Rheumatoid Arthritis

Evidence of immune ageing detected at the earliest stages of RA. Study of 69 controls, 32 CSA, 44 undiff. arthritis (UA), 23 early RA, & 56 DMARD naive RA. UA & CSA had reduced naive CD4 T cells. Th17, Tregs &7 senescent T cells, were only seen once RA was established. https://t.co/c1wiA5gvM5
Dr. John Cush @RheumNow( View Tweet )
SMART study - Single vs. Split Dose Methotrexate in RA Split dose weekly, oral methotrexate (MTX) was shown to be superior to single dose MTX in treating active rheumatoid arthritis (RA) patients. https://t.co/JN5wPGNjao https://t.co/lizsrtVHwf

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Dr. John Cush @RheumNow( View Tweet )
Future Perspectives of Rheumatoid Arthritis Dr. Kuni Yamaoka, shares highlights from the Future Perspectives of Rheumatoid Arthritis session at the APLAR 2025 Congress in Fukuoka, Japan. https://t.co/LGLqe48R2L https://t.co/Kwp3cFPtyw

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Dr. John Cush @RheumNow( View Tweet )
QD Clinic: Progressive RA-ILD Management Dr. Richard Conway, a rheumatologist in Dublin, discusses a case about managing progressive rheumatoid arthritis-interstitial lung disease, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September https://t.co/dLCXeXwl7w
Dr. John Cush @RheumNow( View Tweet )
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STOP-RA: Hydroxychloroquine Fails in ACPA+ Arthralgia

Jack Cush, MD

Deane et al has published the results of the STOP-RA trial, demonstrating that 12 months of hydroxychloroquine (HCQ) did not prevent the development of clinical RA at 36 months. 

The fate of Individuals elevated anti-cyclic citrullinated peptide (anti-CCP) antibodies and

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How to treat CTD ILD? A comparative slide summarizing ACR/BSR and EULAR treatment guidelines Emphasis on combination of Immunosuppressant and Antifibrotics @RheumNow #APLAR25 https://t.co/gLSht6QKh5

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Aurelie Najm @AurelieRheumo( View Tweet )
Peter Taylor on extra articular manifestations of RA Keep an eye on RA patients’ glomerular function RA patients have increased risk of CKD Systematic review >1million pts Risk Ratio 1.52 @RheumNow #APLAR25 https://t.co/5iZwtmvwSR

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Aurelie Najm @AurelieRheumo( View Tweet )
QD Clinic Video: RA and Bronchiectasis Dr. Jeffrey Sparks, Boston, talks about rheumatoid arthritis and bronchiectasis as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025. https://t.co/Y2u3m4rFfj https://t.co/KgrIxXlQo4

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Dr. John Cush @RheumNow( View Tweet )
STOP-RA results published in A&R. 144 at risk, CCP+ pts were enrolled to received HCQ vs PBO for 12 mos, w/ 24 mos F/U. Progression to RA seen in 30.4% on HCQ vs 32.9% on PBO (NS; P=0.52). Also IA, Jt Sxs, severity & adverse events were similar between groups.

Dr. John Cush @RheumNow( View Tweet )

Flow cytometry on Peripheral blood can help patient stratification in RA A cluster rich in TEMRA Terminally Differentiated Effector Memory T Cells is associated with response to treatment and therapeutic decision taking into account showed higher remission 39% vs. 24% Next https://t.co/8ZZ2epf7LK

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Aurelie Najm @AurelieRheumo( View Tweet )
2025 Update of EULAR RA management recommandation Summary slide inspired from Josef Smolen’s presentation @RheumNow #APLAR25 https://t.co/wRzeX9OIry https://t.co/djrd7O9G9H

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Aurelie Najm @AurelieRheumo( View Tweet )
RheumNow Podcast square

RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are there benefits to diet or vegan diets? What's the effect of menopause on CTD?  Ro52 makes a big entrance with all our ILD coverage this month.

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checklist on clipboard

How to assess ILD in your patients?

Janet Pope, MD, MPH, FRCPC

Have a high index of suspicion in your patients with connective tissue disease (especially systemic sclerosis, inflammatory myositis), and rheumatoid arthritis.

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Single center study of 47 RA-ILD pts (Dx Age 64.7 yrs; 30 mos F/U). Median 100 mos from RA Dx to RA-ILD. Nearly half (49%) recv Rx for RA-ILD; few w/ TCZ, nintedanib, pirfenidone. ~90% had RA-ILD stability/improve @ 6 & 12 mos. Progression assoc w/ tobacco use (P .025) @ 6 mos https://t.co/AK4zYgcxeK
Dr. John Cush @RheumNow( View Tweet )
Regional Disparities in DMARD Management for RA Treatment Dr. Aurelie Najm, Glasgow, reports on a session on "Updates on DMARDs treatment: global standards and regional adaptations" from the APLAR 2025 Congress in Fukuoka, Japan. https://t.co/zDo5NxKtbE https://t.co/kF9FxyWkIQ

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Dr. John Cush @RheumNow( View Tweet )
A new player in AIRD ThA age associated T helper cells Displaying both Cytotoxic & APC functions Correlation with disease activity in RA and SLE More research is needed to better characterize function but could be a promising therapeutic target @RheumNow #APLAR25 https://t.co/4SnY65tXpJ

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Aurelie Najm @AurelieRheumo( View Tweet )
#APLAR2025 Prof Peter Taylor RA patients have ⬆️ rates of CKD https://t.co/DZl9qpbLhH

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Dr Gurdeep S Dulay @gurdeep_dulay( View Tweet )
Stay sharp in RA, PsA & SpA care. Get the latest breakthroughs + expert insights at RWCS 2026. Don’t miss 'Year in Review: Rheumatology Advances.' Register now: https://t.co/majEsY4tXK https://t.co/fgGniR1OGk

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RWCS @RWCSmtg( View Tweet )
ILD damage fibrosis path

Antifibrotics - A New Class of Therapies in Rheumatology?

Shervin Assassi, MD

Rheumatologists typically manage systemic autoimmune rheumatic diseases (SARD) and associated interstitial lung disease (ILD) with immunosuppressants. However, evidence increasingly supports also the use of antifibrotic agents in this setting. Pulmonologists have long used

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Metanalysis of 7 studies (1979-2023) shows RA pts on vegetarian or vegan diets achieved no improvement in disease activity or physical function, but did have a small significant improvement in pain. Insufficient Data on Fatigue. Overall, low certainty https://t.co/jeh6gN5Byg
Dr. John Cush @RheumNow( View Tweet )
Where are we now—and where are we going in ILD treatment? 📅 September 9 (TONIGHT!)| ⏰ 7PM EST (LIVE) Rheumatology leaders Drs. Sindhu Johnson, Dr. Anna-Maria Hoffmann-Vold, Dr. Scott Matson, and Dr. Jack Cush will review the latest ACR & EULAR guidelines on interstitial lung https://t.co/E30AirP5WX
Dr. John Cush @RheumNow( View Tweet )
Multimorbidity predicts flares in rheumatoid arthritis A study from Olmstead county and the Mayo Clinic shows that multimorbidity and social factors predict higher rheumatoid arthritis (RA) flares and lower remission rates. https://t.co/yGrvDttcEq https://t.co/45LMtvsFor

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Dr. John Cush @RheumNow( View Tweet )
Is it D2T RA or Clinical inertia? Concept introduced by Dr Kaneko, Japanese Keio RA cohort, followed for 5yrs 5% patients not fitting the D2T RA definition have MDA or HDA The drivers of persistent DA in RA: -overestimation of treatment effectiveness -avoidance of treatment https://t.co/0pkDaUFH4R

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Aurelie Najm @AurelieRheumo( View Tweet )
Peter Taylor on Pre-RA: If Pre-RA is too late for interception, shall we start screening general population? We have to remember RA is a RARE disease Pre-test of RA per year per person would be 0.00025% for primary prevention: A needle in a haystack? @RheumNow @APLAR_org https://t.co/LKGtz1P7sl

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Aurelie Najm @AurelieRheumo( View Tweet )

Peter Taylor describing the range of potential benefits of Interception strategies in Pre-RA: A) From Ideal: full interception B) To Good outcome: stratified intervention based on high risk population for delay/interception C) To ?Beneficial: attenuate severity of established RA https://t.co/6mqA9tV7ME

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Aurelie Najm @AurelieRheumo( View Tweet )

Recent Blogs

Hydroxychloroquine for Everyone

Jack Cush, MD
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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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