Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Adjunctive Prednisolone for Kawasaki Disease
An NEJM study has shown that glucocorticoids provide no added benefit when added to standard primary treatment in Kawasaki disease patients.
https://t.co/dS1uwufh69 https://t.co/wpxyOYXp8l
Dr. John Cush @RheumNow( View Tweet )
Cross-sectional study from UK Clinical Practice Research Datalink Aurum looked at > 40K w/ #PMR Rx w/ steroids - 67% were coprescribed bisphosphonates (BP) & 79% Rx PPIs/H2RAs (less in males & pts deprived areas) resulting more Fx w/in 12 mos (2.32% vs 1.4%). https://t.co/b2DFJMjqCu
Dr. John Cush @RheumNow( View Tweet )
Retrospective study of 374 newly diagnosed microscopic polyangiitis (MPA) pts - 97 (26%) had severe infections w/in 6 mos - signif higher risk w/ high dose prednisone & chronic lung Dz. most common: bacterial (43%) & lung infx https://t.co/XXAxUZw7kx https://t.co/atK8Ob9zyQ
Dr. John Cush @RheumNow( View Tweet )
Adjunctive Prednisolone for Kawasaki Disease
An NEJM study has shown that glucocorticoids provide no added benefit when added to standard primary treatment in Kawasaki disease patients.
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Litifilimab in Cutaneous Lupus Erythematosus
Biogen has announced positive results of their Phase 2 study, evaluating litifilimab in patients with active cutaneous lupus erythematosus (CLE), presented at the recent American Academy of Dermatology (AAD) Annual Meeting.
Litifilimab is an investigational monoclonal antibody that
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JAMA Guideline on the Management of Crohn Disease
JAMA has published a current Clinical Guidelines Synopsis on the Management of Crohn Disease (CD) in Adults.
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Review: Rheumatoid Arthritis–Associated Interstitial Lung Disease
RA-ILD represents the most severe extra-articular manifestation of rheumatoid arthritis, affecting an estimated 1% of the adult population in the US and Northern Europe. Prevalence estimates vary widely (up to 58%), reflecting different diagnostic criteria, imaging modalities, and study
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NEJM: Polymyalgia Rheumatica
Drs. Dejaco and Matteson have published and update and review of polymyalgia rheumatica (PMR) in the NEJM. They lay out the initial approach to diagnosis, initial steroid dosing, management over time and when to use steroid sparing therapy. https://t.co/CGXjcY0J3H
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Moral Distress (3.27.2026)
Dr. Jack Cush reviews the journal reports and news from RheumNow.com. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
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EULAR 2025 Update for Behçet’s syndrome
EULAR has updated its recommendations for the management of Behçet’s syndrome, the last being published in 2018. The current update carries no recommendations from the previous version: seven recommendations have content modifications, four have minor wording amends, and one is entirely new
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Prednisone use in Alberta primary care 546 #RA pts - 40% of PCP RA Rx w/ 1 or more prednisone Rx. 41% Rx w/ both Pred + DMARD, w/ 44% on Pred median 124 day before DMARD. 66% continued Pred >1 yr after DMARD initiation. https://t.co/wrxQRP2TWN https://t.co/XxWpjafBsk
Links:
Dr. John Cush @RheumNow( View Tweet )
RA pt on 7.5 mg/d Prednisone need hip replacement. What do you advise re: pred dose before TKR?
Dr. John Cush @RheumNow( View Tweet )
2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management
The European Alliance of Associations for Rheumatology (EULAR) has updated their rheumatoid arthritis (RA) management recommendations, notably with fewer recommendations (total of 9, down from 11 in 2022 version), by merging and removing previous recommendations.
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Long-Term Hydroxychloroquine Retinopathy Risk
About one in 18 patients taking hydroxychloroquine (HCQ) for 15 years develop retinal damage, a new meta-analysis indicated.
https://t.co/TBSTIb29Pf https://t.co/7TYQe4N4JH
Dr. John Cush @RheumNow( View Tweet )
Long-Term Hydroxychloroquine Retinopathy Risk
About one in 18 patients taking hydroxychloroquine (HCQ) for 15 years develop retinal damage, a new meta-analysis indicated.
https://t.co/Gp6o0FfEYA https://t.co/TjLNXl229v
Dr. John Cush @RheumNow( View Tweet )
Open-label experience with upadacitinib in 27 Behcets pts (median 36 yrs) w/ median BDCAF 4 (2–7). At 6 mos overall response seen in 23/27 (85%) (16 CRs, 7 PRs) w/ signif reductions in BDCAF, CRP, ESR, & steroid dose by week 24. 3 pts relapsed during F/U https://t.co/VXkskVyWgT
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Progress in GCA and Takayasu's Arteritis
Despite carefully planned taper schedules, about 75% of GCA patients remain on glucocorticoids after 4 years, and 74% experience side effects. In rheumatology, prolonged steroid use often leads to expected toxicity. https://t.co/l65ER5rGU8
Dr. John Cush @RheumNow( View Tweet )
Progress in GCA and Takayasu's Arteritis
I recently attended a fascinating lecture by Dr. Anisha Dua on progress in the diagnosis and treatment of large-vessel vasculitis, with a focus on giant cell arteritis (GCA) and Takayasu's arteritis. She opened with what felt like the most honest “state of the union” slide you can show a room
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Epidemiology of Dry Eye Autoimmune Disease
Dry eye rates upwards of 20% were seen across nine common autoimmune diseases other than Sjögren's, most often in rheumatoid arthritis (39.3%) with Crohn's disease bringing up the rear (23.0%), according to Chi-Chin Sun, MD, PhD, of Chang Gung Memorial Hospital in Keelung, Taiwan, and colleagues
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Dermatomyositis outcomes w/ 2475 pts (claims) & 1196 pts (EHR). Half had myositis panels & 35% had + MSAbs. Steroid use common in 69% & 74%. HCQ, MTX, MMF. Outocmes (per 1000PYs) wereL all-cause hospitalisation 92, malignancy 15.3, ILD 6.4, and myocarditis 2.1 https://t.co/DJqKGNGX76
Dr. John Cush @RheumNow( View Tweet )
RT @RichardPAConway
ACR/Chest and EULAR/ERS guidelines for RA-ILD presented by Dr Sparks. I'm posting the one I use ;) #RNL26 https://t.co/a6vwQWbjE7
Dr. John Cush @RheumNow( View Tweet )
Maui Potpourri (2.13.2026)
Dr. Jack Cush reviews the hot item takeaways from last week's RheumNow.Live 2026.
- Diet & Obesity Management in Rheumatology - Uzma Haque, MD
- Mitigating risk for Rheum patients undergoing orthopedic surgery - Susan Goodman, MD
- Paradoxical skin reactions – Joseph
Vasculitis
Sunday’s vasculitis session at RNL26 was a fantastic update on inflamed blood vessels, large and small, by two experts in the field: rheumatologist Dr. Mike Putman and dermatopathologist Dr. Clay Cockerell.
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ANA Pollution (2.06.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory news from this past week on RheumNow.com
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How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?
Please don’t tell your patient that PMR “typically” lasts two years. According to real-world data from the UK, one in four patients with PMR is prescribed steroids by their primary care physician for over four years. But nobody tells them this at the start, and that causes big problems later on.
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Podcasts
ACR 2025 Daily Podcasts Day2b
