Methotrexate Safety Tips (7.31.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Social Media (SM) for Health Information by US (sample 7278 adults) - SM use reported by 88% (representing ~ 228 million). ~22% adults made health decisions based on SM, despite almost 78% reporting distrust of SM. Lower SM use in older, rural, less educated. https://t.co/uYYzBvckFu
Dr. John Cush @RheumNow( View Tweet )
New Avacopan Analysis Sent to FDA
MedPage Today
After data manipulation allegations, the FDA has been calling for the vasculitis drug to be pulled from the market since January.
Amgen has submitted a third-party review of avacopan's (Tavneos) pivotal trial data and other analyses to the FDA in a bid to keep the embattled drug for
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$2 Million in Research Grants for Juvenile Arthritis
July is Juvenile Arthritis Awareness Month, and while many people think of arthritis as a disease of aging, nearly 300,000 children in the U.S. are living with a rheumatic disease.
Equally important is that 2026 marks a 50 year anniversary for Pediatric
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Genetic Risk Loci in Fibromyalgia
Researchers examined genetic data drawn from 11 different worldwide cohorts, that included from more than 2.5 million adults, of which 55,000 had been diagnosed with fibromyalgia. They identified DNA sequence variants in 26 regions of the genome that affect the risk of developing fibromyalgia.
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Uricase-Targeted Therapies in Gout
In most mammals, uricase catalyzes the oxidation of uric acid to allantoin, a highly soluble compound easily excreted by the kidneys. But humans lack functional uricase, leaving xanthine oxidase inhibitors (allopurinol/febuxostat) as first-line urate-lowering therapy (ULT). Uricase-based
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The Wider Implications of Dactylitis
Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis. This review article discusses the wider implications of dactylitis in rheumatology and medicine underscores the
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An AI model trained from routine electronic health record data of 3.7 million individuals predicted cancer 1 year before clinical onset, no less promoted accuracy in detection, staging, treatment response, and prognosis
https://t.co/ORrpJ2vIcR https://t.co/ymJWRAYOSw
Links:
Eric Topol @EricTopol( View Tweet )
Nerandomilast (Jascayd) has been approved in the European Union for adults with idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF). The drug was approved for IPF & PPF by the FDA for US use in late 2025 https://t.co/scOuVb3aYy https://t.co/EcmpRhyWgu
Dr. John Cush @RheumNow( View Tweet )
Chikungunya Club Meeting (7.24.2026)
Dr. Jack Cush reviews the news, journal reports from the past week on RheumNow.com.
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The Lancet Rheumatology has a good editorial about the avacopan bad news reports with EMA, FDA and Japan issuing negative opinions that threaten the drugs future. Yet, since approval real world data on avacopan has been favorable w/ less steroid toxicity & most hepatotoxicity https://t.co/k6ebVeWv2K
Dr. John Cush @RheumNow( View Tweet )
Fibromyalgia: Diagnosis and Management
Fibromyalgia (FM) affects 4–6% of the U.S. population, with nearly a 2 fold female predominance. Nociplastic pain underlies the pathophysiology of FM. CNS hypersensitization to both painful and non-painful stimuli occurs with little or no tissue pathology. Framing FM as a disorder of CNS
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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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Four Things About Allopurinol Hypersensitivity Syndrome
Dr. Robert Terkeltaub discusses allopurinol hypersensitivity syndrome in gout patients.
https://t.co/5seiyfVLW1 https://t.co/0A1Rtk9hzS
Dr. John Cush @RheumNow( View Tweet )
In 2010 Colchicine fell under patent protection and price increased 16 fold, & out-of-pocket price increased 4.4-fold, colchicine use decreased 27%, while allopurinol, steroid & gout visits (ER, Rheum) increased. https://t.co/xyOxsnoM5z https://t.co/yoXehV0mPa
Dr. John Cush @RheumNow( View Tweet )
FDA Delays Gout Drug NASP with Complete Response Letter
On June 26, 2026, SOBI received a Complete Response Letter (CRL) from the U.S. Food and Drug Administration (FDA) that will delay a decision on NASP, pending the company's answer to questions regarding the drugs https://t.co/NmPbWmYd0p
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.
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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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NEJM Retracts Pivotal ADVOCATE Trial of FDA-Approved Avacopan
The New England Journal of Medicine (NEJM) retracted the pivotal study supporting FDA's approval of avacopan (Tavneos) for severe forms of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis. https://t.co/GOVyk5poNq
Dr. John Cush @RheumNow( View Tweet )
FDA Delays Gout Drug NASP with Complete Response Letter
At the end of June, Sobi was awaiting an FDA decision on its Biologics License Application (BLA) for NASP (nanoencapsulated sirolimus plus pegadricase) for the treatment of adult patients with uncontrolled gout. On June 26, 2026, SOBI received a Complete Response Letter from the U.S. FDA that
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NEJM Retracts Pivotal ADVOCATE Trial of FDA-Approved Avacopan
MedPage Today
The New England Journal of Medicine (NEJM) retracted the pivotal study supporting FDA's approval of avacopan (Tavneos) for severe forms of anti-neutrophil
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A federal judge has blocked the Department of Education new rule restricting graduate school loans for NPs and PAs. DEA plan does not qualify NP & PA degrees as "professional", & loans were to be limited to $20,500 annually ($100K lifetime) https://t.co/5eIcFgbbx6 https://t.co/xuik5TWjVU
Dr. John Cush @RheumNow( View Tweet )
DMARD Efficacy in RA-ILD
A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional, low-certainty recommendations.
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RT @aurelierheumo
A long release version of xanthine oxidase inhibitor in gout
-442 pts 36 wks
-HR091506 vs febuxostat
-SUA <300 μmol/L: 63.8% vs 40.7% (Δ +22.9%, p<0.0001)
-higher SUA reduction vs baseline
-Similar overall TEAEs (~90%)
A molecule to keep an eye on!
#LB0008
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Updated CRA/SPARCC Recommendations for Axial Spondyloarthritis
In 2024, the Canadian Rheumatology Association (CMA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) published a comprehensive set of 56 treatment recommendations for the management of axial spondyloarthritis. This first update is focused on the reassessment of IL-17i
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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.
