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Outcomes

Post hoc analysis of 5 ph III Belimumab RCTs (BLISS, etc, N=3086) on skin outcomes BILAG & SLEDAI-2K), BEL was superior to PBO (mcBILAG OR: 1.29; mcSLEDAI-2K OR: 1.37). Also if SLEDAI ≥10 & dsDNA+ pts. BEL prevented skin flares (HR 0.70) https://t.co/p1MVVf97Go https://t.co/qwWUyegpyi
Dr. John Cush @RheumNow( View Tweet )

Autoimmune Disease Impact Report

Integrated Benefit Institute, a nonprofit independent research organization, has published its 2025 Autoimmune Disease Impact Report, which examines the health and productivity impacts of five prevalent and costly autoimmune conditions: rheumatoid arthritis, multiple sclerosis,

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Targeting Obesity in Rheumatic Disease Patients

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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Systematic literature review of sleep Rx in Fibromyalgia - 47 RCTs, 11094 pts, found cognitive behavioral Tx (CBT) significantly benefitted insomnia, but not pain. Pregabalin & sodium oxybate had small effect, but Amitriptyline, milnacipran, & duloxetine showed no benefit for https://t.co/XG8cFlpQqq
Dr. John Cush @RheumNow( View Tweet )

ERA, APPs, & Alpha GAL (3.21.2025)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  Listen in for 2 new case questions - Ask Cush Anything.

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Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis

A prospective French study of rheumatoid arthritis (RA) or spondyloarthritis (SpA) patients showed that most maintained stable disease activity during pregnancy, but over one-third flared and required major changes in treatment.

The aim of this study was to analyze disease activity and

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NP and PA Growth in the USA

Forbes has published a thoughtful perspective on the declining number of US physicians and the growth in the number of advanced practice providers or APPs (nurse practitioners and physician assistants) in the US clinical workforce. Gastroenterologist Dr. Spencer Dorn writes that in the US, there

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Adrenal Dysfunction after Steroids in PMR and GCA Patients

JAMA has published a study of PMR and GCA patients who stopped glucocorticoid (GC) therapy and noted a low (1.2%) risk of GC-induced adrenal insufficiency after planned cessation.

GC are widespreadly and chronically used in rheumatology, often with the

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Study of 26 Enthesitis-related arthritis (ERA) pts (mean Dx age 12 yrs; 77% male; 58% B27+). These were later assessed as adults (20yrs age, <35yrs). Most were in remission/LDAS, but ~20% had synovitis or enthesitis, 73% SI Dz, 15% hip & 8% spinal damage https://t.co/FFEhyA5I6A https://t.co/hE65GNcFpY
Dr. John Cush @RheumNow( View Tweet )

ACR Frustrated with Congress Failures on Physician Fee Schedule and Research Programs

ACR

The American College of Rheumatology (ACR) expressed deep dissatisfaction that the recent passage of the Full-Year Continuing Appropriations and Extensions Act, failed to address payment cuts imposed in the CY25 Medicare Physician Fee Schedule (MPFS) at the beginning

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PAFLAR Guidelines for Polyarticular Juvenile Idiopathic Arthritis

The Pediatric African League against Rheumatism (PAFLAR) initiative has published its guidelines for the diagnosis and treatment of polyarticular juvenile idiopathic arthritis (pJIA

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Single Center study of 112 RA pts from Morocco used machine learning (ML) logistic regression model & identified #Depression in 48% (HADS score >8) w/ 76.5% accuracy, 72.2% precision, 81.2% recall, and an area under the receiver operating characteristic curve (ROC AUC) of… https://t.co/LBvdVEzDGJ https://t.co/bYLqsFagbR
Dr. John Cush @RheumNow( View Tweet )
Cardiovascular and Fracture Risk with Denosumab Versus Bisphosphonates in Dialysis Patients Annals of Internal Medicine has published a Japanese administrative claims database study showing that, compared with oral bisphosphonates (BIS), denosumab (DEN) lowered fracture risk… https://t.co/kNqGNTrsAF https://t.co/xgCeaMDT1N
Dr. John Cush @RheumNow( View Tweet )
Increased Mortality In Arthritis Patients with COPD A new study published in the January 2025 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open-access journal, finds that people with chronic obstructive pulmonary disease… https://t.co/6WCtfcrSaq https://t.co/ydVtBxqy37
Dr. John Cush @RheumNow( View Tweet )

Axial Involvement in Psoriatic Arthritis

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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Mizoribine Effective in Lupus Nephritis

A randomized clinical trial has shown that oral mizoribine, a common immunosuppressant in Japan, was noninferior to intravenous cyclophosphamide (CTX) as induction therapy in patients with active lupus nephritis. 

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Retrospective review of 781#RA pts; 78 Dx w/ILD (77 subclinical, most UIP on HRCT). w/ mean 10 yrs F/U, death rate was 1.5 vs. 7.1 per 100PY (without v with ILD) SMR equal betw RA & gen pop. but 2x higher in RA w/ ILD. Mortality higher w/ ILD (HR~3), age and low BMI… https://t.co/Vj0acewmK8 https://t.co/N1wHTjMfTr
Dr. John Cush @RheumNow( View Tweet )

World Changers (3.14.2025)

Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.

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Still's Dz Afro-Caribbean study of 58 pts (57% AOSD). Sex differed betw kids F 36% vs F71% in adults. Kids had signif more typical skin rashes (100 vs 29%), coronary artery dilation (16 vs 0%), & MAS (52 vs 9%). Adults signif more polyarthalgia (91 vs 32%) & lung dz (51 vs 4%).… https://t.co/AYKNazgio5 https://t.co/1yQgeMiwku
Dr. John Cush @RheumNow( View Tweet )

Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs

A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (

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Study of sarcopenia in 138 young adults with inflammatory arthritis (IA) found sarcopenia in ~47% of IA- Signif different between JIA, SpA, & RA. W/ multivariable analysis, predictors of sarcopenia included BMI (OR 0.84), BMD (OR 0.01), vit D (OR 0.96) & HAQ (OR 14.5)… https://t.co/JHKwF8icj1 https://t.co/ph3pVIYuXx
Dr. John Cush @RheumNow( View Tweet )
A Veterans study of 27,540 #RA pts shows the risk of multiple myeloma (MM) did not differ b/tsDMARD & csDMARD users. 30% took b/tsDMARD during follow-up (192,000 PYs). MM incidence rate: b/tsDMARD-naïve 0.37/1000PYs vs csDMARDs 0.42/1000PYs (HR 1.32; 0.78, 2.26)… https://t.co/Xp4v4eIQnd https://t.co/5MVdz5UQSb
Dr. John Cush @RheumNow( View Tweet )

Glucocorticoid Toxicity Index

Dr. John Stone has led the effort to develop the GTI - glucocorticoid toxicity index. In this review article he acknowledges the need and benefit of steroids, but details a novel means to identify and limit the untoward effects of glucorticoids (GC).

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2024 Rheumatology Year in Review

2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians.  While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list

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Cardiovascular and Fracture Risk with Denosumab Versus Bisphosphonates in Dialysis Patients

Annals of Internal Medicine has published a  Japanese administrative claims database study showing that, compared with oral bisphosphonates (BIS), denosumab (DEN) lowered fracture risk by 45%, but increased the risk for major adverse
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