Psoriatic arthritis

🍋 or ‘Lyme’ - is it Lyme disease? Dr Elizabeth Stringer discusses Eastern Canada 🇨🇦 Epidemic of #Lyme #arthritis Which mimics #pauciarticular #JIA When it is #chronic Work up of all oligoarthritis in endemic areas in kids Includes Validated Lyme test @ORAexec #ORA25 https://t.co/WxU1vaOa7z

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Janet Pope @Janetbirdope( View Tweet )
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Biologics in Pregnancy Patients With Autoimmune Disease

Jack Cush, MD

A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients than those with rheumatoid arthritis (RA), psoriasis (PsO) or psoriatic

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Panacea of Prednisone & Cannabis (5.16.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this week on RheumNow.com.  Interesting trends and results with prednisone in lupus, cannabis in RA and opioid deaths too!

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J&J announced results of Phase 3 ICONIC-TOTAL study of qd icotrokinra, an oral IL-23 receptor inhibitor, in 311 ps w/ difficult scalp and genital psoriasis (PSO) -success in 57%; skin clearance in 66% & genital psoriasis resp in 77% treated https://t.co/WftyEcDh8u https://t.co/Ydy37Eo0jX

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Dr. John Cush @RheumNow( View Tweet )
TriNetX EMR ulation study of CV risk w/ biologics in Psoriasis pts shows signifcant reduced CV events in PsO pts taking r\TNFi (HR 0.886), IL-17i (HR 0.724), IL-23i (HR 0.739); not anti-IL-12/23 (HR 0.915); Risk reduction applied to all subgroups (age, comorbidity, Wt) https://t.co/67c5yqK80h
Dr. John Cush @RheumNow( View Tweet )
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EULAR Guidelines on Reproductive Health

MedPage Today

Rheumatology patients considering or actually having babies can safely take most of the medications currently used to treat their conditions, according to an updated guideline from the European Alliance of Associations for Rheumatology (EULAR).

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IL-17 inhibitors increase risk of IBD. TriNetX database study of PsO & AS pts starting IL-17i vs apremilast. 13,216 matched pts per group, 142 developed IBD w/ IL-17i vs. 60 with apremilast (aHR = 2.50, 95% CI: 1.85–3.39). https://t.co/sSPqKsfbZ4 https://t.co/YCqDUzX9xq

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Dr. John Cush @RheumNow( View Tweet )
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Rheumatology: Believe It or Not (4/25/2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?

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An emulation trial shows that Humira biosimilars (Amjevita & Imraldi) were equivalent to Humira in psoriasis & achieving PASI <=2, both for new biologic starts and for biologic switchers. https://t.co/8lTGGs2rbP https://t.co/T6rTJ5ESj2

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Dr. John Cush @RheumNow( View Tweet )
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2025 BSR Guideline for Treatment of Axial Spondyloarthritis

Jack Cush, MD

The British Society of Rheumatology has published its 2025 Guidelines for the Treatment of Axial Spondyloarthritis (axSpA); addressing axial and extra-musculoskeletal manifestations including acute anterior uveitis, psoriasis and IBD.  They address the effectiveness and safety of

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Ultrasound lesions of dactylitis associ w/short-term development of PsA. Study of 64 PsO +arthralgia pts. IUS PD synovitis & B mode enthesitis predicted PsA Dx (p < .001) w/ an accuracy of 89.1 %, a sensitivity of 86.7 % and a specificity of 89.8 %. https://t.co/KoXMmoxXhP https://t.co/tj2NxKDkqh

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Dr. John Cush @RheumNow( View Tweet )
The Increasing Cost of First-Line Biologics for Plaque Psoriasis A national commercial claims analysis of first-line use of biologics in biologic−naive plaque psoriasis patients found a near doubling of net treatment costs from 2007 to 2021 ($21 236 to $47 125). Despite the https://t.co/mWXz2o0mwz
Dr. John Cush @RheumNow( View Tweet )
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Osteoarthritis Risky Business (4.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com.  Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.

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The Increasing Cost of First-Line Biologics for Plaque Psoriasis

Jack Cush, MD

A national commercial claims analysis of first-line use of biologics in biologic−naive plaque psoriasis patients found a near doubling of net treatment costs from 2007 to 2021 ($21 236 to $47 125). Despite the increasing costs, the 2021 average cost could have been 44% lower if the lowest-

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Ultrasound lesions of dactylitis associ w/short-term development of PsA. Study of 64 PsO +arthralgia pts. IUS PD synovitis & B mode enthesitis predicted PsA Dx (p < .001) w/ an accuracy of 89.1 %, a sensitivity of 86.7 % and a specificity of 89.8 %. https://t.co/Ij6oYP1TuK https://t.co/55sO4uFXNI

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Dr. John Cush @RheumNow( View Tweet )
Phase 2, DBRPCT of nanobody anti-IL-17, izokibep in 172 Psoriatic arthritis pts, showed higher ACR50 rates for izokibep 80mg vs PBO at wk 16 (52% vs 13%; p=0.0006) w/ 40mg=48%. Other arthritis, psoriasis, enthesitis, dactylitis, QOL outcomes also improved.https://t.co/CQn9EVjr9g https://t.co/vVnTo2FPV6

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Dr. John Cush @RheumNow( View Tweet )
2nd Opinions in Rheumatology https://t.co/R4CjJHEaL4 https://t.co/0quDwdANyU

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Dr. John Cush @RheumNow( View Tweet )
Bimekizumab efficacy and safety in patients with psoriatic arthritis who had skin and nail psoriasis at baseline: Up to 2-year results from two phase 3 studies Sponsored by UCB https://t.co/461bFRZwjw

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Dr. John Cush @RheumNow( View Tweet )

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EMR Messaging Woes (4.11.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com

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Korean insurance claims study (2008–2021) 183,212 psoriasis & PsA pts, found Biologic Rx assoc w/ lower risk of new-onset & recurrent MACEs vs phototherapy (adj HR, 0.45 & 0.34). Nonbiologic systemic Rx lowered MACE risk (v photoRx) only in pts w/ prior Hx MACE (0.79) https://t.co/1RC8bMSZJ3
Dr. John Cush @RheumNow( View Tweet )
Korean insurance claims study (2008–2021) 183,212 psoriasis & PsA pts, found Biologic Rx assoc w/ lower risk of new-onset & recurrent MACEs vs phototherapy (adj HR, 0.45 & 0.34). Nonbiologic systemic Rx lowered MACE risk (v photoRx) only in pts w/ prior Hx MACE (0.79) https://t.co/08wNm1AbpC
Dr. John Cush @RheumNow( View Tweet )
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/YkUspqd92h https://t.co/cmAUWaScri

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Dr. John Cush @RheumNow( View Tweet )
Diagnostic delays and Undertreatment of Psoriatic Arthritis New research from the University of Bath in the UK reveals delayed diagnosis and undertreatment of psoriatic arthritis often results in irreversible damage to joints. https://t.co/AyaxUXJs8n https://t.co/9x9GhnTR1Y

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Dr. John Cush @RheumNow( View Tweet )
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/0Ra8eUeBOi https://t.co/0dwOSxjVxs

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Dr. John Cush @RheumNow( View Tweet )
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/7sY1sX9B3O https://t.co/EislRI5WAy

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Best of 2022: The Enthesitis Challenge in Psoriatic Arthritis

Robert Chao, MD
heel enthesitis spur calcaneal
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!  Read Post

Best of 2022: Toss of a Coin - How do You Choose PsA Medication?

M. Elaine Husni, MD, MPH
Coin toss
When balancing all these disease domains, individual phenotypes, and comorbidities, sometimes treatment decisions can feel like tossing a coin. Fortunately, numerous guidelines have been published to help us do better than tossing a coin…or do they?  Read Post
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