Rare Diseases

B Cell Targeting in Idiopathic Thrombocytopenic Purpura The New England Journal of Medicine has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune https://t.co/VN0KjE478B
Dr. John Cush @RheumNow( View Tweet )
purpura

B Cell Targeting in Idiopathic Thrombocytopenic Purpura

EurekAlert!

The New England Journal of Medicine  has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune

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Hematologic Malignancies Increased in Systemic Sclerosis Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen. https://t.co/K1WuMC0mXI https://t.co/MGkvwESqIe

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Dr. John Cush @RheumNow( View Tweet )
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APPs in the News (12.5.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.

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Hematologic Malignancies Increased in Systemic Sclerosis Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen. https://t.co/BypsCRUthe https://t.co/lfLJhSqn9e

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Dr. John Cush @RheumNow( View Tweet )
10 yr European retrospective study of haemophagocytic lymphohistiocytosis found 3345 deaths due HLH from 29 countries. Crude mortality rate = 5.3 per 10million PYs (range: 1.1-11.3). From 2011 to 2021, increasing from 3.9 to 6.6/10millPYs, varying by country, sex, age. https://t.co/58gCQ72saF
Dr. John Cush @RheumNow( View Tweet )
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Hematologic Malignancies Increased in Systemic Sclerosis

Jack Cush, MD

Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.

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A New Disease Activity Score for Antiphospholipid Syndrome? APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and https://t.co/G2xGtOPmwb
Dr. John Cush @RheumNow( View Tweet )
coccyx

Coccyx and Sacrococcygeal Joint Disorders

Jack Cush, MD

Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, anatomy, biomechanics, presentations, diagnostic evaluation,

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Stills,continuum

Treating Refractory Still's Disease

Jack Cush, MD

A full read systematic review article examined treatment options for difficult to manage systemic juvenile idiopathic arthritis, or Still’s disease. It classified these refractory disease patients as those with either (1) persistent arthritis, (2) recurrent or difficult-to-treat

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ILD in Patients with Connective Tissue Disease Dr. Janet Pope reports on abstract 0154 (Incidence and Prevalence of Connective Tissue Diseases with Interstitial Lung Disease (CTD-ILD) in the United States) at #ACR25. https://t.co/WrJhsMizwV https://t.co/rkFny5ZjZQ

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Dr. John Cush @RheumNow( View Tweet )
Organ Involvement with Behçet’s A review of patient data from the International AutoInflammatory Disease Alliance (AIDA) Network registry identifying those with mucocutaneous Behçet’s disease (BD) may progres to major organ involvement (MOI)m especially at later stages. https://t.co/jqM4IZuobe
Dr. John Cush @RheumNow( View Tweet )
A New Disease Activity Score for Antiphospholipid Syndrome? APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and https://t.co/eouynDPLUX
Dr. John Cush @RheumNow( View Tweet )
Myelodysplastic & chr myelomonocytic leukemia pts rarely get lupus. Review of 19 w/ SLE & 5 w/ CLE; these were older (65 yrs), more male (15M/9F), w/ less renal [10%] & articular [36%] Dz w/ less dsDNA [32%]. Thought to be clonal inflammatory, & not autoinflammatory, process. https://t.co/EAvkJm6GQs
Dr. John Cush @RheumNow( View Tweet )
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Organ Involvement with Behçet’s

Jack Cush, MD

A review of patient data from the International AutoInflammatory Disease Alliance (AIDA) Network registry identifying those with mucocutaneous Behçet’s disease (BD) may progres to major organ involvement (MOI)m especially at later stages.

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Pulse Steroids and Mycophenolate in Juvenile Dermatomyositis

Jack Cush, MD

JAMA Dermatology has published a pilot study demonstrating the safety and efficacy of intermittent intravenous methylprednisolone pulse (IVMP) therapy plus mycophenolate in 28 patients with juvenile dermatomyositis (JDM).

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20-40% of Autoimmune hepatitis (AIH) is associated with other autoimmune diseases - lead by autoimmune thyroiditis, type 1 DM, ulcerative colitis, Crohn disease, & celiac (but less so for RA, PBC, SLE, Sjögren syndrome, vitiligo). AIH Dx Abs include ANA, ASMA, LKM1. https://t.co/FphWZwwohx
Dr. John Cush @RheumNow( View Tweet )
Beyond malignancy, look out for LICATS with CAR-T CD19 chimeric antigen receptor (CAR) T cell therapy took the centre stage in 2022 where data pertaining to a successful case series of 5 patients with refractory SLE were published by Prof Schett’s group. Since then, this area https://t.co/JbTB033gti
Dr. John Cush @RheumNow( View Tweet )
DAHLIAS study - Nipocalimab in Sjögren's Disease Nipocalimab, a neonatal Fc receptor blocker that reduces circulating IgG and autoantibodies, was shown to be effective in a phase 2 trial in patients with severe Sjögren's disease. https://t.co/tpoh8YF0F1 https://t.co/jFB1RKOqDV

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Dr. John Cush @RheumNow( View Tweet )
CAR-T Therapy: Where is it Heading? Dr. Peter Nash summarizes several abstracts looking at CAR-T therapy from #ACR25. https://t.co/bC8p1LnZMW https://t.co/KKn3jjsBW0

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Dr. John Cush @RheumNow( View Tweet )
Combining CAR-T with CAR-Treg All in One Dr. Alfred Kim reports on abstract 0981 (GNTI-350: A CAR-Treg Therapy Offering Durable Immune Reset with Improved Safety for B Cell–Driven Autoimmune Diseases). https://t.co/SXuLYyUCXo https://t.co/5CAzoGfOyf

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Dr. John Cush @RheumNow( View Tweet )
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Genetic Risks and Severe Cutaneous Reactions to Allopurinol

Jack Cush, MD

A matched cohort study shows that HLA-B*58:01 and HLA-A*34:02 are strongly associated with allopurinol-induced severe cutaneous adverse reactions (SCARs), these alleles were absent in more than one-third of those affected, suggesting these are strong but incomplete indicators of SCAR risk.

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20-40% of Autoimmune hepatitis (AIH) is associated with other autoimmune diseases - lead by autoimmune thyroiditis, type 1 DM, ulcerative colitis, Crohn disease, & celiac (but less so for RA, PBC, SLE, Sjögren syndrome, vitiligo). AIH Dx Abs include ANA, ASMA, LKM1. https://t.co/I3ZPHiRgqZ
Dr. John Cush @RheumNow( View Tweet )
Beyond the Breakthrough: Equity and Access in CAR-T Cell Therapy for RA At #ACR25, abstract 1039, "Global Cost-Effectiveness and Equity in CAR-T Cell Therapy for Rheumatoid Arthritis," highlights the critical economic and ethical dimensions of CAR-T cell therapy in autoimmune https://t.co/Rci0dL7THj
Dr. John Cush @RheumNow( View Tweet )
IgG4: Rare, but new treatments on the horizon IgG4 is a rare autoimmune disease with excessive IgG4 immunoglobulins that can affect multiple organs yielding plasma cell deposition (inflammation) and fibrosis. https://t.co/v07Kp5tQXg https://t.co/rIvOF0mrM1

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

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”. Read Post

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. Read Post
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