Follow the Money (4.23.2026)
Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week.
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Does monotherapy work? network meta-analysis of 31 RCTs, 13 csDMARDs, Leflunomide, SSZ & gold were better than placebo & equal to MTX regarding annual xray progression scores. Evidence in favor BUT failed to study monoRx vs Combo Rx https://t.co/cMSZ4QHi5G https://t.co/o9ikhJu3UM
Dr. John Cush @RheumNow( View Tweet )
Mortality in Rheumatoid Arthritis: A Story of Decline, Delay, or Plateau? Dr. Elena Myasoedova
In this https://t.co/4UQlqwujiR 2026 podcast, Dr. Elena Myasoedova examines mortality trends in RA, exploring whether we are seeing continued decline, delayed impact, or a concerning https://t.co/yUob3Tv0tR
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Dr. John Cush @RheumNow( View Tweet )
Chinese target emulation trial of MDA-5+, dermatomyositis w/ ILD. 106 Rx w/ UPA & 328 w/ TOFA. 6-month lung transplantation-free survival 72% vs 67% (UPA v TOFA). UPA non-inferior to TOFA in MDA5+DM-ILD https://t.co/BBAfbM06AM https://t.co/QP8YdX7CcH
Dr. John Cush @RheumNow( View Tweet )
Twofold Mortality in SLE
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
NSAIDs in Inflammatory Bowel Disease?
MedPage Today
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 trigger IBD flares.
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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.
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 )
Aspirin Cardiovascular Prevention in Giant Cell Arteritis
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
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 )
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
Dr. John Cush @RheumNow( View Tweet )
Simulation cost-effectiveness/QOL study compared Rx of psoriasis w/ biologics, phototherapy, or step-therapy Rx. Biologics had best QOL gains; step-therapy Rx similar w/ less variability & lower costs; phototherapy was cost-effective for payors. Pts had highest willingness to pay https://t.co/RyNooKhgQh
Dr. John Cush @RheumNow( View Tweet )
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 )
Prescribing Lessons (4.17.2026)
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
Dr. John Cush @RheumNow( View Tweet )
152 pts w/ immune thrombocytopenia (ITP) Rx in DBRPCT of Ianalumab (9mg or 3 mg/kg) or PBO q mo x 4 mos (all on Eltrombopag). Time to Rx failure signif longer w/ ianalumab. Stable 6 month response better w/ 9-mg group vs PBO (62% vs 39%; P=0.045) https://t.co/J04trYAwLu https://t.co/Alm8V2SAXn
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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.
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Still's Disease Update
Arthritis Research & Therapy has published an overarching review of Still's disease - claiming it to be a single acquired and complex autoinflammatory disease in which both pediatric and adult forms share core pathogenic mechanisms, genetic associations and clinical presentations, with minor
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Screening High Risk Myositis Patients for Cancer
An Italian retrospective study of 411 idiopathic inflammatory myopathies (IIM) patients applied IMACS criteria to assess the risk of cancer and found significantly more cancers in those at high risk.
https://t.co/AHvC5xfsCr https://t.co/Bd4VMRX9PU
Dr. John Cush @RheumNow( View Tweet )
A LESSON FOR GC OVERUSE: Inappropriate PPI use was Twice as successful w/ reduced w/ GP & Pt-facing intervention (15 vs 7%) vs usual care or GP-only intervention. Study of 1498 GPs, 34K pts https://t.co/4cxoeanAK8 https://t.co/FdfUdST40o
Dr. John Cush @RheumNow( View Tweet )
Litifilimab in Cutaneous Lupus Erythematosus
Biogen has announced positive results of their Phase 2 study, evaluating litifilimab in patients with active cutaneous lupus erythematosus (CLE), presented at the recent American Academy of Dermatology (AAD) Annual Meeting.
Litifilimab is an investigational monoclonal antibody that
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Modest Benefits with AI Scribes on EHR Documentation
EurekAlert!
Documenting a patient visit in the electronic health record (EHR) is essential to healthcare delivery, but also a major contributor to clinician burnout. Artificial intelligence (AI)-enabled ambient documentation, or “AI scribes,” can automatically generate draft clinical notes for review
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Global Study of #gout - incidence increased by 158% (from 1990 to 2023), during which mean onset agerose from 58 to 62 years; but % young-onset gout dropped 15.8% to 9.8%. #s due to aging, not younger onset. https://t.co/5pqMwPEnuj https://t.co/414vJHnBYi
Dr. John Cush @RheumNow( View Tweet )
Screening High Risk Myositis Patients for Cancer
An Italian retrospective study of 411 idiopathic inflammatory myopathies (IIM) patients applied IMACS criteria to assess the risk of cancer and found significantly more cancers in those at high risk.
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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.
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I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”.
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Podcasts
Are your patients with moderate to severe RA getting the appropriate dose? Sponsored by Genentech, Inc
