Influential Rheumatoid Factors (5.8.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com
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Review of Toll-like Receptor Research
A new review on TLRs systematically summarizes 40 years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding of multilayered regulatory mechanisms that https://t.co/Rvy24nmuTj
Dr. John Cush @RheumNow( View Tweet )
EMA/European Commission has aproved Sotyktu (deucravacitinib) for the Treatment of Active Psoriatic Arthritis in Adults https://t.co/Fv9DON1AvB https://t.co/Li79tKzMxK
Dr. John Cush @RheumNow( View Tweet )
Breaking the Rules: Dual-Advanced Combinations in Rheumatology
For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes.
https://t.co/4lyYTTwJUU https://t.co/sYpYbCjlzm
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4/30/26 US Dept of Education finalized is rule on Grad loans "Reimagining and Improving Student Education (RISE)" that will markedly cut Federal Grad loans for nurses, nurse practitioner (NP) and physician associate (PA) training. https://t.co/kdm0ZLZfnL https://t.co/OGr3BEYga7
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Taiwan, real-world study 267 RA new DMARD starts w/ tofacitinib (145) or TNFi (122). Post adjustments; no significant difference in Efficacy, AEs, Serious AE (20 v 21%), MACE (0 v 0.8%), CA (2% vs 0.8%), deaths (1.4% vs 3.3), SIE (13% vs 8.2%) or H zoster (12% v 3%) https://t.co/XLsdfKyeGx
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A Patient’s Plea for a New Paradigm in Autoimmune Disease
A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?
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Breaking the Rules: Dual-Advanced Combinations in Rheumatology
For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes.
Read Article
U.S. spending on prescription drugs in 2025 jumped 13% to $915 billion=projected to surpass $1 trillion in 2026, according to ASHP/USA today. One major reason– the popularity of the weight-loss and diabetes drugs tirzepatide and semaglutide. https://t.co/EQ9yFCCdBp https://t.co/cig1jNp6NF
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FDA Targeting the Safety of Avacopan
The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market. https://t.co/Otl0WQaOqo
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Anifrolumab (Saphnelo) approved in the US for subcutaneous self-administration as a new autoinjector for the treatment of systemic lupus erythematosus based on SC-TULIP study. Presumeably, all prior CRL issues resolved to FDA satisfaction... https://t.co/ZtZmJLcGYa https://t.co/4B2YDpFaep
Dr. John Cush @RheumNow( View Tweet )
FDA Targeting the Safety of Avacopan
The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market. https://t.co/4PyIoqwNIL
Dr. John Cush @RheumNow( View Tweet )
APR: Steroids
https://t.co/FxqGaijo6w https://t.co/OrybGNXsdf
Links:
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COVID Virus Persistence with DMARD Use
MedPage Today
Drugs commonly used to treat systemic autoimmune rheumatic diseases (SARDs) may keep the SARS-CoV-2 circulating after COVID-19 infection in patients with these conditions, with researchers documenting substantially increased viral antigen persistence compared with other post-COVID patients.
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Review of GLP-1 Receptor Agonists in Psoriasis
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed cardiometabolic medicine and are now attracting intense interest in inflammatory disorders.
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FDA Targeting the Safety of Avacopan
The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market.
The FDA’s concern is that the data, orginally
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Sun Pharma buys out Organon w/ $11.75 billion buyout. Both generated $6.2 billion in 2025 sales. Organon spun off from Merck in 2021, specializes in women’s health and is top 7 in biosimilars. Sun is into dermatology, ophthalmology and oncology-dermatology. https://t.co/zb4hucTqCJ
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Neoplasia and Autoimmune Disease
Malignancy rivals cardiovascular disease as a leading cause of death in patients with systemic autoimmune diseases. Chronic inflammation and immune dysregulation can drive oncogenesis, while antitumor immune responses can trigger autoimmune phenomena (paraneoplastic syndromes, checkpoint
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Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA
After the first tumour necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid arthritis (RA) responded by switching to upadacitinib, compared to cycling to a second TNFi, adalimumab.
FDA has accepted Genetech application for obinutuzumab (Gazyva) to treat SLE (currently only approved for lupus nephritis) - based on Phase III ALLEGORY study w/ Gazyva showing signif reduced dz activity https://t.co/louTYyN6bN https://t.co/Hy1gGliamn
Dr. John Cush @RheumNow( View Tweet )
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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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
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Prescribing Lessons (4.17.2026)
https://t.co/6JfMvsGIdS https://t.co/W6BNcwMD3O
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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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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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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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Until the publication of the SEAM trial, evidence in the medical literature for the efficacy of the most commonly used drug for psoriatic arthritis worldwide, methotrexate, has been lukewarm at best. Yet we all employ it commonly, either as monotherapy or in combination with biologic or targeted synthetic DMARD treatment. It is inexpensive and widely available, and only modestly toxic.
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With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.
