Rheumatoid Arthritis

RT @Gibson_RheumPAC Obesity doesn’t just increase risk of rheumatic diseases-it worsens outcomes. Patients with obesity have higher disease activity, poorer biologic response, and 20–25% lower remission rates in inflammatory arthritis. #RNL26

Dr. John Cush @RheumNow( View Tweet )

Haque and Goodman

Obesity, Surgery, and Optimizing Patient Care

Eric Dein, MD

Rheumatologic care involves multidisciplinary approaches and collaboration with specialties to treat complex, systemic diseases. While many Pods at RheumNow Live are disease specific, the Pod II focused on Advancing Practice on important and emerging areas affecting rheumatologic patients. This

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RT @richardPAconway Dr Sparks shows risk factors for RA-ILD. Important for diagnosis (and screening?) Focus interventions on the modifiable ones! #RNL26 https://t.co/lE9Mkbq8oh
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway UIP is predominant radiologic pattern in RA-ILD. Contrast with our other diseases. But by no means exclusive - up to 50% of RA-ILD have a more inflammatory pattern. Important treatment implications! #RNL26 https://t.co/HmW1mz429i
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway Updated data on RA-ILD from Olmstead County. Cumulative incidence of 15.3% over 20 years! #RNL26 https://t.co/wVrTc3QM6Y
Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinmd Mucosal Hypothesis RA #RNL26 Demoruelle Mucosal origins of RA? Key sites of immune-environment interaction initiate local inflamm, becomes systemic Link of lung inflamm/immune dysregulation - ass w/ smoking, ILD NETs in lung drive RA path? Gut/oral microbes drive

Dr. John Cush @RheumNow( View Tweet )

Advances in RA-ILD Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26. https://t.co/xO7hBRKeqE https://t.co/rs1MS08Svl

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Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinmd Mucosal Hypothesis RA #RNL26 Demoruelle ACPA can predate RA development Nam et al: non-specific jt pain: 42% developed RA in 12 mos Circiumaro et al: MSK complaints 38% devel RA in 36 mo APIPPRA: 29% at 12 mo, 37% at 24 mo, StopRA 18% in 12 mo, 33% at 36 mo https://t.co/DxGhhFL1gO
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway Dr Sparks. RA-ILD is common. Pooled prevalence of 11% from recent meta-analysis. Less common than SSc or IIM, but more frequent than we think! #RNL26 https://t.co/mJSmMakSBM
Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinMD Mucosal Hypothesis RA #RNL26 Demoruelle ACPA can predate RA development Nam et al: non-specific jt pain: 42% developed RA in 12 mos Circiumaro et al: MSK complaints 38% devel RA in 36 mo APIPPRA: 29% at 12 mo, 37% at 24 mo, StopRA 18% in 12 mo, 33% at 36 mo https://t.co/JYiWmn0N0g
Dr. John Cush @RheumNow( View Tweet )
RT @richardPAconway Dr Sparks. RA-ILD is common. Pooled prevalence of 11% from recent meta-analysis. Less common than SSc or IIM, but more frequent than we think! #RNL26 https://t.co/TCsDfeQjZC
Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinmd Mortality risk in RA #RNL26 Myasoedova Most common mortality: 1.5-1.6x increase risk CVD 2-3x increase risk ILD +ACPA increases risk in both https://t.co/Luwyy6UFg6
Dr. John Cush @RheumNow( View Tweet )
RT @ericdeinmd Mortality risk in RA #RNL26 Myasoedova Premature deaths in up to 1/4 of pts Decline in mortality in RA after year 2000 Full siblings of RA also high mortality (shared genetic or environ factors affect risk?) Risks: Seropositivity, esp ACPA, CRP, extra-artic https://t.co/ytm6odmtgR
Dr. John Cush @RheumNow( View Tweet )
Sparks RNL26

Advances in RA-ILD

Richard Conway, MBBChBAO, PhD

Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26. 

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Methotrexate intolerance in rheumatoid arthritis A current large rheumatoid arthritis (RA) cohort study from Cairo assessed methotrexate (MTX) use and found over half were MTX intolerant and a third of patients were noncompliant with MTX. https://t.co/ODiVqUXBb9 https://t.co/QwmNkrjvn6

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Dr. John Cush @RheumNow( View Tweet )
Always on exams, but I've never seen a case! JAMA Dermatology reviews Multicentric Reticulohistiocytosis - pt w/ multiple nodules on hands & pain in shoulders, elbows, MCPs, IPs. Erythema over face, chest, & back & bead like Perionychial papules. Rx w/ MTX + Pred https://t.co/QgS5VBOB51
Dr. John Cush @RheumNow( View Tweet )
ALTO: Long-Term Abatacept Outcomes in At-Risk RA Lancet Rheumatology has published the ALTO results - long term outcomes of the APIPPRA trial, demonstrating that treatment with abatacept (ABA) in at risk patients can delay progression to rheumatoid arthritis (RA) for up to 4 https://t.co/Lb8md9cYbG
Dr. John Cush @RheumNow( View Tweet )
Study of 286 RA pt finds comorbidity burden—particularly psychological comorbidity—was strongly associated with poorer HRQoL and greater management difficulty in RA. https://t.co/F90S55DaI6 https://t.co/4Hw1yTUgP5

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Dr. John Cush @RheumNow( View Tweet )
RA outcomes according to onset: typica RA vs undifferentiated inflam arthritis (UIA) or palindromic rheumatism (PR). Progress to RA = RA > UIA > PR. PR has more +FHx & ACPA; UIA more females w/ Knee Sxs. Best remission rates w/ PR onsets. https://t.co/JJRCdKcs1u https://t.co/n385f6EF59

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Dr. John Cush @RheumNow( View Tweet )
Methotrexate intolerance in rheumatoid arthritis A current large rheumatoid arthritis (RA) cohort study from Cairo assessed methotrexate (MTX) use and found over half were MTX intolerant and a third of patients were noncompliant with MTX. https://t.co/PDUv2YRFIq https://t.co/2DuBXjNqec

Links:

Dr. John Cush @RheumNow( View Tweet )
RA,polyarticular,black,rheumatoid

ALTO: Long-Term Abatacept Outcomes in At-Risk RA

Jack Cush, MD

Lancet Rheumatology has published the ALTO results - long term outcomes of the APIPPRA trial, demonstrating that treatment with abatacept (ABA) in at risk patients can delay progression to rheumatoid arthritis (RA) for up to 4 years.

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2016 ARTIC trial tested T2T w/ MTX & "bridging" tapered Prednisolone (15 mg --> 0mg over 7wks) in 237 new DMARD naive RA pts. PRED discontinuation successful in 84% @7wks, 89% @3mos, 95% @ 24 mos. Only 5% require Pred @ every visit for 2 yrs. You can D/C pred! https://t.co/O23PHq81YP
Dr. John Cush @RheumNow( View Tweet )
Notch and TGFβ Signaling in Refractory Rheumatoid Arthritis Spatial transcriptomic profiling of rheumatoid arthritis (RA) synovial biopsies (pre- and post-treatment) has revealed new insights into the pathobiology or treatment resistent RA. https://t.co/vCvFpnIOvS https://t.co/EV6OihT0br

Links:

Dr. John Cush @RheumNow( View Tweet )
research2.jpg

Canada's 2025 Top 10 Funded Rheumatology Projects

Arthritis Society

Arthritis Society Canada (ASC) is Canada’s largest charitable funder of cutting-edge arthritis research, investing more than $240 million in research projects since its founding, and over $7 million invested in 2024-2025. Below are the investigators and projects that were funded in 2025.

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MTX.box

Methotrexate intolerance in rheumatoid arthritis

Jack Cush, MD

A current large rheumatoid arthritis (RA) cohort study from Cairo assessed methotrexate (MTX) use and found over half were MTX intolerant and a third of patients were noncompliant with MTX.

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Recent Blogs

Advanced Practice Rheum

Difficult to Treat Rheumatoid Arthritis

Jack Cush, MD
D2T RA Cover
Dr. Cush addresses the management of difficult-to-treat rheumatoid arthritis (D2TRA). Read Post
Advanced Practice Rheum

Methotrexate

Jack Cush, MD
APR MTX Cover
In this session, Dr. Jack Cush reviews methotrexate. Read Post
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Rx Updates (filtered for Topic)

Therapeutic Updates

The Impact of Obesity on Psoriatic Arthritis

Sponsored by Lilly Medical Affairs
A person indoors raises one arm in a flexed pose while holding the elbow with the opposite hand, with a sofa and light curtains in the background
Image alt text: A person indoors raises one arm in a flexed pose while holding the elbow with the opposite hand. Is obesity common in your patients with PsA? Learn more about the intersection of disease pathogenesis between PsA and obesity and how weight intervention can affect PsA outcomes.
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