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 )
Real-world safety of tofacitinib vs biologics in 48,167 #PsA pts Rx w/ TOFA (3,166); TNFi (27K); IL-17Ai (20K); risankizumab (4,381); ustekinumab (4,499). Crude IRs/100 PY were 1.78-2.53 for serious infxn, 0.27–0.61 MI/stroke, 0.17–0.42 VTE, & 0.74–1.06 cancer. TOFA had signif https://t.co/Z5wZTGc5gB
Dr. John Cush @RheumNow( View Tweet )
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. Armstrong et al
Retrospective TriNetX Network cohort study of adult PsA (N 123,031) pts, propensity- matched to non-PsA controls. PsA had signif higher CV morbidity: MACE (HR 1.74); mortality (HR 1.95); CHF (HR 1.96), MI (HR 1.71), & CVA (HR 1.49). bDMARDs reduced MACE (HR 0.95) & mortality (HR https://t.co/bHrq9KpwBM
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Prevalence of fibromyalgia in PsA = 18%. FM-PsA pts have higher scores Dz activity scores from FM, rather than inflammation. Fibromyalgia is assoc w/ worse disease outcomes, including failure to achieve low disease activity state and poorer response to therapy. https://t.co/utQRXPmpDs
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Long-Term Bimekizumab Safety Data
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. https://t.co/AaJxewNQmQ
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FDA has approved secukinumab (Cosentyx) for use pediatric patients (aged >12yrs) with moderate to severe hidradenitis suppurativa https://t.co/oX4LGU16QP
Dr. John Cush @RheumNow( View Tweet )
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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FDA Approves Icotrokinra for Plaque Psoriasis
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 are candidates for systemic therapy or phototherapy, according to a https://t.co/q5b3TceFHx
Dr. John Cush @RheumNow( View Tweet )
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
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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 approved secukinumab (Cosentyx) for use pediatric patients (aged >12yrs) with moderate to severe hidradenitis suppurativa https://t.co/G1BtS15sWT
Dr. John Cush @RheumNow( View Tweet )
ILD found in 3% of #PsA pts. Metanalysis of 6 studies, 14,272 pts found ILD pooled prevalence was 3% in PsA; highers ((6%) in studies w/ CT, HRCT. Smoking was a signif. risk factor for ILD in PsA (OR 2.94, 95% CI: 1.22–7.12; I2 = 1.8%). https://t.co/9mY4Eiqc9d
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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
Links:
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Pitfalls of autoimmune serologic testing
Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of serological autoimmune markers.
A current review focuses commonly used serologies and autoimmune tests to identify
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UCB announced topline results of the BE-BOLD head-to-head study where bimekizumab (IL-17i) was superior to risankizumab (IL-23i) study; 553 active PsA in achieving an ACR50 response at 16 weeks. Enrolled PsA pts were either bilogic naïve or who had previous exposure to 1 TNFi
Dr. John Cush @RheumNow( View Tweet )
https://t.co/4UQlqwujiR 2026 — On Demand
Catch the sessions everyone in rheumatology is talking about:
• RA advances
• Psoriatic arthritis decisions
• Spondyloarthritis updates
• Autoimmune disease highlights
• Vasculitis insights
Full recordings + slides available now. https://t.co/QT6NOXakVv
Links:
Dr. John Cush @RheumNow( View Tweet )
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 )
Rheumatic Immune-related Adverse Effects with Checkpoint Inhibitor Therapy
A retrospective study of patients who developed rheumatic immune-related adverse events (R-irAEs) after receiving immune checkpoint inhibitors (ICIs) at two oncology centers in Spain suggests that early recognition can lead to effective management that allows continuation of cancer therapy.
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UCB announced topline results of the BE-BOLD head-to-head study where bimekizumab (IL-17i) was superior to risankizumab (IL-23i) study; 553 active PsA in achieving an ACR50 response at 16 weeks. Enrolled PsA pts were either bilogic naïve or who had previous exposure to 1 TNFi
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 )
https://t.co/4UQlqwujiR 2026 — On Demand
Catch the sessions everyone in rheumatology is talking about:
• RA advances
• Psoriatic arthritis decisions
• Spondyloarthritis updates
• Autoimmune disease highlights
• Vasculitis insights
Full recordings + slides available now. https://t.co/wGrptPBYNu
Links:
Dr. John Cush @RheumNow( View Tweet )
Korean National Insurance claims study (2010–2023) of treatment persistence of IL-17i vs TNFi (IL-17i: 375; TNFi: 1285) in 1660 axSpA pts found equal Tx durations. However, primary nonresponse D/C was significantly higher w/ TNFi vs IL-17i (adj HR 1.54 to 2.11) https://t.co/2CF4OCPT6z
Dr. John Cush @RheumNow( View Tweet )
Therapeutic Updates
5-Year Results of an IL-23 Inhibitor in Patients With PsA
Sponsored by AbbVie Medical Affairs + Health Impact
Dr. Alvin Wells and Dr. Shikha Singla share their clinical perspectives on using an IL–23 inhibitor to manage patients with PsA throughout their treatment journey in the context of 5-year data from the KEEPsAKE trial program.
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Poster Hall
Recent Blogs
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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A colleague of mine once told me an interesting story of how her father, who was a doctor, misdiagnosed his wife with fibromyalgia when she actually had psoriatic arthritis with enthesitis all along. I would venture out and say that the average physician would have trouble evaluating enthesitis because even we, as rheumatologists do!
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Podcasts
ACR 2025 PsA Topic Podcasts Compilation 6
ACR 2025 Daily Podcasts Day4b-
ACR 2025 Daily Podcasts Day4a
