Rheumatoid Arthritis

CorEvitas RA registry study of 9601 RA pts starting b/tsDMARDs (52K yrs F/U) - 10.4% had eGFR<60 9CRI). Achieving CDAI remission was lower w/ CRI - 28% vs 19%(adj HR 0·76 [0·66–0·88]) https://t.co/E42N3PQHwG https://t.co/WNIGGCpCfZ

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Dr. John Cush @RheumNow( View Tweet )
Full read review of Preclinical Rheumatoid Arthritis: - Mucosal Origin Hypothesis - Gut Microbiota - Smoking & environment - Periodontitis - Immunosenescence - T cell abnormalities - Drug prevention https://t.co/SdcDtYGObO https://t.co/2UYGs5eTsu

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Dr. John Cush @RheumNow( View Tweet )
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/8VnmVsuU2h

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Dr. John Cush @RheumNow( View Tweet )
24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/hwkpeav4MQ
Dr. John Cush @RheumNow( View Tweet )
Medicare analysis of RA pts w/ metastatic nonsmall cell lung CA (mNSCLC) looked at 663 ICI-treated pts - 46% Rx w/ glucocorticoids (median Pred 6.6 mg/d). GC use was not associated with survival outcomes https://t.co/mwQeAgyKTC https://t.co/SR2XRD5Rhx

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Dr. John Cush @RheumNow( View Tweet )
Breaking the Rules: Dual-Advanced Combinations in Rheumatology For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes. https://t.co/4lyYTTwJUU https://t.co/sYpYbCjlzm

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Dr. John Cush @RheumNow( View Tweet )
Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis In this prospective observational study 811 CIA patients analyze outcomes in patients with and without MetS, including cardiovascular death/hospitalization and all-cause death/hospitalization. https://t.co/WT3wTpeGPi
Dr. John Cush @RheumNow( View Tweet )
More Comorbidity in Difficult-to-Treat RA A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA). https://t.co/guMm6mqJGr https://t.co/xiykw5tBlJ

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Dr. John Cush @RheumNow( View Tweet )
TLR

Review of Toll-like Receptor Research

EurekAlert!

A new review on Toll-like receptors (TLRs) systematically summarizes forty years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding

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Full read review of Preclinical Rheumatoid Arthritis: - Mucosal Origin Hypothesis - Gut Microbiota - Smoking & environment - Periodontitis - Immunosenescence - T cell abnormalities - Drug prevention https://t.co/UgqNBnKLMT https://t.co/2YZEiRCKNi

Links:

Dr. John Cush @RheumNow( View Tweet )
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/TmoodnuJTe

Links:

Dr. John Cush @RheumNow( View Tweet )
24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/pAEqYJIKaw
Dr. John Cush @RheumNow( View Tweet )
Taiwan, real-world study 267 RA new DMARD starts w/ tofacitinib (145) or TNFi (122). Post adjustments; no significant difference in Efficacy, AEs, Serious AE (20 v 21%), MACE (0 v 0.8%), CA (2% vs 0.8%), deaths (1.4% vs 3.3), SIE (13% vs 8.2%) or H zoster (12% v 3%) https://t.co/XLsdfKyeGx
Dr. John Cush @RheumNow( View Tweet )
Biologic.choice.MD_.jpeg (keep)

Breaking the Rules: Dual-Advanced Combinations in Rheumatology

Jack Cush, MD

For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes. 

Read Article
French prospective study of pregnancy in 94 RA & 124 SpA pts. RA more likely to flare 1st 6 mos postpartum (62 v 43%), while SpA remained stable in preg & postpartum. bDMARD continuation during pregnancy was more frequent in SpA; 55-60%restarted bDMARD postpartum. https://t.co/usKHS4wYbN
Dr. John Cush @RheumNow( View Tweet )
Level, monitor, calculate, glucose, diabetes

Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis

Jack Cush, MD

Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.

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morbidity,covid,heart,lung,brain

More Comorbidity in Difficult to Treat RA

Jack Cush, MD

A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).

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Among 1074 #PsA tested annually, RF positivity was found in 16.1% overall (5.1% RF+ at baseline). RF+ rediced odds of MDA (OR 0.53) w/ incr risk of bDMARD discontinuation (OR 2.65) https://t.co/AmG6hkWABW https://t.co/MYhkfxAh0r

Links:

Dr. John Cush @RheumNow( View Tweet )
True or False: In a meta-analysis, RA was associated with a significantly increased risk of osteoporotic fractures in female patients but not in male patients. See if you got it right in the latest RheumIQ quiz at https://t.co/HCxOwRl2Tq. https://t.co/O9WRKQKmu4

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Dr. John Cush @RheumNow( View Tweet )
Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA After the first tumor necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid arthritis (RA) responded by switching to upadacitinib, compared to cycling to a second TNFi, adalimumab. https://t.co/Cml3Z7ZyQP
Dr. John Cush @RheumNow( View Tweet )
EULAR Recommendations for Physical Activity in Arthritis EULAR has published a 2025 update for physical activity recommendations for patients with osteoarthritis (OA) and rheumatoid arthritis (RA). https://t.co/RFECflCUgf https://t.co/Da7D6KpN6q

Links:

Dr. John Cush @RheumNow( View Tweet )
Study of 216 RA pts - Serum IL-8 independently assoc w/ RA Dz activity. CRP & IL-6 significantly associated w/ higher IL-8 levels, but RF & CCP did not. IL-8 also correlated w/ CV risk (SCORE2) & carotid intima media thickness https://t.co/aqUoAeXFFP https://t.co/ZW7OAx8YGK

Links:

Dr. John Cush @RheumNow( View Tweet )
Dental study from India assessed periodontal Dz (PD) in 170 RA vs 170 non-RA pts. RA had more PD, ^ESR, more mild PD (39% v 29%). DAS-28 correlated w/ PD severity. Pts w/ periodontitis had 3X ods of RA (OR = 2.9) /https://t.co/bvOnFzbRcd https://t.co/cSxfiIR4iS

Links:

Dr. John Cush @RheumNow( View Tweet )
exercise,group

EULAR Recommendations for Physical Activity in Arthritis

Jack Cush, MD

EULAR has published a 2025 update for physical activity recommendations for patients with osteoarthritis (OA) and rheumatoid arthritis (RA). 

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Danish registry study of truncal (2,260) vs superselective (3,810) vagotomy (1977-95) vs general popul. (10:1). Truncal incr. RA risk (aHR 2.62), but selective did not (aHR 1.05. Neither had effect on OA risk https://t.co/dqejtN9TwY https://t.co/R0OJZTxd5T 

Links:

Dr. John Cush @RheumNow( View Tweet )

Therapeutic Updates

Expert insights on the 2024 ACR Guideline recommendations for lupus nephritis

Sponsored by Aurinia
Aurinia 2026 May RX Update
Two experts in lupus care offer a balanced perspective on applying the updated ACR Guideline recommendations and the clinical nuances of managing lupus nephritis.
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Recent Blogs

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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Advanced Practice Rheum

Methotrexate

Jack Cush, MD
APR MTX Cover
In this session, Dr. Jack Cush reviews methotrexate.
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Podcasts

  • ACR 2025 RA Topic Podcasts Compilation 6
  • ACR 2025 Daily Podcasts Day4b
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