspectives.

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TOPKAT Trial: Partial vs Total Knee Replacement Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little bit https://t.co/MNpVeHQbJ2
Dr. John Cush @RheumNow( View Tweet )
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Canada's 2025 Top 10 Funded Rheumatology Projects

Arthritis Society

Arthritis Society Canada (ASC) is Canada’s largest charitable funder of cutting-edge arthritis research, investing more than $240 million in research projects since its founding, and over $7 million invested in 2024-2025. Below are the investigators and projects that were funded in 2025.

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MTX.box

Methotrexate intolerance in rheumatoid arthritis

Jack Cush, MD

A current large rheumatoid arthritis (RA) cohort study from Cairo assessed methotrexate (MTX) use and found over half were MTX intolerant and a third of patients were noncompliant with MTX.

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Clinical contributors to pathogenesis and treatment outcomes for rheumatoid arthritis. Full read review of pathogenesis and unmet needs in #RA https://t.co/IEC0tsp1Rk https://t.co/jIsqhy9rQh

Links:

Dr. John Cush @RheumNow( View Tweet )
APPIPRA Study - Benefits of Early Treatment Treating people who are at high risk of rheumatoid arthritis (RA) can delay the onset of the disease for several years, with benefits also continuing well after treatment has stopped. https://t.co/GYguq7VlqT https://t.co/5Z0BXIm3cM

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Dr. John Cush @RheumNow( View Tweet )
Remission? Single center study of 100 RA, 100 SLE pts assessed by SLEDAI-2K, SDAI, VAS. Remission/LDA found in 88% of 392 SLE visits & 91% of 389 RA visits(p=NS). Remission was more common in SLE vs RA (79% vs 69%; p= 0.0018). https://t.co/ZPRrYQMsCT

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Dr. John Cush @RheumNow( View Tweet )

Physical activity (PA) is assoc w/ reduced all-cause mortality in RA pts. Study of 1493 NHANES & 1724 UK Biobank RA cohorts showing robust inverse association between PA and all-cause mortality (HR: active = 0.48, highly active = 0.61) https://t.co/K6ALzqP3QQ https://t.co/2XJ0zD7FA3

Links:

Dr. John Cush @RheumNow( View Tweet )
Electronic EHR reminders to deprescribe works! EHR study of 1146 pts(mean 74 yrs) showed 2 methods of E-reminder notifications resulted in either a 10.4% or 6.5% deprescribing (vs usual care); deprescribing was 40% more likely (RR 1.40; 95% CI, 1.14-1.73) https://t.co/sXnW5gUP0q https://t.co/n9LhUG612M

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Dr. John Cush @RheumNow( View Tweet )
errors.doctor

Retractions in Rheumatology

Jack Cush, MD

Retraction of rheumatology studies is not uncommon; a recent analysis shows retractions have risen substantially.

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Notch and TGFβ Signaling in Refractory Rheumatoid Arthritis

EurekAlert!

Spatial transcriptomic profiling of rheumatoid arthritis (RA) synovial biopsies (pre- and post-treatment) has revealed new insights into the pathobiology or treatment resistent RA. 

The following transcript comes from an interview on this paper that appeared in Nature

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APP Survey Results: 2017 and 2025 https://t.co/UEfYsKL74u https://t.co/SYTA7OOOvV

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Dr. John Cush @RheumNow( View Tweet )
Consensus on Managing Vertebral Fractures in Advanced CKD A coalition of leading international experts has released the first comprehensive Consensus Statement on the Management of Vertebral Fractures in Chronic Kidney Disease (CKD) Stages G4–G5D. The statement highlights a https://t.co/gilX13EaUi
Dr. John Cush @RheumNow( View Tweet )
Minnesota Mayo clinic retrospective, population study of RF & CCP in 1373 incident RA pts. At Dx, 37% dual seropositive, 13% +CCP only, 12% +RF only, & 38% seronegative. zDual seropositives had more erosions (31%) & flares (69% vs 51%). But +RF only highest mortality (adj 2.18) https://t.co/hPQewVgPoq
Dr. John Cush @RheumNow( View Tweet )
knee.surg2_.jpg (keep)

TOPKAT Trial: Partial vs Total Knee Replacement

MedPage Today

Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little bit better.

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Longitudinal study of 1761 US military service pre- & post-deployment. The prevalence of fibromyalgia in Males/Females was 2.%/2% (sames as civilians) but post-deploy incr to 8%/11% (P < 0.001). PTSD incr from 21% /18% to 23%/26%. PTSD predeployment lead to a 3 fold risk of FM. https://t.co/XTjuhjx0zd
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

rheumthought

CNS Lupus (NPSLE)

Jack Cush, MD
Cush RhTh CNS
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose? Read Post

Hydroxychloroquine for Everyone

Jack Cush, MD
ra.hands2_.JPG
Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit. Read Post
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Rx Updates (filtered for Topic)

Therapeutic Updates

The Impact of Obesity on Psoriatic Arthritis

Sponsored by Lilly Medical Affairs
Lilly February 2026
Obesity is common in PsA and may worsen disease activity and reduce treatment effectiveness through shared inflammatory pathways. Weight intervention may improve outcomes and support achievement of targets of disease control.
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