Rheumatoid Arthritis

NEJM images: Jaccoud’s arthropathy is a chronic, deforming;from laxity of the ligaments & tendons (not damage to bone & cartilage). Deformities are reducible & no erosions on Xray. Jaccoud’s mimics RA, but most seen w/ SLE. https://t.co/99WDNcpT5c https://t.co/EdiGW1dDWY

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Dr. John Cush @RheumNow( View Tweet )
QD Clinic: RA, IBD and Frank's sign Daric Mueller, PA-C, St. Clair Shores, MI, presents a case called, "Rheumatoid Arthritis, IBD and Frank's Sign", as part of RheumNow's "The Obesity Imperative" campaign presented in September 2026. https://t.co/XMD0b35fiu https://t.co/9WUdZKAR0w

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Dr. John Cush @RheumNow( View Tweet )
“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis The proposed approach to D2T-RA is based on the EULAR definition (having failed 2 or more b/tsDMARDs). It is estimated that up to 20% of RA patients meet this D2T-RA definition and can be plagued by active or https://t.co/o39IREvjI4
Dr. John Cush @RheumNow( View Tweet )
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Treating Obesity is Disease-Modifying (9.4.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  New drugs approved, new drugs halted and some drugs out of control. Ready to test your knowlege? Take this week's quiz!

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NEJM images: Jaccoud’s arthropathy is a chronic, deforming;from laxity of the ligaments & tendons (not damage to bone & cartilage). Deformities are reducible & no erosions on Xray. Jaccoud’s mimics RA, but most seen w/ SLE. https://t.co/99WDNcpT5c https://t.co/77zAjpQh9A

Links:

Dr. John Cush @RheumNow( View Tweet )
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BMI Affects JAK Inhibitor Responses in Rheumatoid Arthritis

Jack Cush, MD

A meta-analysis of Janus kinase (JAKi) inhibitors clinical trials in rheumatoid arthritis (RA) has shown higher BMI was associated with poorer responses and a reduced treatment benefit with JAK inhibitors in RA patients.

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VA (VARA) registry study of 2723 RA pts showed frailty was independently associated with increased cancer incidence. Age-adjusted CA incidence rates (per 1,000PYs) were 12.3 (robust), 15.5 (pre-frail), and 19.9 (frail). CA mortality rates were 7.8, 10.6, & 9.8/1,000PYs https://t.co/Ex52R56oT1
Dr. John Cush @RheumNow( View Tweet )
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“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis

Jack Cush, MD

The proposed approach to difficult-to-treat rheumatoid arthritis is based on the EULAR definition (having failed 2 or more b/tsDMARDs). The authors provide guidance in the form of an easy acronym, A B C D E, which covers both diagnostic and therapeutic considerations.

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empty bed

Sleep and Obesity: A Bidirectional Relationship

Jack Cush, MD

In July 2026, JAMA concisely reviewed the bidirectional relationship between sleep health and obesity. Obesity affects roughly 40% of US adults and sleep problems affect nearly one-third. This review outlines the biological mechanisms and clinical interventions relevant to weight management.

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Rheums! Do you have a Rheumatology question or case for Dr. 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/LZ59KW8HdA https://t.co/DwHdvpTYax

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Dr. John Cush @RheumNow( View Tweet )
Resolved HBV infx (HBsAg-neg/anti-HBc+) retrospective study of HBc seroclearance in 230 pts Rx w/ anti-CD20 mAb. anti-HBc seroclearance seen in 16.5% (assoc w/ Younger age, less CD20 Rx, MMF Rx). HBV reactivation seen 5/230 (2.2%), including two w/ HBc seroclearance. HBc https://t.co/T0gfxftOgu
Dr. John Cush @RheumNow( View Tweet )
Phase 1/2 COMPARE trial of CD19 CAR-T Rx in 6 ACPA+ RA pts w/ severe refractory Dz; after lymphodepletion, given mivocabtagene autoleucel (miv-cel), followed < 52wks. All had CRS, No ICANSs or serious AEs. All had CD19 cell depletion & Decr in AutoAbs. Efficacy: 3/6 had ACR70 & https://t.co/28dWMGWbKB
Dr. John Cush @RheumNow( View Tweet )
Aortic inflammation (Aortopathies) occurs in autoimmune rheumatic diseases (ARD) including Takayasus, #GCA, SLE, RA, AS, SSc, relapsing polychondritis, Cogan’s syndr, Behçet’s, & IgG4-related disease). Dx imaging options: CTA, MRI, & PET/CT. Underlying path may be granulomatous, https://t.co/paUlV4kdwJ
Dr. John Cush @RheumNow( View Tweet )
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NME: New Molecular Entities (8.28.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com. Take this week's RheumIQ and test your knowledge!

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Phase 1/2 COMPARE trial of CD19 CAR-T Rx in 6 ACPA+ RA pts w/ severe refractory Dz; after lymphodepletion, given mivocabtagene autoleucel (miv-cel), followed < 52wks. All had CRS, No ICANSs or serious AEs. All had CD19 cell depletion & Decr in AutoAbs. Efficacy: 3/6 had ACR70 & https://t.co/qfSdq2g0rk
Dr. John Cush @RheumNow( View Tweet )
Aortic inflammation (Aortopathies) occurs in autoimmune rheumatic diseases (ARD) including Takayasus, #GCA, SLE, RA, AS, SSc, relapsing polychondritis, Cogan’s syndr, Behçet’s, & IgG4-related disease). Dx imaging options: CTA, MRI, & PET/CT. Underlying path may be granulomatous, https://t.co/lKBhEnTcKB
Dr. John Cush @RheumNow( View Tweet )
Spyre Therapeutics topline results of its anti-TL1A Ab (SPY072) in RA (n 133) sub-study: Phase 2 SKYWAY 12wk trial showed 2 doses SPY072 were signif better vs PBO for ACR20 (63% & 58% vs 43%), ACR50 (31% &38% vs 19%), DAS28-CRP reductions (-1.5 & -1.9 vs -1.3). TL1A inhib are https://t.co/S6gapB21uq
Dr. John Cush @RheumNow( View Tweet )
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Insights into Sjögren’s Disease - A Rheum Survey

Jack Cush, MD

RheumNow recentlty surveyed rheumatologists about Sjogren’s disease (SjD) - how they approach diagnosis, treatment, and unique challenges; all important as new advances in SjD evolves.

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402 RA pts w. symptomatic Extra-articular manifestations (eg, neuropathy, KCS) had significant impairment in quality of life and work productivity, independent of disease activity. They had lower HAQ (0.92 vs 0.68) & more Absenteeism https://t.co/1FH9gyxoxK https://t.co/faToGXpdSQ

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Dr. John Cush @RheumNow( View Tweet )
Risk of Venous Thromboembolism in RA RA confers a 50–100% excess risk of venous thromboembolism (VTE) that remains even when remission is achieved. Disease control reduces but does not eliminate thrombotic risk. https://t.co/GXvuucL3ze https://t.co/fTw6UY7eZH

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Dr. John Cush @RheumNow( View Tweet )
steroid prednisone lab

Glucocorticoids: Use vs.Toxicity

Jack Cush, MD

This review article addresses the recognition, prevention and management of glucocorticoid toxicity in rheumatic patients.

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e-cigarette use assoc w/ a 1.5-fold incr risk of RA & SLE. All of Us Research prg matched 15,909 e-cig users vs nonusers. 66 new RA or SLE among current e-cig (IR 1.43/1,000PYs) vs nonusers (0.93/1,000PYs; IRR 1.54); applies to past or current smokers https://t.co/xYRezwQFYC https://t.co/pnNANfui4Y

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Dr. John Cush @RheumNow( View Tweet )
VA study of 4108 RA-ILD (2006-21). PRED use was 65-77%, A& 1st line Rx (MMF, AZA, RTX, CTX) incr after ILD, use was low (1.2-12%). MTX decr (47 to 30%), but LEF, TNFi, ABA incr. Predictors of ILD Rx: FVC, CCP+, ILD Dx after 2012. https://t.co/GT3Vwo11w1 https://t.co/KFDKsjkN0k

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Dr. John Cush @RheumNow( View Tweet )
In rheumatoid arthritis, which RA-specific factor is the strongest modifiable driver of venous thromboembolism risk? Test your knowledge in this week's RheumIQ at https://t.co/TBlB4pmnKa. https://t.co/L69CPXWqfl

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Dr. John Cush @RheumNow( View Tweet )
Risk of Venous Thromboembolism in Rheumatoid Arthritis RA confers a 50–100% excess risk of venous thromboembolism (VTE) compared with the general population, with adjusted hazard/odds ratios ranging from 1.3–2.2 across large cohort studies (Vojinovic, Askling, Antovic; https://t.co/IsS6vqo6vU
Dr. John Cush @RheumNow( View Tweet )

Therapeutic Updates

Make Rheum for Rads: Autoimmune ILD Diagnosis, Monitoring, and the Patient Experience

Sponsored by Boehringer Ingelheim Pharmaceuticals, Inc.
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Drs. Elizabeth Volkmann and Robert Suh explore the roles rheumatologists and radiologists play in diagnosing and monitoring autoimmune ILD and hear from a patient about her experience.
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Recent Blogs

Advanced Practice Rheum

Safety of Biologics and Novel Agents

Jack Cush, MD
APR Safety Video Cover
Dr. Jack Cush reviews safety of biologics and novel agents.
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Advanced Practice Rheum

Steroids

Jack Cush, MD
STEROIDS COVER
In this Advanced Practice Rheum, Dr. Jack Cush reviews steroids.
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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).
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Podcasts

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