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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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
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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/hgYMJJDKGA https://t.co/41sZkXPM7W
Dr. John Cush @RheumNow( View Tweet )
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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Gabapentinoid use 2008-2018: worldwide there was an annual incr of +17.2% (from 4.2/d to 18.3/d per 10K pop. Highest gaba use in high income countries, 6X higher than lower income (40/d vs 6.1/d) https://t.co/jXjxNj1Uyz https://t.co/GmQJ3UGGw9
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A LESSON FOR GC OVERUSE: Inappropriate PPI use was Twice as successful w/ reduced w/ GP & Pt-facing intervention (15 vs 7%) vs usual care or GP-only intervention. Study of 1498 GPs, 34K pts https://t.co/QWW0VYVpzU https://t.co/X3V6NMawq2
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Simulation cost-effectiveness/QOL study compared Rx of psoriasis w/ biologics, phototherapy, or step-therapy Rx. Biologics had best QOL gains; step-therapy Rx similar w/ less variability & lower costs; phototherapy was cost-effective for payors. Pts had highest willingness to pay https://t.co/RyNooKhgQh
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152 pts w/ immune thrombocytopenia (ITP) Rx in DBRPCT of Ianalumab (9mg or 3 mg/kg) or PBO q mo x 4 mos (all on Eltrombopag). Time to Rx failure signif longer w/ ianalumab. Stable 6 month response better w/ 9-mg group vs PBO (62% vs 39%; P=0.045) https://t.co/J04trYAwLu https://t.co/Alm8V2SAXn
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Litifilimab in Cutaneous Lupus Erythematosus
Biogen has announced positive results of their Phase 2 study, evaluating litifilimab in patients with active cutaneous lupus erythematosus (CLE), presented at the recent American Academy of Dermatology (AAD) Annual Meeting. https://t.co/3Wb6iFViOm
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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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Physician Use of Augmented Intelligence has Doubled
A 2026 Physician Survey to assess artificial intelligence and its use in Medical Practice has been published and follows earlier surveys around adoption and use. This is the third in a series of longitudinal surveys (prior waves 2023, 2024), enabling meaningful trend analysis. AI adoption has
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A LESSON FOR GC OVERUSE: Inappropriate PPI use was Twice as successful w/ reduced w/ GP & Pt-facing intervention (15 vs 7%) vs usual care or GP-only intervention. Study of 1498 GPs, 34K pts https://t.co/4cxoeanAK8 https://t.co/FdfUdST40o
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Potential new mechanism of MTX Effx - MTX polyglutamates accumulates in monocytes by D5, modulates transcriptional signature “non-classical monocyte”-assoc genes by Wk4, & predicts MTX responses https://t.co/g14GONKgvq https://t.co/oyoua9xAN4
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Litifilimab in Cutaneous Lupus Erythematosus
Biogen has announced positive results of their Phase 2 study, evaluating litifilimab in patients with active cutaneous lupus erythematosus (CLE), presented at the recent American Academy of Dermatology (AAD) Annual Meeting.
Litifilimab is an investigational monoclonal antibody that
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OL phase 2 study 50 active systemic JIA pts Randomized to IL-1 inhibitor, firsekibart or TCZ q2wk x 24 wks. At day 28, modified ACR Pedi 30response (no fever) favored FIRS 3mg dose (94% vs 75% vs 82%). Also higher ACR Pedi 70/90 responses & steriod tapers. https://t.co/8bdCLUFFLT https://t.co/ddQe7k25UE
Links:
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2023 FDA’s removal of REMS in-person Rx requirement for mifepristone was assoc w/ large increase in mifepristone Rx at pharmacies (most thru mail order where abortion is legal and telehealth Rxing is permitted https://t.co/9NHMmxUpLl https://t.co/jkV5DmIaJt
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Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/0JRd1k0R2R
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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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Opioids Down, Gabapentins Up
The number of U.S. patients prescribed long-term opioid therapy declined from 2015 to 2023, but co-prescribing of opioids with gabapentinoids increased, prescription data showed.
In 2023, 4.2 million people had an active long-term opioid therapy episode, defined as a period of opioid
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Malignancies Not Increased with Biologic Therapies
The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo
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JAMA Guideline on the Management of Crohn Disease
JAMA has published a current Clinical Guidelines Synopsis on the Management of Crohn Disease (CD) in Adults.
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Update on Primary CNS Angiitis
The Journal of Neurology has posted a review and update of Primary CNS vasculitis (PCNSV), also termed primary angiitis of the CNS (PACNS). PCNSV is rare, potentially fatal, and highly treatable, making timely recognition and accurate diagnosis https://t.co/cjGX1ig8Lp
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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.
