Generic Tofacitinib (6.26.2026)
Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Updates on tofacitinib, CAR-T therapy and AI.
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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 )
2026 Guidelines for the Treatment of Axial Spondyloarthritis
New guidelines offer clinicians and patients clearer directions on diagnostic workup, treatment selection, and long-term disease management, while emphasizing shared decision-making due to ongoing evidence gap. https://t.co/SUFnOMAUw8
Dr. John Cush @RheumNow( View Tweet )
2026 Guidelines for the Treatment of Axial Spondyloarthritis
ACR
New and updated clinical guidelines released today provide comprehensive, evidence-based recommendations for the management of axial spondyloarthritis (axSpA) for both adults and children. The effort includes an update to the 2019 ACR/SAA/SPARTAN treatment guidelines focusing on adults,
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Steroids in SpA? DBRPCT of 94 (nonPsA) SpA pts w/ peripheral arthritis (SJC ≥ 2) placebo or steroids (GC) (csDMARDs background allowed). 76% male, age 32 yrs, TJC 10, SJC 3.6. Wk 24 there was no signif diff betw groups for ACR 50, ACR70 or PSpARC outcomes. https://t.co/snJovW31Uk
Dr. John Cush @RheumNow( View Tweet )
Redefining axial spondyloarthritis
An editorial in Lancet Rheumatology calls for "..reframing axSpA as a systemic, autoimmune inflammatory disease with multiorgan involvement and substantial unmet need."
The pathogenesis relies on not only HLA-B27, but also on environmental triggers, immune dysregulation, and
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JAMA Review on Low Back Pain
A comprehensive JAMA review synthesizes current evidence on the epidemiology, pathophysiology, clinical evaluation, and treatment of nonspecific low back pain, drawing on 108 publications identified from a PubMed search (2005–2026) and the most recent guidelines from the WHO, ACP, and NICE.
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A Disease Seeking Its Identity: Peripheral SpA, PsA, and the SPARTACUS Evidence
For years, peripheral spondyloarthritis has been managed with a cautious, stepwise approach: start with NSAIDs, escalate to conventional synthetic DMARDs, and only reach for biologics when everything else fails. The SPARTACUS trial, presented at EULAR 2026 in London, challenges that paradigm
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EULAR 2026: Updated Recommendations for Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases
This update includes new pandemic era evidence, recombinant zoster vaccine data, and new perspectives on vaccination in patients taking novel immunosuppressants. Five overarching principles and 10 vaccine recommendations follow.
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Late-Breaking Studies at EULAR 2026
MedPage Today
Late-breaking abstracts presented at the European Alliance of Associations for Rheumatology's (EULAR) annual meeting, held here last week, addressed a wide range of clinical
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Long-term Cancer Risk with Targeted Therapy in SpA
Dr. Antoni Chan reports on abstract OP0238 presented at EULAR 2026 in London
https://t.co/f67SvKI6Vk https://t.co/fPp2H0aMoK
Dr. John Cush @RheumNow( View Tweet )
Imaging in SpA: are we seeing a clearer picture?
As EULAR2026 comes to a close, practical learnings take precedence as clinicians head back to their clinics. Among them, the 2026 EULAR Update on Imaging Recommendations in SpA stands out.
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True or False: Current guidelines for peripheral SpA recommend initiating treatment with TNF inhibitors before trying NSAIDs or conventional synthetic DMARDs. See if you got it right in this week's RheumIQ quiz at https://t.co/6uiqJjYUVo https://t.co/9hHFjaGUdt
Dr. John Cush @RheumNow( View Tweet )
EULAR 2026 Rheumatology RoundUp
It’s time for Rheumatology RoundUp from EULAR 2026 from London, UK. Drs. Artie Kavanaugh and Jack Cush review their choice presentations from the meeting, offering their perspectives on impact and applicability.
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New: Classification Criteria and Recommendations in SpA
ASAS and SPARTAN have updated their key classification criteria for axSpA. EULAR has also recently revised its recommendations on the role of imaging in the diagnosis and clinical management of SpA. https://t.co/YOWfwTkbqp
Dr. John Cush @RheumNow( View Tweet )
Improving Referrals for Inflammatory Arthritis
Dr. Antoni Chan discusses abstracts POS1284 and POS0784 presented at EULAR 2026 in London
https://t.co/p1iT8yPNzF https://t.co/gEyuEwW4aj
Dr. John Cush @RheumNow( View Tweet )
Strike First: TNFi vs. Step-Up Therapy in Early Peripheral SpA
The approach to treating peripheral SpA has remained the same for a long time. The guidelines recommend starting with NSAIDs, escalating to conventional synthetic DMARDs, typically sulfasalazine or methotrexate, and https://t.co/iEqzp6FStv
Dr. John Cush @RheumNow( View Tweet )
New Oral Option for axSpA: Filgotinib for Radiographic and Non-Radiographic Disease
The Janus kinase inhibitor (JAKi) class has been increasingly used in the management of axial spondyloarthritis (axSpA) over the past five years, offering effective oral alternatives to injectable biologics. But are all JAK inhibitors the same?
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The pain that inflammation does not explain in SpA and PsA
At EULAR 2026, the NEUPIA study (OP0317), a prospective observational investigation conducted at KU Leuven and University Hospitals Leuven, provides the most detailed longitudinal characterisation to date of these https://t.co/OYMf4KKBc1
Dr. John Cush @RheumNow( View Tweet )
🏠 Take Home Messages from the early #axSpA session
🔺 Earlier diagnosis is possible and better
🔺 Early axSpA is not synonymous to mild
🔺 Longitudinally, early axSpA is heterogeneous
🔺 MRI has transformed the field
❗️Beware of pitfalls
#EULAR2026 @RheumNow https://t.co/IhGQSxssyd
Links:
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Day 4 EULAR Report
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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Patient-initiated telemedicine follow-up cut rheumatology visits by 25% in stable #SpA, but not equally for everyone. Reductions were greatest in men, axSpA, bDMARD users, and the oldest patients (64+, 34% fewer visits). Patient-centered care delivery @RheumNow #EULAR2026 POS1345
Jiha Lee @JihaRheum( View Tweet )
SELECT-Axis 2 trial and Withdrawal of Upadacitinib - Of 734 pts, 194 were in remission at wk104--> UPA w/d & 22% maintained drug-free remission for >48wks. Rest flared, median time to flare: 3.1 mos (89% regained LDA by wk24 w/ restart) #EULAR2026 #axSpA POS1350 https://t.co/7A7CAHxLxX
Dr. John Cush @RheumNow( View Tweet )
Risk of Parkinsons? RA patients have 28% lower Parkinson's risk vs general population (HR 0.72); axSpA had HIGHER risk (HR 1.29). Non-TNF biologics in RA reduced PD risk further (HR 0.74). No effect seen in PsA/axSpA. #EULAR2026 Abstr #POS1116 https://t.co/1vZoZGEu5Z
Dr. John Cush @RheumNow( View Tweet )
🏠 Take Home Messages from the early #axSpA session
🔺 Earlier diagnosis is possible and better
🔺 Early axSpA is not synonymous to mild
🔺 Longitudinally, early axSpA is heterogeneous
🔺 MRI has transformed the field
❗️Beware of pitfalls
#EULAR2026 @RheumNow
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Therapeutic Updates
5-Year Results of an IL-23 Inhibitor in Patients With PsA
Sponsored by AbbVie Medical Affairs + Health Impact
Dr. Alvin Wells and Dr. Shikha Singla share their clinical perspectives on using an IL–23 inhibitor to manage patients with PsA throughout their treatment journey in the context of 5-year data from the KEEPsAKE trial program.
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Recent Blogs
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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Imagine that 100 years from now, your great granddaughter, an eminent rheumatologist, reviews the history of rheumatoid arthritis mimics.
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With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.
Podcasts
EULAR 2026 Daily Podcast Day 4a
Day 4 Recap EULAR 2026-
EULAR 2026 Daily Podcast Day 3a
