TNF inhibitor

Korean insurance claims study (2008–2021) 183,212 psoriasis & PsA pts, found Biologic Rx assoc w/ lower risk of new-onset & recurrent MACEs vs phototherapy (adj HR, 0.45 & 0.34). Nonbiologic systemic Rx lowered MACE risk (v photoRx) only in pts w/ prior Hx MACE (0.79) https://t.co/1RC8bMSZJ3
Dr. John Cush @RheumNow( View Tweet )
Korean insurance claims study (2008–2021) 183,212 psoriasis & PsA pts, found Biologic Rx assoc w/ lower risk of new-onset & recurrent MACEs vs phototherapy (adj HR, 0.45 & 0.34). Nonbiologic systemic Rx lowered MACE risk (v photoRx) only in pts w/ prior Hx MACE (0.79) https://t.co/08wNm1AbpC
Dr. John Cush @RheumNow( View Tweet )
pediatric eye uveitis

Uveitis Risk with Slow Adalimumab Weaning

MedPage Today

Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.

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Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/YkUspqd92h https://t.co/cmAUWaScri

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Dr. John Cush @RheumNow( View Tweet )
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/7sY1sX9B3O https://t.co/EislRI5WAy

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Dr. John Cush @RheumNow( View Tweet )
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An Epidural Letdown (4.4.2025)

Jack Cush, MD

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

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Review article shows that in psoriasis pts, adding #MTX to TNFi increases efficacy, but there is limited data on adding MTX to either IL-17 or IL-23. But in Psoriatic Arthritis (PsA), adding MTX provides no added efficacy compared to biologic monotherapy https://t.co/FiSFIjpsXo https://t.co/ComFg253u9

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Dr. John Cush @RheumNow( View Tweet )
Cancer Survival with TNF Inhibitors Dr. Jack Cush reviews the news and journal reports from this past week on https://t.co/V10S4oVFsv https://t.co/MKJKAi0BPV

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Dr. John Cush @RheumNow( View Tweet )

Stillsnow, Stills, podcast

1st Line Biologics vs csDMARDs in Adult Still's Disease

Jack Cush, MD

A German multicentre, retrospective study assessed the first-line efficacy of biologics and conventional synthetic DMARD therapy in patients with adult-onset Still's disease and found biologic agents were significantly better with sustained, event-free remissions and fewer complications.

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MD Anderson Cancer Center study of 1991 RA pts w/ prostate, lung or colon cancer showed TNFi use in 1st 3yrs did NOT affect survival. Use of TNFi vs csDMARDs - nonsign lowering in CRCA (HR 0·72;0·43–1·21), Lung CA (0·70;0·49–1·00), Prostate CA (0·80;0·44–1·44) https://t.co/8zJ0OBWjbm
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Rheums! Have a rheumatology question or case for Dr.Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/VkPL7thzo8 https://t.co/h85iF6tIVk

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Cancer Survival with TNF Inhibitors (3.28.2025)

Jack Cush, MD

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

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Veterans Admin (VA) EHR study of #RA-associated ILD (n 1047), matched 237 RA-ILD pts who Rx w/ TNFi vs 237 Rx w/ non-TNF biologics (mean age 68y; 92% male). Death & Resp hospitalisation were similar (adj HR 1·21, 1·27), as was mortality (1·15), Resp mortality (1·38) https://t.co/03LV5B4FSV
Dr. John Cush @RheumNow( View Tweet )
Prgnancy,outcome

Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis

Jack Cush, MD

A prospective French study of rheumatoid arthritis (RA) or spondyloarthritis (SpA) patients showed that most maintained stable disease activity during pregnancy, but over one-third flared and required major changes in treatment.

The aim of this study was to analyze disease activity and

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Spatial transcriptomic profiling on pre- and post-Rx synovial tissue Bxs from RA - Tx naive pts on DMARDs or adalimumab. Rx refractory patients had high expression of COMP, and fibroblast TGFβ signaling driving synovial tissue fibrosis https://t.co/1xFVvoddCD https://t.co/kYvhyX8VuS

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Dr. John Cush @RheumNow( View Tweet )
Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs A retrospective US administrative claims cohort study of Rheumatoid arthritis (RA) patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a… https://t.co/8jqJwkEbZF https://t.co/cQ9aheU5mc
Dr. John Cush @RheumNow( View Tweet )
poly.jia_.jpg

PAFLAR Guidelines for Polyarticular Juvenile Idiopathic Arthritis

Jack Cush, MD

The Pediatric African League against Rheumatism (PAFLAR) initiative has published its guidelines for the diagnosis and treatment of polyarticular juvenile idiopathic arthritis (pJIA

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Stelara Biosimilar Steqeyma Launches at 85% Discount https://t.co/2ZR7LMq1JT https://t.co/coHj1jh8JB

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Dr. John Cush @RheumNow( View Tweet )
LBP_0.jpg

Axial Involvement in Psoriatic Arthritis

Jack Cush, MD

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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Are Combination Biologics Safe? Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution. https://t.co/zcmo9mTRoS https://t.co/Q1lB0LvymF

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Dr. John Cush @RheumNow( View Tweet )
Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/aU8j4d6pei https://t.co/Ft99jwzPB3
Dr. John Cush @RheumNow( View Tweet )
Available the first time: https://t.co/4UQlqwujiR 2025 On Demand! On Demand gives you access to all lectures, Q & A panels, and STEP talks, and all speaker slides and handouts — all packed with insights you won’t find anywhere else. Non-CME, practical, and finally here.… https://t.co/qZb8OKjPpw https://t.co/Exr8u6QkNc

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World Changers (3.14.2025)

Jack Cush, MD

Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.

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cancer.cross_.jpg

Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs

Jack Cush, MD

A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (

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Are Combination Biologics Safe? Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution. https://t.co/IEIi6kQI4b https://t.co/KVSbqeMbyA

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Infections Rheums Should Worry About

Cassandra Calabrese, DO
TB.EMimage.CDC_.jpg
With the increasing development and use of new biologics and oral targeted therapies to treat RA and other immune mediated inflammatory diseases, an awareness of infection risk and prevention has become of increasing interest as well. While our patients may be susceptible to many different types of infections depending on immunosuppressive regimen, age and co-morbidities, I’ll highlight a few of the “usual suspects”. Read Post

Hard Conversations: DMARDs and Malignancy

Michael Putman, MD, MSCI
Risk Option Decision
Cancer is the most difficult DMARD risk to discuss with patients. Few warnings could scare people away from a drug faster than the words “may increase risk of cancer,” yet the risks (even when substantiated) have all been low and may be counterbalanced by the benefits of disease control. Read Post
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