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Steroids

GC dose and tapering may influence serious infection risk in patients with GCA. Discover the key safety outcomes observed during a year of JAKi therapy in a Phase 3 trial. Sponsored by AbbVie Medical Affairs +Health Impact. https://t.co/1B5dj7KJJr https://t.co/aRMAdanFhb
Dr. John Cush @RheumNow( View Tweet )

The 2025 Rheumatology Year in Review

The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.

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UK study of 1846 RA pts starting a b/tsDMARDs, ~30% on steroids & majority (2/3) continued use over the first year of new novel treatment. This suggests these aer either severe RA pts or that we are not vigilant in limiting/weaning/stopping steroids in RA patients - which is it? https://t.co/TrAktincKT
Dr. John Cush @RheumNow( View Tweet )

2026 Resolutions (1.9.2026)

Dr. Jack Cush reviews the news, announcements and journal articles from this past week on RheumNow.com. More on Variable bendability, a better way to treat RA, and a novel advance for GLP1a in PsA; and 2026 Resolutions!

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Glucocorticoid Injections in Knee Osteoarthritis A randomized clinical trial of 60 patients found that glucocorticoid injections into the infrapatellar fat pad (IPFP) did not significantly reduce pain scores in patients with inflammatory knee osteoarthritis (OA) (compared to https://t.co/4bKAxER0wq
Dr. John Cush @RheumNow( View Tweet )
VA registry study; among 2771 RA pts (~65y), 64 (2.3%) had CPPD by ICD9/10 codes. RA+CPPD pts signif older [68 v. 64y], w/ more comorbidity/OA (94 v 80%), spine Dz, DM, but less ACPA (63 v 78%). SNRA+CPPD achieved less LDA, more use of pred & b/tsDMARDs (OR >2), death, TJR. Is https://t.co/hUPJzDseVc
Dr. John Cush @RheumNow( View Tweet )
58 newly Dx #PMR pts (on <8 wks steroids/GC) randomised 1:1 MTX 25 mg/wk or placebo, w/ 24-week GC-tapering protocol. @wk 52 GC-free remission achieved in 80% of MTX vs 46% of placebo pts (risk difference 34%, 1-sided 95% CI: 14%, 1-sided P = .0042) https://t.co/75SLx5LtqZ https://t.co/HtDAJe5VI2
Dr. John Cush @RheumNow( View Tweet )

APP Pearls “Steroids: Set a stop date upfront, educate on side effects, and teach "every milligram matters." Prevents dependence and eases tapering” - Barbara A. Slusher, MSW, PA-C, DFAAPA, DipACLM

Dr. John Cush @RheumNow( View Tweet )

Glucocorticoid Injections in Knee Osteoarthritis

A randomized clinical trial of 60 patients found that glucocorticoid injections into the infrapatellar fat pad (IPFP) did not significantly reduce pain scores in patients with inflammatory knee osteoarthritis (compared to placebo).

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UK study of 1846 RA pts starting a b/tsDMARDs, ~30% on steroids & majority (2/3) continued use over the first year of new novel treatment. This suggests these aer either severe RA pts or that we are not vigilant in limiting/weaning/stopping steroids in RA patients - which is it? https://t.co/7NWeAWTjSy
Dr. John Cush @RheumNow( View Tweet )
Best of 2025: Glucocorticoids in SLE: how to start, how to follow, how to stop 70+ years after their debut, glucocorticoids remain a fast, powerful tool for SLE—but long-term toxicity comes at a high cost. Guidelines now favor GC “bridging therapy”: use briefly, taper fast. The https://t.co/RS0JQquv6j
Dr. John Cush @RheumNow( View Tweet )
APP Pearls “Steroids are not a long-term plan; AND One visit cannot fix everything” - Claudia Rivera-Salas, NP

Dr. John Cush @RheumNow( View Tweet )

Best of 2025: Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients

More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the

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Best of 2025: ERS/EULAR guidelines for CTD-related interstitial lung disease

The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in

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GC dose and tapering may influence serious infection risk in patients with GCA. Discover the key safety outcomes observed during a year of JAKi therapy in a Phase 3 trial. Sponsored by AbbVie Medical Affairs +Health Impact. https://t.co/xIC7Vqx659 https://t.co/6n3XfXeeg2
Dr. John Cush @RheumNow( View Tweet )

Best of 2025: Targeting Obesity in Rheumatic Disease Patients

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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Best of 2025: Glossary for Giant Cell Arteritis

Dejaco and colleagues have published a glossary of terms often used in conjunction with giant cell arteritis. The glossary of definitions for 23 signs and symptoms of GCA was developed through a consensus process involving international experts.

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Best of 2025: Glucocorticoids in SLE: how to start, how to follow, how to stop

Current guidelines recommend limiting the use of glucocorticoids by coining the new concept of “bridging therapy”, that is, use GCs when the disease is active and get rid of them as soon as you can. This way of thinking is conceptually attractive, however, the formula for translation to real

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Tricks of the Trade – Clinic Advice from APPs

J. Cush and many APPs

December 2025 is focused on advanced practice providers, their impact, education and priorities.  In seeking and soliciting the help and advice of leaders in the rheumatology APP world, I have been impressed by APP pride, dedication and passion for what they do.

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Disease Activity Criteria for Adult-Onset Still's Disease: EULAR Points to Consider

EULAR has published a "points to consider" (PtCs) guidance on the development of criteria for the assessment of the disease activity in adult-onset Still’s disease (AOSD).

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Reefer Madness (12.12.2025)

Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com.  B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.

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Study of 2280 dermatomyositis (DM) & polymyositis (PM) pts looked at short term (ST: <3 mos) vs long term (LT) steroid (GC) use. Vs ST, LT GC use assoc w/ higher risks of heart failure (adj OR 1.8), osteoporosis (1.9), all-cause & PM/DM-related admission (3.8) & higher costs https://t.co/Q9xt06yzew
Dr. John Cush @RheumNow( View Tweet )
Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual

Dr. John Cush @RheumNow( View Tweet )

Pulse Steroids and Mycophenolate in Juvenile Dermatomyositis 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 JDM. https://t.co/i2HBycbWY9
Dr. John Cush @RheumNow( View Tweet )

Vitamin D and Lupus Outcomes (11.21.2025)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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