Rare Diseases

Eular stage

What’s New in Macrophage Activation Syndrome Therapeutics

Bella Mehta, MBBS, MS

MAS, the most severe complication of Still’s disease, is increasingly recognized as a cytokine-driven hyperinflammatory state centered on interferon gamma (IFNγ). Therapeutic advances presented at EULAR 2026 demonstrate both consolidation of established pathways and expansion into novel biologic

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EULAR.Docs.APP

Day 4 EULAR Report

Jack Cush, MD

The last day in London was exciting as both the Late-Breaking abstracts and new EULAR guidelines were presented. Guidelines presented addressed several significant unmet need areas including PMR, GCA, Takayasu’s arteritis, Vaccinations in Rheumatic patients, Imaging in spondyloarthritis and

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Good performance of #definite #antisynthetase #syndrome ✅+antibody mandatory Possible also does ok @RheumNow #EULAR2026 June 6 #antisynthetase #classifiaction #criteria https://t.co/5sxogTX9YT

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Janet Pope @Janetbirdope( View Tweet )
Checklist IgG4

INDIGO: Switching B Cells Off, Not Out, in IgG4-Related Disease

Henrique Dalmolin, MD

B-cell targeting has moved to the centre of IgG4-related disease treatment, with inebilizumab, a CD19 depleter, as the recent benchmark. At EULAR 2026, INDIGO tested whether the disease can be controlled by switching B cells off rather than depleting them.

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#immune #reset may be ‘asking the earth’ and we may need to consider #immune #dimming ➡️esp if multi drug failure already By Hector Chinoy #WIN #IIM June5 Excellent #CAR-T review should re think of Total immune reset in many #SARD PTS is unlikely EULAR2026 @RheumNow https://t.co/eqKzxzqa0z

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Janet Pope @Janetbirdope( View Tweet )
Sarcoidosis increases the risk of MGUS and multiple myeloma. Propensity matched Data from a large global collaborative network study with 40k pts. POS0231 #EULAR2026 @RheumNow https://t.co/mygYCjigFV

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Bella Mehta @bella_mehta( View Tweet )
Understanding how Bispecific T cell engagers work: remarkable mode of action! Let’s hope it works as well as in oncology! #teclistamab in #SSc #HOT session Pr Oliver Distler #EULAR2026 @RheumNow https://t.co/waSCXKA79Y

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
#OP088 at #EULAR2026 found that rare deleterious variants in telomere-related genes were associated with increased RA-ILD risk, independent of MUC5B status. The effect size was similar to that seen in idiopathic pulmonary fibrosis. @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

#EULAR2026 OP077 Another promising CAR-T in autoimmunity. In a Phase II study, Rap-Cel autologous CD19 CAR-T (shorter infusion time ~2d & low dose) vs traditional CAR-T showed drug-free improvement in N=6 #IIM & N=6 #SSc patients. Safety similar to other CAR-Ts @RheumNow https://t.co/byNn5X8JGh

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
EGPA https://t.co/zlquehIZQ6

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Rheumatology update @aabdogafar( View Tweet )
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Count Your Telangiectasias (5.29.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and missed quiz questions.

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Retrospective Intl SSc study of MD & PT telangiectasia counts (TC) (0, 1–6, 7–15 or > 15) of face, forearms & hands. High TC correlated w/ PAH (AUC 0.824–0.875) & digital ulcers. Moderate agreement betw MD & Pt for face & forearms TC (kappa 0.648 & 0.605, p< 0.001) https://t.co/jtHgVABFiA
Dr. John Cush @RheumNow( View Tweet )
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Trends and Innovations in Lupus Nephritis Clinical Trials

Jack Cush, MD

Xu et al. from Shanghai University have written an analysis of global lupus nephritis (LN) clinical trials and call for innovation.

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Update on Multicentric Reticulohistiocytosis Have you ever seen multicentric reticulohistiocytosis (MRH)? Don't worry, it's a rare non-Langerhans cell histiocytosis condition characterized by papulonodular skin lesions and symmetric erosive polyarthritis, and it has only been https://t.co/1VrT8HFmva
Dr. John Cush @RheumNow( View Tweet )
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Quiz Talk (5.22.2026)

Jack Cush, MD

Dr. Jack Cush talks of birthdays, Quizzes and journal articles this week on the podcast.

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Early GI Involvement Predictive of Scleroderma Outcomes

Jack Cush, MD

Rheumatology has published a cohort study showing that earlyGI symptoms and overall symptom burden predict both GI progression and mortality in Systemic Sclerosis (SSc).

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Update on Multicentric Reticulohistiocytosis Have you ever seen multicentric reticulohistiocytosis (MRH)? Don't worry, it's a rare non-Langerhans cell histiocytosis condition characterized by papulonodular skin lesions and symmetric erosive polyarthritis, and it has only been https://t.co/koXOwktDgA
Dr. John Cush @RheumNow( View Tweet )
undifferentiated,arthritis,early,RA

ABA versus HCQ in Palindromic Rheumatism

Jack Cush, MD

Palindromic rheumatism may develop rheumatoid arthritis (RA) and could be an at-risk population. A pilot trial compared abatacept (ABA) versus hydroxychloroquine and demonstrated ABA reduces RA development in a 2 year study. 

An open-label, multicenter, randomized trial enrolled 70

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Multicentric reticulohistiocytosis

Update on Multicentric Reticulohistiocytosis

Jack Cush, MD

Have you ever seen multicentric reticulohistiocytosis? Don't worry, it's a rare non-Langerhans cell histiocytosis condition, characterized by papulonodular skin lesions and symmetric erosive polyarthritis, and has only been described in fewer than 500 cases reported worldwide.

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Infectious Rheumatology (5.15.2026)

Jack Cush, MD

Dr. Jack Cush discusses his favorite journal articles from the past week on RheumNow.com.

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UCB has aquired Candid Therapeutics for $2 billion; plan to lead in autoimmune dz by acquiring cizutamig - a T cell engager. Its been studied in >100 pts, including early Global Phase 2 RCTs of myasthenia gravis & ILD. https://t.co/xz4uEhvxu6 https://t.co/6FS1riLecW

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Dr. John Cush @RheumNow( View Tweet )
Eosinophil

EGPA Review

Jack Cush, MD

A current review of eosinophilic granulomatosis with polyangiitis (EGPA) provides current recommendations on diagnosis and management.

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Predictors of renal crisis & pulm. arterial HTN (PAH) in systemic sclerosis - retrospect. study of 234 SSc pts; 7.3% had PAH & SRC. PAH may precede overlap w/ SRC. SSc w/ both at hi risk for GI bleed (OR 9.5). SRC+PAH assoc w/ Older age, elevated NT-proBNP https://t.co/MsaiPdcDrb https://t.co/CyMrL8izxP

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Dr. John Cush @RheumNow( View Tweet )
ANCA assoc. pachymeningitis (AAP) is rare. 230 systemic vasculitis, from 177 reports (108 MPO+, 71 PR3+); age~60; HA & cranial neuropathy (hearing/visual loss, diplopia) common. 89% w/ systemic Sxs (ENT, lungs, orbits, kidneys). Look for abnl ESR/CRP, CSF https://t.co/bHQegYYl5V https://t.co/hpfu8iaIkx

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Dr. John Cush @RheumNow( View Tweet )
In Still's disease, what is the primary life-threatening complication clinicians must monitor for? If you think you know the answer, prove it in this week's RheumIQ quiz at https://t.co/KVK8J2iaFQ https://t.co/O62ZpIciWW

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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Choice Overload (and the Way Out)

Jack Cush, MD
paint,choice,overload,color
I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”.
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Best of 2022: Five Mistakes When Diagnosing Still’s Disease

Jack Cush, MD
Thermometer
Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.
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