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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“60-40-20” - Ed Keystone
(rumor has it he was actually bidding on a copy of my textbook!)
Dr. John Cush @RheumNow( View Tweet )
Have a Rheumatology question or case for Jack Cush? Record it here, and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/yyGRvXx3lL https://t.co/MgPqpaFLOc
Dr. John Cush @RheumNow( View Tweet )
Nurses - the calm through chaos
Nurses are a unique breed. When they appear, it’s always a blessing. But who goes into nursing? What kind of person choose nursing over doctoring?
https://t.co/smUWg06nVh https://t.co/swQYJ3NfZF
Dr. John Cush @RheumNow( View Tweet )
Supposedly there's a shortage of Infectious Dz specialists & Fellowship applic are down. Survey of 380 Int. Med residents (41 prgs) shows ID interest signif assoc w/ exposure to ID in Yr 1 & 2, outpt clinics, ID- research. https://t.co/AUkiIvsuaV https://t.co/pOqkBhy93U
Dr. John Cush @RheumNow( View Tweet )
American Nurses Assoc. response to Dept of Education’s Final Rule on Graduate Loans for nurses: "..profoundly dismayed by DoE exclusion of nursing from....“professional degree” programs... this ignores the voices of over 245,000 nurses and nurse advocates https://t.co/WEYdiO9x4n https://t.co/3wxOwDBHVg
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
A Review of Hydroxychloroquine Ocular Toxicity
While hydroxychloroquine (HCQ) is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal toxicity, risk stratification, and evidence-
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Gout Control Lowers Cardiovascular Events
A large target emulation trial suggests that gout patients prescribed urate-lowering treatment who achieve a serum urate level lower than 6 mg/dL significantly lower their risk of cardiovascular events.
Cohorts were derived from the Clinical Practice Research
STEP Talk: Mitigating Surgical Risk with Dr. Susan Goodman
Surgery is high stakes for rheum patients.
Dr. Susan Goodman shares how to mitigate perioperative risk and optimize outcomes at #RheumNowLive 2026.
Smart prep = better recovery.
https://t.co/AM1N3SimiY
#Rheumatology https://t.co/wk99ytXZKl
Dr. John Cush @RheumNow( View Tweet )
Review of Toll-like Receptor Research
EurekAlert!
A new review on Toll-like receptors (TLRs) systematically summarizes forty years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding
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Nurses - the calm through chaos
Gloria was the charge nurse on 3 West when a “code” was called. Action, running, and commotion ensues as the crash cart, nurses, and respiratory therapist appear at the bedside. Two residents emerge as the patient is hooked up to the monitor. While everyone assumes their position and role,
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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.
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Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis
Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.
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More Comorbidity in Difficult to Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
Knee pain: JAMA review
- 5% PCP visits knee pain
- Knee OA ~654 million worldwide
- Patellofemoral pain: <40 yrs & physically active; pain on squat
- Meniscal tears in 12% adults (McMurray 61% sensitive; 84% specific; Joint line tender 83% sensitive; 83% specific) https://t.co/2fdpl464mb
Dr. John Cush @RheumNow( View Tweet )
Prospective study of 305 Consecutive newly diagnosed axSpA pts (55% male; Dx delay 6 yrs; 75% B27+). 56% w/ r-axSpA more male w/ hi CRP. nr-axSpA had more inflam LBP, +FHx SpA. SpA Dx made without sacroiliitis in 12%; only 2/38 later developed sacroiliitis https://t.co/xPlGwZ7Kjk https://t.co/2TBQALvxsG
Dr. John Cush @RheumNow( View Tweet )
Great Lectures; Great Presentations
Dr. Jack Cush lectures on giving a great presentation; based on 40 years of lecturing in Rheumatology.
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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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A man spends 50 years teaching at MIT.
He knows his time is running out.
So he records one last lecture — everything he knows, distilled into a single hour.
He died 5 months later.
This is that lecture.
The most important hour you'll watch this week. 👇
Bookmark it for later https://t.co/tRUH05ysSt
Suryansh Tiwari @Suryanshti777( View Tweet )
APR: Methotrexate
Companion slide deck for the Advanced Practice Rheum: Methotrexate video, featuring Dr. Jack Cush.
https://t.co/8422FKN4dq https://t.co/6gVS7dA8Gi
Links:
Dr. John Cush @RheumNow( View Tweet )
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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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.
Therapeutic Updates
Lupus Nephritis
Sponsored by RheumNow
View our six video perspectives on lupus nephritis, including Management of CKD in Lupus Nephritis.
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Recent Blogs
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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