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Rheumatoid Arthritis

Dr. John Cush
@RheumNow
JAMA Uveitis review: Uveitis peaks at 20–50 yrs; 41–60% is anterior. ~40 linked to systemic disease (HLA-B27=axSpA). 1st exclude infection (TB, toxo, herpes). Anterior UV: topical steroids. Posterior/pan UV: DMARDs first (MTX remission 52%, MMF 71%); adalimumab if refractory https://t.co/jQQGzhAm7c
Dr. John Cush
@RheumNow
Treat-to-Target has Excellent 10-Year Outcomes in RA Most patients with RA whose initial treatment used a stringent treat-to-target strategy in a clinical trial were in remission 10 years later, with only modest radiographic progression over that time, researchers said. https://t.co/aWQgQAsoSI
Dr. John Cush
@RheumNow
Cryptococcus is rare, but twice as likely with JAK inhibitors. Retrospective TriNetX analysis of RA pts (>30k/grp) starting JAKi vs TNFi; JAKi vs non-TNFi; & TNFi vs non-TNF. Crypto seen in <0.2% in all groups; but signif higher HR for JAKi (HR 2.2 & 2.15) https://t.co/1J4SjcqF8u
Dr. John Cush
@RheumNow
Joint Disease in SLE Reconsidered A new Frontiers in Immunology review from Ong, Wincup and colleagues, shows that lupus arthropathy is not a single uniform entity and it is biologically under-studied and clinically mismeasured, Moreover, the biology of lupus arthritis may https://t.co/M5m6TMZr3x

Double Trouble (10.23.2026)

Jack Cush, MD

Dr. Jack Cush reviews the journal articles and regulatory announcements from this past week on RheumNow, including: two crystals in one joint, twice the cryptococcus risk in JAKs; Myositis and Scleroderma; and Sjögren’s plus early damage = >> 2 fold risk lymphoma. Double trouble week

Treat-to-Target has Excellent 10-Year Outcomes in RA

MedPage Today

Most patients with rheumatoid arthritis (RA) whose initial treatment used a stringent treat-to-target strategy in a clinical trial were in remission 10 years later, with only modest radiographic progression over that time, researchers said.

Dr. John Cush
@RheumNow
Cryptococcus is rare, but twice as likely with JAK inhibitors. Retrospective TriNetX analysis of RA pts (>30k/grp) starting JAKi vs TNFi; JAKi vs non-TNFi; & TNFi vs non-TNF. Crypto seen in <0.2% in all groups; but signif higher HR for JAKi (HR 2.2 & 2.15) https://t.co/fJeKwDZABL
Dr. John Cush
@RheumNow
Polish study compared comorbidities #s in incident RA & PsA. RA pts were older at dx (61 vs 44 yrs) & may drive higher rates in RA. 23/3 comorbidities (74%) were signif more prevalent in RA, including HTN (18 v 12%), ischemic HD (11 v 6%), cerebrovascular dz (4 vs 2%) https://t.co/l0RW6bVVHd
Dr. John Cush
@RheumNow
No difference in MACE risk betw TNFi vs JAKi in 6174 RA pts. Korean claims data compared TNFi (n 5,152) vs JAKi (n 1,022) initiators. MACE risk was 4.1 & 3.6/1000PYs w/ TNFi vs JAKi, respectively. MACE risk did not differ significantly between JAKi and TNFi (adj HR 0.636; 0.283, https://t.co/035WSUQAhJ
Dr. John Cush
@RheumNow
Placebo beats probiotics in PsA. And nearly 90% of well-controlled RA patients may be able to cut their targeted therapy dose in half. Dr. Jack Cush breaks down the findings worth a closer look in this week's RheumNow podcast, Troubles with ‘Gut Feelings’. Probiotics in PsA: https://t.co/Aqy4HxGHbU

‘Tis the Season for Vaccination

Eric Dein, MD

As the leaves start changing color and spooky decorations populate neighborhood doorsteps, another autumnal tradition begins: vaccination counseling. Fall offers a golden opportunity to protect our patients before respiratory viruses fill our waiting rooms. In patients with rheumatologic

Dr. John Cush
@RheumNow
Can DMARD Doses Be Safely Reduced for RA Patients? Close to 90% of patients with rheumatoid arthritis (RA) well controlled on targeted therapies were able to take 50% dosage reductions without experiencing worsened disease activity in a randomized trial, South Korean https://t.co/MyjZdRaGb4
Dr. John Cush
@RheumNow
Study of Prognostic Nutritional Index (PNI) in 984 RA pts shows PNI is independently inversely corelated w/ RA dz activity, esp. PNI <45. PNI = ser albumin & lymphocyte count calculation (10 × s albumin [g/dL]) + (0.005 × lymphocyte count/mm³]). Other studies have shown modest https://t.co/AV3AGXwSfg
Dr. John Cush
@RheumNow
French National Health System study of 214,892 #RA pts (~40K on TNFi) found 562 demyelinating events (2008-2023) w/ cumulative 10 yr incidence of 0.32% w/ csDMARDs & 0.50% w/ TNFi (HR 1.47;1.11-1.95). Demyelinating events are rare in RA, but signif higher w/ TNFi https://t.co/6vUy5nsQ27
Dr. John Cush
@RheumNow
? value of FamHx in Rheum evals? My bias is that few Dz are heritable - #Ank Spondylitis, #gout, DIP Osteoarthritis! But literature says there's high heritability for SLE, RA, systemic sclerosis, Sjögren's, & autoimmune endocrinopathies. WHAT do you think? https://t.co/WGyQqpY1qX
Dr. John Cush
@RheumNow
Can DMARD Doses Be Safely Reduced for RA Patients? Close to 90% of patients with rheumatoid arthritis (RA) well controlled on targeted therapies were able to take 50% dosage reductions without experiencing worsened disease activity in a randomized trial, South Korean https://t.co/GGPOBhVhJe
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