Rheumatoid Arthritis

#RA linked to 40% incr risk of serious dental Infx. National Inpatient Sample (2016-2022) retrospective study of ~15 million adult inpatient records, 10.7K (0.07%) had oral Infx Hosp. Risk factors included RA (1.9%; OR 1.4, male (1.79), Black (1.23), smoking (1.33) https://t.co/pr4Uf6ywJ7
Dr. John Cush @RheumNow( View Tweet )
1,494 Ehrlangen RA pts - machine learning used baseline variables to predict remission at 6 mos. Best/most predictive results w/ AdaBoost modelingdemonstrated strongest accuracy of 85.71% (based on DAS28, Age, VAS and swollen joints. https://t.co/h9UgUKUFo4

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Dr. John Cush @RheumNow( View Tweet )

❓️Is early intensive therapy with combination csDMARDs or TNFi superior to standard step care for the treatment of moderate to severe #psoriatic_arthritis? 🅰️ Yes 🔅Check out the SPEED RCT presented by @DrLauraCoates at #EULAR2025 OP0089 @RheumNow #Strategy

Dr. John Cush @RheumNow( View Tweet )

The Spectrum of RA https://t.co/5GlXcRkMJg https://t.co/JWfncLbEQx

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Dr. John Cush @RheumNow( View Tweet )
Sex differences in biologic response in PsA. DISCOVER-2 post hoc analysis showed: •Radiographic progression at Week ♂️: 2.22 units ♀️: 1.10 units •Early ACR-like response (cDAPSA LDA at 8wks) linked to less damage in men (0.39 vs 2.24) Women less likely to progress https://t.co/hvRxKTMJT5
Dr. John Cush @RheumNow( View Tweet )
What happens in pre-RA when you stop #abatacept after 1 yr Rx At 6 yrs approx 60% on #Placebo V 50% who initially got #ABA Prolonged damped effect of development of #RA NNT for 1 yr is ~10 with a range as low as 6 #EULAR2025 @RheumNow @eular_org Abst#OP0004 https://t.co/eCXEWQhvWM
Dr. John Cush @RheumNow( View Tweet )
Puzzle pieces

ICYMI: Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD

Mrinalini Dey, MD

Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic

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Weed, THC

ICYMI: ACP: Best Practice Advice on Cannabis or Cannabinoids Use for Chronic Noncancer Pain

Jack Cush, MD

The American College of Physicians published a best practice advisory on cannabis or cannabinoids in the Annals of Internal Medicine.

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ICYMI: Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs

Jack Cush, MD

A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (

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If you successfully taper off DMARDs in RA patients in remission, do you risk bringing new joints in the mix? Leiden post-hoc trial: these patients don’t do worse than those who never get off drug. Drug-free remission tricky but new joints not a worry. #EULAR2025 @RheumNow https://t.co/bwXgrB875k
Dr. John Cush @RheumNow( View Tweet )
Clinical determinants of multiple drug failure in D2T RA 2000+ RA cohort 250+ refractory -Low financial status -Cancer Hx -CV comorbidities -Chronic use of NSAID or GCs Protective: Regular participation in leisure activities #POS0030 @RheumNow #EULAR2025 https://t.co/mdePGkHU82
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Introducing Polyrefractory RA: A New Frontier in Difficult-to-Treat RA At a EULAR 2025 session titled “What makes ‘Difficult-to-treat RA’ so difficult to treat? And what can we do?”, Drs. Paula David and Dennis McGonagle introduced the emerging concept of polyrefractory https://t.co/Qy9fy3GWKm
Dr. John Cush @RheumNow( View Tweet )
Hepatitis B (Keep)

ICYMI: AGA Guideline: Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals

Jack Cush, MD

The American Gastroenterology Association has published its revised clinical practice guidelines for the prevention and treatment of hepatitis B virus (HBV) reactivation in at-risk patients, particularly those with immune-mediated disease, receiving immunomodulatory therapy and steroids.

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arthritis.RA_.Xray_.hands_.jpg (keep)

ICYMI: Is Rheumatoid Arthritis Becoming Milder?

Jack Cush, MD

A 24 year, prospective study analyzing very early rheumatoid arthritis (RA) in three consecutive eras suggests that RA has evolved since 2005, demonstrating less seropositivity, inflammation, and erosions but is characterized by more comorbidity, smoking and corticosteroid use.

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human figures on blue circle

ICYMI: Introducing Polyrefractory RA: A New Frontier in Difficult-to-Treat RA

Jiha Lee, MD

At a EULAR 2025 session titled “What makes ‘Difficult-to-treat RA’ so difficult to treat? And what can we do?”, Drs. Paula David and Dennis McGonagle introduced the emerging concept of polyrefractory rheumatoid arthritis (RA), a term now being used to describe a subset of patients who have

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JAK Inhibitors: The Latest from the JAK-pot Study Dr. David Liew reports on abstract POS0150 - Evolution of Janus Kinase Inhibitors (JAKi) Prescriptions Since 2015 In An International Collaboration of Rheumatoid Arthritis Registers (The 'JAK-pot' Study): Effect of Regulatory https://t.co/KiOZuphQTx
Dr. John Cush @RheumNow( View Tweet )
All Rheumatoid Arthritis is Not the Same Dr. Jonathan Kay reviews abstracts OP0323 and OP0328 from the EULAR 2025 meeting in Barcelona, Spain. https://t.co/rbK3Y1NHVI https://t.co/eYPdbx87kt

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Dr. John Cush @RheumNow( View Tweet )
Rheumatoid Arthritis Panel: EULAR 2025 Panelists Drs. Mrinalini Dey, Janet Pope, Jonathan Kay and Jack Cush review RA studies and sessions presented at the 2025 EULAR meeting in Barcelona, Spain. Abstracts discussed: OP0004; OP0105; LB0006; OP0327; OP0330; OP0232; 0P0190. https://t.co/hmosUKOgTt
Dr. John Cush @RheumNow( View Tweet )
Jekyll and Hyde: which RA-ILD is it? Dr. David Liew reports on abstract OP0329 presented at the EULAR 2025 meeting in Barcelona, Spain. https://t.co/oH9nXaKRDz https://t.co/iUAJk2Q856

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Dr. John Cush @RheumNow( View Tweet )
Prospective KORAIL study of 138 RA pts w/ ILD on chest CT -60% had UIP ILD. After F/U of 2.9 yrs, 35% had RA-ILD progression. Baseline predictors of progression = UIP, ILD >10 %, DLCO %pred, CCP+, KL-6 levels, RA Dz activity. Useful to ID high-risk RA-ILD pts.

Dr. John Cush @RheumNow( View Tweet )

What we need in very early arthritis It's easy to think that in our current world that we've done it all for rheumatoid arthritis, that there's nothing left to be done after b/tsDMARDs have become relatively widespread and accessible. If we aren’t satisfied that we’ve done all https://t.co/v8T3JQwuhM
Dr. John Cush @RheumNow( View Tweet )
Korean Health claims data study of 35,133 newly Dx, seropositive #RA pts (2011 to 2020) & 1,386 (3.9%) were Dx w/ new-onset stroke (CVA). Signif. lower risk of CVA w/ SSZ (aOR: 0.79) or HCQ (aOR: 0.83), but Increased risk w/ glucocorticoids (aOR: 1.71) & tocilizumab (aOR: 3.47) https://t.co/rPaj6cH74K
Dr. John Cush @RheumNow( View Tweet )
Using Veterans Affairs data (2006 - 2020) on RA-ILD patients, a target emulation trial showed no difference in mortality or respiratory hospitalization comparing RA-ILD Rx w/ either RTX, abatacept, tocilizumab, tofacitinib. Does this mean? they Dont Work or the Do Work? https://t.co/MkQmKsE3WQ
Dr. John Cush @RheumNow( View Tweet )
EULAR 2025 – RA Panel Discussion Leading experts in rheumatology dive into the latest advances, treatment strategies, and emerging research in rheumatoid arthritis. Don’t miss this in-depth panel as they unpack key findings from EULAR 2025 and discuss what’s next for RA care. https://t.co/hoxz0zWieN
Dr. John Cush @RheumNow( View Tweet )
UK study of 17472 newly Dx #RA pts (10997 MTX, 4,540 csDMARDs; 13680 steroids-CS) w/ 1307 Serious Infx (SI) (3/100PY) & 311 SI deaths. MTX signif decr. SI (adj HR 0.72) & CS no effect HR 0.99. SI assoc w/ age, smoker, comorbidity, seropositive, high DAS28. 1 DAS unit incr SI https://t.co/Zmsuaf7Rw3
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Hydroxychloroquine for Everyone

Jack Cush, MD
ra.hands2_.JPG
Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit. Read Post

Best of 2023: New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?

Richard Conway, MBBChBAO, PhD
Lungs ILD
Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base.  Read Post
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