Seronegative RA Disease Activity (7.17.2026)
Dr. Jack Cush reviews the news, journal articles and Gout features from this past week on RheumNow.com
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QD Clinic: When There's Doubt in Gout
Dr. Eric Dein discusses how imaging was used in correctly diagnosing a mid-foot symptom in gout.
https://t.co/FNI6rlOz1O https://t.co/Xpw98DiEvs
Dr. John Cush @RheumNow( View Tweet )
Saliva and Uric Acid Testing
A recent report from China reaffirms the potential utility of salivary uric acid (UA) testing delivers smartphone-guided, enzyme-free gout screening at home for pennies per test.
https://t.co/VtvJuPNEWA https://t.co/pdBmy5JoQd
Dr. John Cush @RheumNow( View Tweet )
Systemic sclerosis metanalysis of 31 studies (32,134 pts) shows malignancy risk signif increased (SIR 1.66; CI 1.32 - 2.08). Highest: esophageal, liver, cervical, lung, & Heme (SIR 3.35 - 13.95). 7.4 yr mean from SSc to CA dx. https://t.co/IhxvfkMqkf https://t.co/qvxKgvBzWu
Links:
Dr. John Cush @RheumNow( View Tweet )
Genicular artery embolization for knee OA does not work in a 12-mos randomized sham-controlled trial of 58 pts. Pain scores improved equally in both groups https://t.co/7wwmzpTaNL https://t.co/8MsRXqKDo2
Dr. John Cush @RheumNow( View Tweet )
Intl consortium (10 EU countries) of 3952 RA pts, 184 MACE events seen 1985-2012. MACE risk signif assoc w/ DAS28 (HR 1.18;1.03-1.35), but NOT RF (HR 1.26; 0.82 to 1.94) or ACPA (HR 1.25; 0.85 to 1.83). RA activity assoc w/ MACE seen in seronegative and double positive https://t.co/RGO5IAM5oL
Dr. John Cush @RheumNow( View Tweet )
Congratulations to Dr. Chandra Mohan and Univ. of Houston for receiving a $4 million NIH grant for a 10-year longitudinal study to identify the earliest biological triggers of autoimmune disease https://t.co/6kMcv9PD5r https://t.co/CsY8QAxrXR
Dr. John Cush @RheumNow( View Tweet )
ACP Position Paper on Dietary Supplements
More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives. The paper notes that under DSHEA, dietary
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Retrospective study 1420 newly Dx non-tuberculous mycobacterial (NTM) infx (2012-2024) - 66 (4.6%) Dx w/ RA (55 after RA dx). Having RA + NTM incr risk of Resp. death (HR 4.3) w/ lower 5yr survival (75% vs 93%) partly explained by ILD and sytemic inflamm. https://t.co/6sdR7XwwD7
Dr. John Cush @RheumNow( View Tweet )
Hip Replacement Advances
Hip replacement surgery has been a major advance in the management of patients with hip damage and diminishing quality of life. While this review provides new information regarding a new type of hardware (end of article), lets begin with a general overview.
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Gout Cavalcade (7.10.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week. July is Gout: More than Flares month.
https://t.co/I1zWdx9fzU https://t.co/EYQ3D9Z42t
Dr. John Cush @RheumNow( View Tweet )
Guidelines to Spot Cancer in High Risk Dermatomyositis
MedPage Today
International guidelines can help identify dermatomyositis patients with a particularly high risk for cancer, according to a retrospective single-center U.S. study.
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Uric Acid: Is Lower Better?
There is good evidence that a serum urate less than 6 mg/dL is required to meaningfully reduce urate crystal and gout flare burden, but is even lower better and are there any tradeoffs?
https://t.co/W5FsDC5FG0 https://t.co/7mRgkg00uV
Dr. John Cush @RheumNow( View Tweet )
Updated Algorithm for the Management of Restless Legs Syndrome
Diagnose: chronic vs intermittent RLS (no need for polysomnography)
Test Iron levels (& Rx if)
Consider: remove exacerbators; walking/massage/heat; carbidopa/ levodopa; pramipexole or ropinirole; low potency opioids; https://t.co/XdzIipw1X8
Dr. John Cush @RheumNow( View Tweet )
The mortality gap in gout has not improved in 20 years – CV disease is the leading cause of death (2-fold increase).
For more gout content, follow our Gout: More than Flares campaign at https://t.co/xnBVBN5IXZ, https://t.co/c12GmMaatt
Dr. John Cush @RheumNow( View Tweet )
Problems with treatment adherence in the management of gout
Compared to common medical conditions such as hypertension, type 2 diabetes, hyperlipidemia or osteoporosis, where the reported drug adherence rates are between 50% to 70%, the drug adherence for gout is 37%. This https://t.co/OoLh0HUUH2
Dr. John Cush @RheumNow( View Tweet )
🎥 In this RheumNow Therapeutic Update, Dr. Nicola Dalbeth reviews the latest evidence on the Outcomes of Tophaceous Gout and what every rheumatologist should know.
Watch now: https://t.co/KQmkdziLF5
#Gout #Rheumatology #MedEd #SystemicBurdenOfGout https://t.co/h8LhE5XW00
Dr. John Cush @RheumNow( View Tweet )
Netherlands pragmatic open-label RCT from 8 rheum centres tested T2T vs Sx Rx in 308 Gout pts starting ULT (87% male; 66 yrs). Remission (no flares & pain < 2) betw 18-24 mos was more in T2T pts (39% vs 24%; p=0.02), but more AE w/ Sx driven Rx (53 vs 42%) https://t.co/5g2dY5y900
Dr. John Cush @RheumNow( View Tweet )
Saliva and Uric Acid Testing
A recent report from China reaffirms the potential utility of salivary uric acid (UA) testing delivers smartphone-guided, enzyme-free gout screening at home for pennies per test.
Read Article
Raynauds: Using the Clinical Practice Research Datalink Aurum (PCP) database (1998 - 2023) the prevalence of Raynaud’s 894/100 000, or 158449 cases in 2023. More in elderly & females, less in blacks. Incidence rate 46/100K https://t.co/S5Eg4AZSPU https://t.co/nG2p2g2Jc1
Dr. John Cush @RheumNow( View Tweet )
QD CLINIC: Senior Year Gout
Daric Mueller, PA-C, discusses a case of difficult-to-treat gout in an individual first diagnosed at age 18 who is now in his early 30s. This QD Clinic is presented as part of RheumNow's "Gout: More than Flares" campaign.
https://t.co/9GNk8ZqwyS https://t.co/hAFz6zPcay
Dr. John Cush @RheumNow( View Tweet )
Do we need Better Strategies to Prevent Osteoporotic Fractures?
In a recent JAMA Viewpoints article, Dr. Susan Ott addresses several controversies in preventing osteoporosis (OP) related fractures.
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The Power of Self-Management with Chronic Low Back Pain
Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the https://t.co/urZPsVwCV8
Dr. John Cush @RheumNow( View Tweet )
Uric Acid: Is Lower Better?
There is good evidence that a serum urate less than 6 mg/dL is required to meaningfully reduce urate crystal and gout flare burden, but is even lower better and are there any tradeoffs?
https://t.co/yVZOuMhZmr https://t.co/Ldc1pBQThH
Dr. John Cush @RheumNow( View Tweet )
< 40% of gout patients are on ULT; <40% of ULT-treated gout patients achieve T2T (SUA < 6.0 mg/dl).
For more gout content, follow our Gout: More than Flares campaign at https://t.co/j3iLMZz4HM, https://t.co/zFTozS62me
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
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
EULAR 2026 Daily Podcast Day 2c
Are your patients with moderate to severe RA getting the appropriate dose? Sponsored by Genentech, Inc
