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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Real-world safety of tofacitinib vs biologics in 48,167 #PsA pts Rx w/ TOFA (3,166); TNFi (27K); IL-17Ai (20K); risankizumab (4,381); ustekinumab (4,499). Crude IRs/100 PY were 1.78-2.53 for serious infxn, 0.27–0.61 MI/stroke, 0.17–0.42 VTE, & 0.74–1.06 cancer. TOFA had signif https://t.co/dErlkyY9WC
Dr. John Cush @RheumNow( View Tweet )
Real-world safety of tofacitinib vs biologics in 48,167 #PsA pts Rx w/ TOFA (3,166); TNFi (27K); IL-17Ai (20K); risankizumab (4,381); ustekinumab (4,499). Crude IRs/100 PY were 1.78-2.53 for serious infxn, 0.27–0.61 MI/stroke, 0.17–0.42 VTE, & 0.74–1.06 cancer. TOFA had signif https://t.co/Z5wZTGc5gB
Dr. John Cush @RheumNow( View Tweet )
Spotty Medicare Coverage for Newer Rheumatoid Arthritis Meds
MedPage Today
Medicare coverage of targeted disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) -- both under Medicare Advantage and in separate Part D plans -- is likely to leave many patients wanting, researchers found.
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Retrospective TriNetX Network cohort study of adult PsA (N 123,031) pts, propensity- matched to non-PsA controls. PsA had signif higher CV morbidity: MACE (HR 1.74); mortality (HR 1.95); CHF (HR 1.96), MI (HR 1.71), & CVA (HR 1.49). bDMARDs reduced MACE (HR 0.95) & mortality (HR https://t.co/bHrq9KpwBM
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Long-Term Bimekizumab Safety Data
Adverse effects from bimekizumab through 2 years or more of treatment for psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) were about as expected from shorter-term data, results from long-term extension studies indicated. https://t.co/AaJxewNQmQ
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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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UCB announced topline results of the BE-BOLD head-to-head study where bimekizumab (IL-17i) was superior to risankizumab (IL-23i) study; 553 active PsA in achieving an ACR50 response at 16 weeks. Enrolled PsA pts were either bilogic naïve or who had previous exposure to 1 TNFi
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Annual fibromyalgia survey (FIRST) in axSpA pts in the DESIR cohort. FM was found in 22% (& assoc w/ less HLA-B27+ & XRay sacroiliitis, equal MRI SI a& ^ CRP. FM/AxSpA had less self-reported Dz activity, QOL, more disability & more likely to Rx w/ TNFi (64% vs 41%), but resp https://t.co/9rkZFUSB2M
Dr. John Cush @RheumNow( View Tweet )
UCB announced topline results of the BE-BOLD head-to-head study where bimekizumab (IL-17i) was superior to risankizumab (IL-23i) study; 553 active PsA in achieving an ACR50 response at 16 weeks. Enrolled PsA pts were either bilogic naïve or who had previous exposure to 1 TNFi
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Swiss study of 1st TNFi efficacy in 3324 axial spondy (axSpA) (≤1 yr=very early Dz,441; 1-2 yrs =early axSpA, 218; >2 yrs=establi axSpA, 2575). After adjusting for age/sex, B27, etc, no signif. difference seen when TNFi started regarding later outcomes: TNFi retention, or ASDAS https://t.co/1EaP8UOsVt
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Korean National Insurance claims study (2010–2023) of treatment persistence of IL-17i vs TNFi (IL-17i: 375; TNFi: 1285) in 1660 axSpA pts found equal Tx durations. However, primary nonresponse D/C was significantly higher w/ TNFi vs IL-17i (adj HR 1.54 to 2.11) https://t.co/2CF4OCPT6z
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UBER Rheumatology Ride (3.6.2026)
Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com
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Taiwan National retrospective study (2001-20) of 8732 newly Dx, biologic-naïve RA pts initiating b/tsDMARDs. Found no difference in malignancy event rates between DMARDs. 2.16% over 5-yr & 2.89% over 18yrs. (6384 Rx w/ TNFis, 667 w/ TCZ, 656 w/ ABA, 1025 on tsDMARDs) https://t.co/54ZMPywEYI
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Sonelokimab (SLK) is a nanobody that inhibits IL-17A & IL-17F. Press release from Moonlake shows SLK was effective in the phase 2, S-OLARIS study of 26 axial spondyloarthritis pts where 80+% of patients achieved ASAS40 by Week 12 https://t.co/BQjBcvESfe https://t.co/tXRKj8CPbz
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Peripheral manifestations are inconsistently assessed in axSpA trials. b/tsDMARDs have small-to-mod effects on peripheral Sxs & may be underestimated. Assessments in axSpA RCTs were low for periph arthritis 54%, enthesitis in 64% and dactylitis in only 10% of studies. https://t.co/cCNvU1oZMh
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J Rheum full read editorial on What HLA-B27 Can—and Cannot—Tell Us!. HLA-B27 also holds prognostic and theragnostic value, given its association with greater structural damage, higher inflammatory burden, and better response to tumor necrosis factor and interleukin 17 inhib. https://t.co/3xNDtePEzn
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Diagnosing and Managing GCA and Takayasu’s Arteritis
Giant-cell arteritis and Takayasu’s arteritis are both large-vessel vasculitides, but each brings its own diagnostic and management challenges. Many of the difficulties overlap because they are rare, heterogeneous, and lack perfect diagnostic tests or specific biomarkers.
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Paradoxical Reactions, Target Selection & the Future of Imaging in Psoriatic Care
From paradoxical psoriasis to IL-23 vs IL-17 to imaging in PsA, speakers in RheumNow Live's "Decisions in Psoriatic Arthritis" pod delivered valuable, clinically relevant education.
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RT @ericdeinMD
#RNL26
Paradoxical psoriasis with TNF
Highest in infliximab
Seen highest in IBD, particular Crohn's
Palmopustular is most common manifestation
May have overlap appearance with psoriaform with eczema, histology with psoriaform spongiotic dermatosis with https://t.co/SKQZgbLQUS
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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
Advances in RA-ILD
Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26.
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Notch and TGFβ Signaling in Refractory Rheumatoid Arthritis
EurekAlert!
Spatial transcriptomic profiling of rheumatoid arthritis (RA) synovial biopsies (pre- and post-treatment) has revealed new insights into the pathobiology or treatment resistent RA.
The following transcript comes from an interview on this paper that appeared in Nature
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Retrospective real-world study of 87 Behcets dz pts & inital Rx w/ IFX (n 45) or ADA (n 42) (2020 to 2025) & >60% were on AZA. Complete remission achieved in 76% (IFX) vs 79% (ADA) initially, & 89% vs 77% last visit. Same Rx retention but more relapses w/ IFX (38% v 17%) https://t.co/6FiuYe0GI9
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BIOBADASER III Registry shows No Cancer Risk with b/tsDMARDs
A large, real-world cohort study of rheumatoid arthritis (RA) finds patients treated with biologic and targeted synthetic DMARDs (b/tsDMARDs) do not have an increased risk of cancer.
Researchers used 2000–2023 data for RA patients from the BIOBADASER III registry,
Recent Blogs
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”.
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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.
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Podcasts
ACR 2025 SpA Topic Podcasts Compilation 1
ACR 2025 Daily Podcasts Day2d
EULAR 2021 - Day2a00:38:00
