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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Systemic Treatments for Chronic Plaque Psoriasis
JAMA Dermatology has published a review of the pharmacologic landscape on managing adults with moderate to severe plaque psoriasis.
https://t.co/fJQDvZDdbs https://t.co/IYAsdujsMf
Dr. John Cush @RheumNow( View Tweet )
Spotty Medicare Coverage for Newer Rheumatoid Arthritis Meds
Medicare coverage of targeted disease-modifying anti-rheumatic drugs (DMARDs) for RA -- both under Medicare Advantage and in separate Part D plans -- is likely to leave many patients wanting, researchers found. https://t.co/CW6gIHtnIw
Dr. John Cush @RheumNow( View Tweet )
NEJM: Polymyalgia Rheumatica
Drs. Dejaco and Matteson have published and update and review of polymyalgia rheumatica (PMR) in the NEJM. They lay out the initial approach to diagnosis, initial steroid dosing, management over time and when to use steroid sparing therapy.
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#Glucocorticoid-induced #osteoporosis results from direct suppression of osteoblast & osteocyte function, a transient stimulation of osteoclast formation & activity, catabolic effects on #bone matrix & muscle protein, and metabolic alterations https://t.co/ZmMFAOJkmw
#OpenAccess https://t.co/6CubKRbjin
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The Lancet Diabetes & Endocrinology @TheLancetEndo( View Tweet )
Spotty Medicare Coverage for Newer Rheumatoid Arthritis Meds
MedPage Today
Medicare coverage of targeted disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) -- both under Medicare Advantage and in separate Part D plans -- is likely to leave many patients wanting, researchers found.
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phase 3 VALOR trial of 6-valent OspA-based Lyme dz vaccine (LB6V) vs placebo; 4 doses given @ Mos 0, 2, 5-9, & 12 mos later. LB6V reduced Lyme Dz risk by 73.2% @28d after 4th dose. But it was only 15.8% effective (falling short of prespecified 20%) because of fewer than expected https://t.co/TcX0GV05gY
Dr. John Cush @RheumNow( View Tweet )
Who Treats Spondyloarthritis Better?
MedPage Today
European nations may be winning at optimizing care for people with axial spondyloarthritis (axSpA), international survey data indicate. In data collected from physicians and patients in the U.S. and five European countries, American patients reported a greater symptom burden on average after
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EULAR 2025 Update for Behçet’s syndrome
EULAR has updated its recommendations for the management of Behçet’s syndrome, the last being published in 2018. The current update carries no recommendations from the previous version: seven recommendations have content modifications, four have minor wording amends, and one is entirely new
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FDA has accepted the supplemental biologics license application for use of interleukin-23 inhibitor tildrakizumab (Ilumya; Sun Pharma) in active psoriatic arthritis (PsA) in adults. https://t.co/cwqz9DoWsL https://t.co/ut0A4MwqW7
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Retrospective Japanese study of 544 pts w/ GPA or microscopic polyangiitis (MPA) followed > 48 wks; only 29 (5.3%) achieved steroid free remission (GFCR) at wk 48. Predictors of GFCR: rituximab induction (OR 3.9) & avacopan use (OR 24.3). MP pulse RX had lower likelihood of GFCR https://t.co/EMRqA5oHJQ
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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Predictors of Response in Lupus
A systematic review suggests that traditional measures (serologies and disease activity) are superior to biomarkers in predicting response to biologics in systemic lupus erythematosus (SLE) patients.
Long-Term Bimekizumab Safety Data
MedPage Today
Adverse effects from bimekizumab through 2 years or more of treatment for psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) were about as expected from shorter-term data, results from long-term extension studies indicated.
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SOLSTICE: phase 3b RCT of IL-23i, guselkumab vs PBO in 451 active PsA pts (GUS q4wk vs q8wk vs PBO). @wk 24 GUS signif better than PBO-ACR20 (59%/62% vs 35%), ACR50 (31%/32% vs 12%), ACR70 (17%/17% vs 2%), PASI 90 (49%/45% vs 12%), MDA (19%/24% vs 5%) ction) https://t.co/QDMCnGdN6J
Dr. John Cush @RheumNow( View Tweet )
FDA Approves Icotrokinra for Plaque Psoriasis
Today the FDA approved an oral IL-23 inhibitor, icotrokinra (Icotyde), for use in moderate-to-severe plaque psoriasis in adults and children 12 years of age and older (who weigh at least 40 kg) who are candidates for systemic therapy or phototherapy.
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FDA has accepted the supplemental biologics license application for use of interleukin-23 inhibitor tildrakizumab (Ilumya; Sun Pharma) in active psoriatic arthritis (PsA) in adults. https://t.co/cwqz9DoWsL https://t.co/fN8pbWtmfT
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Dr. John Cush @RheumNow( View Tweet )
Poets Know It (3.13.2026)
Dr. Jack Cush reviews the news, regulatory decisions and new journal articles.
https://t.co/gFToRS2xh4 https://t.co/FUIWlNG5QJ
Dr. John Cush @RheumNow( View Tweet )
2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management
The European Alliance of Associations for Rheumatology (EULAR) has updated their rheumatoid arthritis (RA) management recommendations, notably with fewer recommendations (total of 9, down from 11 in 2022 version), by merging and removing previous recommendations.
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Worldwide Trends in Hyperuricemia
A Lancet Rheumatology systematic review shows the prevalence of hyperuricaemia has risen markedly over the past two decades in both men and women, owing to population growth, aging, and increasing age-specific rates
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Basic, full-read overview of "JAK inhibitors: risks and safety principles" from the Pharmaceutical Journal. Addresses MOA, indications, warnings, monitoring, adverse effects, interactions, Serious AEs, vaccination and best practices. https://t.co/6kZCde1NdF https://t.co/NlEKtvUGPa
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Dr. John Cush @RheumNow( View Tweet )
The Role of Calcineurin Inhibitors in Lupus Nephritis
In the U.S, lupus nephritis affects approximately 40–50% of patients with systemic lupus erythematosus (SLE), contributing significantly to the morbidity and mortality of the affected individuals (1). However, significant https://t.co/sc4cgAYzGy
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Data from the KEEPsAKE 1 trial in bio-naive patients with PsA Dr. Wells and Dr. Singla share 5-year safety and efficacy data of an IL–23 inhibitor and their thoughts on using it to manage PsA. Sponsored by AbbVie Medical Affairs + Health Impact. https://t.co/xoPdYAof7m https://t.co/ycqMod2qLN
Dr. John Cush @RheumNow( View Tweet )
Basic, full-read overview of "JAK inhibitors: risks and safety principles" from the Pharmaceutical Journal. Addresses MOA, indications, warnings, monitoring, adverse effects, interactions, Serious AEs, vaccination and best practices. https://t.co/qrqeu1CzRg https://t.co/7qIszLwUrf
Dr. John Cush @RheumNow( View Tweet )
TYK2 Inhibitor Deucravacitinib FDA Approved for Psoriatic Arthritis
On Friday, March 6th, the FDA approved deucravacitinib (Sotyktu) for the treatment of adults with active PsA based on the results of the pivotal Phase 3 POETYK PsA-1 and POETYK PsA-2 clinical trials. https://t.co/a6rmortnoS
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
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.
