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Pediatric Rheum

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.

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Top Four and More (4.10.2026)

Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.

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19 yr old male is Dx w/ Stills Dz (Fever 104F, pleuritis, organomegaly, WBC 24k, ESR 98, CRP 11 mg/L) - what drug do you prescribe first?

Dr. John Cush @RheumNow( View Tweet )

Portugese multicentre retrospective of 748 adults with JIA (age 28 yrs; Dz duration 21 yrs). Oligoarticular JIA was the most common subtype (29.9%). HTN (9%), psychiatric dz (8%), & osteoporosis (5%) were most prevalent comorbidities. bDMARD use reduced risk of psych Dz https://t.co/xCrTDxirlj
Dr. John Cush @RheumNow( View Tweet )
19 yr old male is Dx w/ Stills Dz (Fever 104F, pleuritis, organomegaly, WBC 24k, ESR 98, CRP 11 mg/L) - what drug do you prescribe first?

Dr. John Cush @RheumNow( View Tweet )

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/V7OxwEI4it
Dr. John Cush @RheumNow( View Tweet )

Moral Distress (3.27.2026)

Dr. Jack Cush reviews the journal reports and news from RheumNow.com.  This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.

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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/XWJSsIE7Pn
Dr. John Cush @RheumNow( View Tweet )

Rheumatology Pitfalls (3.20.2026)

Dr. Jack Cush reviews the regulatory actions, news and journal reports from this past week on RheumNow.com.

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FDA has approved secukinumab (Cosentyx) for use pediatric patients (aged >12yrs) with moderate to severe hidradenitis suppurativa https://t.co/G1BtS15sWT

Dr. John Cush @RheumNow( View Tweet )

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 )
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 )

UBER Rheumatology Ride (3.6.2026)

Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com

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New studies posted this week in Arthritis & Rheumatology: Adalimumab ± MTX as first-line therapy for childhood-onset chronic uveitis https://t.co/L4QiZZBBG7 Bisphosphonates & PPI/H2RA coprescriptions in polymyalgia rheumatica https://t.co/62Pqt5Ab58 Phase 3b SOLSTICE trial: https://t.co/MsK4XC3eNh
American College of Rheumatology @ACRheum( View Tweet )
Spectrum of skin Sxs in 518 pts w/ Stills dz from AutoInflammatory Dz Alliance (AIDA) Network Registry dedicated to Still’s disease includes Salmon evanescent rash (64%), macules (7.7%), urticaria (6%), persistent pruritic papules & plaques (PPPP) (4.8%) https://t.co/DW9NoaxNPP https://t.co/U5GrCutYT0
Dr. John Cush @RheumNow( View Tweet )
Study of 90 adolescents (46 w. Juvenile fibromyalgia (JFM) & 44 controls) finds that JFM pts have greater sensitivity to non-painful sensory stimuli, such as sounds and bright lights; such hypersensitivity is closely related to the severity of the disease and brain function https://t.co/KGqzRK6e4a
Dr. John Cush @RheumNow( View Tweet )
DMARD Responses in Localized Scleroderma JAMA Dermatology has published the results of a juvenile localized scleroderma (JLS) trial showing that mycophenolate mofetil (MMF) and methotrexate (MTX) are equally effective in treating JLS, noting low flare rates and possibly better https://t.co/6bDtVoCgRj
Dr. John Cush @RheumNow( View Tweet )
DMARD Responses in Localized Scleroderma JAMA Dermatology has published the results of a juvenile localized scleroderma (JLS) trial showing that mycophenolate mofetil (MMF) and methotrexate (MTX) are equally effective in treating JLS, noting low flare rates and possibly better https://t.co/BbIS5rdRYU
Dr. John Cush @RheumNow( View Tweet )

DMARD Responses in Localized Scleroderma

JAMA Dermatology has published the results of a juvenile localized scleroderma (JLS) trial showing that mycophenolate mofetil (MMF) and methotrexate (MTX) are equally effective in treating JLS, noting low flare rates and possibly better tolerability with MMF.

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Emergencies, Independence & Hemorrhage (1.23.2026)

Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com

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Nurse Practitioner Independence

A JAMA Viewpoint article reports on a March 2025 Nurse Practitioner (NP) Entrepreneurship Summit in Boston in March 2025 identifying barriers and opportunities to NP-owned medical practices.

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A 2 yr. old female pt reported w/ a a novel P435S gain-of-function variant in TLR7 (thought pathogenic in SLE) - pt dx w/ juvenile SLE, recurrent infection, and neuroinflammatory features. A review of 12 other TLR7 GOF variants revealed similar SLE associations. https://t.co/NU553QwCtj
Dr. John Cush @RheumNow( View Tweet )

The 2025 Rheumatology Year in Review

The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.

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