Gout Cavalcade (7.10.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week. July is Gout: More than Flares month.
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Metanalysis of 51 studies shows vaccination is suboptimal in Rheum. Influenza Vax rates: RA 50%, SLE 42%, AS 43% & Psa 53%. Pneumococcal vaccinations even lower: 37%, 30%, 39% and 41%. More by with age & comorbidites and by rheumatologists (vs PCPs) https://t.co/3DborC9BLW https://t.co/MPDeJUH0HI
Dr. John Cush @RheumNow( View Tweet )
#THA revisions in 3657 RA vs 446428 OA pts (mean F/U ~7y) find RA has signif incr risk of revision (HR 1.35); espec due to infx (HR 1.48), dislocation (1.87), aseptic loosening (0–3m; 2.81). No diff w/ cemented, cementless, hybrid THA. Age > 65 was main risk factor. https://t.co/iK6pL3QF1W
Dr. John Cush @RheumNow( View Tweet )
Rheumatoid arthritis is found in 2-3.8% of gout patients.
For more gout content, follow our Gout: More than Flares campaign at https://t.co/lQoiFjubZJ, https://t.co/moAOVUJjKZ
Dr. John Cush @RheumNow( View Tweet )
ARTIC trial enrolled 234 DMARD naive RA (<2yrs) pts; 15.4% (36) were seronegative (SNRA). @enrollment SNRA worse than SPRA(+) w/ higher SJC (17 vs 8, p<0.001), DAS28 (3.9 vs 3.4, p=0.03), US scores (55 vs 25, p<0.001), MD global (49 vs 39, p=0.006). No diff in Sharp score, https://t.co/xDxQKY8ZG2
Dr. John Cush @RheumNow( View Tweet )
Intl consortium (10 EU countries) of 3952 RA pts, 184 MACE events seen 1985-2012. MACE risk signif assoc w/ DAS28 (HR 1.18;1.03-1.35), but NOT RF (HR 1.26; 0.82 to 1.94) or ACPA (HR 1.25; 0.85 to 1.83). RA activity assoc w/ MACE seen in seronegative and double positive https://t.co/RGO5IAM5oL
Dr. John Cush @RheumNow( View Tweet )
Glucocorticoid use in 1st yr of 574 newly DX RA cases-- 75% recv GC in 1st yr; 313 (55%) Rx at 1st visit. (m GC dose =9.3 mg/day. 1/2 (47%) recv IA GC injx. 20% had 1st yr infx. Risk of infx was NS (RR 1.13; 0.77 to 1.67) for 0-10 mg/d vs no GC https://t.co/s9YaGZsUjr https://t.co/ESHvVK1Egx
Dr. John Cush @RheumNow( View Tweet )
Retrospective study 1420 newly Dx non-tuberculous mycobacterial (NTM) infx (2012-2024) - 66 (4.6%) Dx w/ RA (55 after RA dx). Having RA + NTM incr risk of Resp. death (HR 4.3) w/ lower 5yr survival (75% vs 93%) partly explained by ILD and sytemic inflamm. https://t.co/6sdR7XwwD7
Dr. John Cush @RheumNow( View Tweet )
DMARD Efficacy in RA-ILD
A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional,
Dr. John Cush @RheumNow( View Tweet )
CAR-T Therapy: EULAR 2026 Conference Recap
CAR-T therapy in autoimmune disease is moving fast - but is it ready to move beyond specialized referral centers? This EULAR 2026 recap covers the mechanistic data, relapse biology, and access innovations shaping that answer.
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Whats the BEST FIRST Rx in DMARD-Naive #RA - Tofacitinib or MTX. RCTs (ORAL Start, RA-BEGIN, SELECT-EARLY, FINCH 3) prove JAKi > MTX. A recent 116 RCT from China also shows Tofa > MTX by SDAI50 (94% v 75%) @3 mos & Tofa was more cost effective. https://t.co/KL2qlDgF6D https://t.co/wNVBgQkaMI
Dr. John Cush @RheumNow( View Tweet )
EULAR26: ANCHOR-RA Study of RA-ILD
People with rheumatoid arthritis are at risk of developing interstitial lung disease (RA-ILD), which is associated with high mortality. ANCHOR-RA is a large, international cross-sectional prospective study that will enable the development of a https://t.co/tsOpA4SAZP
Dr. John Cush @RheumNow( View Tweet )
DMARD Efficacy in RA-ILD
A network meta-analysis in the Journal of Autoimmunity reviews the pharmacologic options for rheumatoid arthritis–associated interstitial lung disease (RA-ILD). RA-ILD guidelines were recently presented by ERS/EULAR, but these were mainly conditional, low-certainty recommendations.
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RheumIQ: Per the 2025 EULAR RA recommendations, if a csDMARD strategy fails, which drug class requires careful risk assessment before use? Test your knowledge this week at https://t.co/z8mLbcgE5D. https://t.co/r61gvyMHPS
Dr. John Cush @RheumNow( View Tweet )
RT @jiharheum
MTX PO split dose MTX (15mg AM + 10mg PM) vs SC in early seropositive #RA in SCOOT RCT (n=252): SC MTX had better EULAR response at 16 wks (OR 0.55, p=0.049) and ↑ transaminitis with oral split. SC MTX remains the preferred route above 15mg/wk. #EULAR2026 OP0206
Dr. John Cush @RheumNow( View Tweet )
EULAR26: ANCHOR-RA Study of RA-ILD
EurekAlert!
People with rheumatoid arthritis are at risk of developing interstitial lung disease (RA-ILD), which is associated with high mortality. ANCHOR-RA is a large, international cross-sectional prospective study that will enable the development of a multivariable model to help detect RA-ILD.5
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ICYMI: 2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management
EULAR has updated their rheumatoid arthritis (RA) management recommendations, notably with fewer recommendations (total of 9, down from 11 in 2022 version), by merging and removing previous https://t.co/6WAZB1dOpI
Dr. John Cush @RheumNow( View Tweet )
RT @aurelierheumo Failure to achieve early remission RA asso w/ non-inflammatory pain
NORD-STAR 526 early RA pts)
no remission at 24 wks increased risk of 48wk
• unacceptable pain (OR ~6)
• refractory pain (OR ~6)
• fibromyalgic RA (OR ~16)
Signal strongest w/ very early
Dr. John Cush @RheumNow( View Tweet )
EULAR26: GLP-1 Agonist Use in the RISE Registry
EurekAlert!
At EULAR 2026, McCormick and Curtis et al presented data from the American College of Rheumatology’s (ACR) Rheumatology Informatics System for Effectiveness (RISE) registry on the use of GLP-1 agents in rheumatic diseases (RMD).
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Which is NOT a key feature of inflammatory back pain: relief with activity; morning stiffness; age under 40 years; unilateral pain? Test your knowledge in this week's RheumIQ quiz at https://t.co/z8mLbcgE5D. https://t.co/tOdPfEBJa4
Dr. John Cush @RheumNow( View Tweet )
Spotlight on Comorbidities from EULAR 2026
EurekAlert!
Systemic autoimmune diseases are associated with increased cardiovascular morbidity and mortality – possibly through autonomic imbalance, myocardial inflammation, or fibrotic infiltration of the conduction system. A team in Colombia have been looking into the
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EULAR26: Pitfalls in T2T
EULAR recommends T2T strategy in the management of RA and other RMD aiming for clinical remission or low disease activity guided by frequent monitoring and prompt therapy adjustments. But real-world daily implementation in remains poorly investigated. https://t.co/V6mCcdmyJz
Dr. John Cush @RheumNow( View Tweet )
ICYMI: 2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management
The European Alliance of Associations for Rheumatology (EULAR) has updated their rheumatoid arthritis (RA) management recommendations, notably with fewer recommendations (total of 9, down from 11 in 2022 version), by merging and removing previous recommendations.
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Prospective study of 6 newly Dx RA pts starting MTX shows MTX causes a decline in T follicular helper (Tfh) cells and plasmablasts (@ wk 3 before clin response), selectively in responders but not nonresponders. MTX shifts cellular & gene expression towards a more physiological https://t.co/scmfAAE9XA
Dr. John Cush @RheumNow( View Tweet )
Is there a path to precision medicine in #RA? Theres a substantial unmet need. Immunoengineering is possible thru nanotechnological delivery vectors, cellular therapeutics, & biomaterial scaffolds, with compelling preclinical and early clinical support. https://t.co/gL56EOlt7p https://t.co/31IRNXckym
Dr. John Cush @RheumNow( View Tweet )
Therapeutic Updates
Expert insights on the 2024 ACR Guideline recommendations for lupus nephritis
Sponsored by Aurinia
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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A JAKi CHAT: Shared Decision-Making in RA
Sponsored by AbbVie Medical Affairs + Health Impact
Experts Dr. Jeffrey Curtis and Dr. Kevin Winthrop discuss best practices for shared decision-making, how to talk with patients about the risks of poorly controlled RA, and ways to use a new tool for visualizing the long-term safety of a JAKi.
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Poster Hall
Sponsored by AbbVie Medical Affairs + Health Impact
Real-World Predictors and Early Indicators for IBD in Patients With PsA
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