TNF inhibitor

DMARDs,biologics,RA

DMARD Treatment Lags for Minority Groups with Rheumatoid Arthritis

MedPage Today

Use of disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) was markedly lower among all major racial-ethnic minority groups in the U.S. compared with white patients, analysis of federal survey data indicated, even after adjusting for income, education, and other factors

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Turkey Tryptophan (11.28.2025) Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders? https://t.co/cnxxwqwyTE https://t.co/82zugQnp2Y

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Dr. John Cush @RheumNow( View Tweet )
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Turkey Tryptophan (11.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

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Study of 452 #PsA pts who failed 1st line TNFi Rx (LOE) - 275 Cycled to another TNFi vs 177 Swapped to an IL-17i. Higher Retention in Swap (78%) vs cycled (68%) PsA pts (p < 0.001) @12 mos (60 v 40%@3yrs). Tx failure predicted by cycling, Dz Activity, Rx year, axial & mixed https://t.co/VQLBlBEw4W
Dr. John Cush @RheumNow( View Tweet )
No risk of MACE seen w/ initiation of IL-17(R)A inhib. French study of 34 241 ipts Rx IL-17(R)Ai and 381 MACEs. MACE risk was not elevated (OR, 1.25 [95% CI, 0.75-2.08] vs TNF-α inhibitors. https://t.co/WcjgRhr8mj https://t.co/Gp54eLlXSI

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Dr. John Cush @RheumNow( View Tweet )
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Vitamin D and Lupus Outcomes (11.21.2025)

Jack Cush, MD

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

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Serious infections w/ adalimumab. Marketscan MarketScan claims study (1/17-12/20) of ADA Rx in Hidradenitis Supprativa (n 1650) or psoriasis(8699). Risk of SIE & hospitalization greater w/ HS (HR 1.53); esp for sepsis & GU infxn https://t.co/2qa7O2v6fm

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Dr. John Cush @RheumNow( View Tweet )

GLP-1 Receptor Agonists in PsA: Mortality and MACE Dr. Antoni Chan reports on abstract 0849 (Mortality and Major Adverse Cardiac Events (MACE) with GLP-1 Receptor Agonists in Psoriatic Arthritis), presented at #ACR25. https://t.co/XNyt3UIjgp https://t.co/RUnZCjXF9T

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Dr. John Cush @RheumNow( View Tweet )
Late-Breaking Trials in axSpA and PsA https://t.co/EWeF0nkb1h https://t.co/HgY0be0PDX

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Dr. John Cush @RheumNow( View Tweet )
Systematic review of 10 studies showed TNFi exposure in utero not assoc w/ incr risk of infant severe infxn (4 RCTs); same for breast milk exposure (2 RCTs). Infant vaccination outcomes unaffected by TNFi use, but rec delaying BCG vaccination if TNFi exposed https://t.co/02Nn6TuzR3
Dr. John Cush @RheumNow( View Tweet )
syringe, pill, DMARD, Treatment, therapy

What should head-to-head studies in inflammatory arthritis teach us?

Janet Pope, MD, MPH, FRCPC

The multimillion dollar question for inflammatory arthritis prescriptions is: which drug should I use next?

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Marketscan claims study of 62,813 IMID women w/ 70,529 pregnancies & 69,412 births, 4,485 (7.1%) were exposed to at least one TNFi during pregnancy & 3,559 postpartum. TNFi use NOT assoc w/ SIE risk during Preg (HR 1.39; 0.95-2.05) or postpartum (HR 1.22; https://t.co/NsxOLpT0ds
Dr. John Cush @RheumNow( View Tweet )
Cush and Kavanaugh

ACR 2025 Rheumatology Round Up

Jack Cush, MD

Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.

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What happens if you have #axSpA & concomitant #FM? Pts with both have less TNFi retention, -residual pain may lead to d/c Rx. Need to determine if axSpA pt has #fibromyalgia as there may not be objective findings if no peripheral arthritis in axSpA. #ACR25 @RheumNow abst#534

Janet Pope @Janetbirdope( View Tweet )

Excited about this target trial emulation in RA-ILD Compared to RTX, NO significant difference in hospitalization/transplant/death for JAK, ABA, IL6 or TNF Trends toward ABA and JAK looking better than RTX Need trials for sure, but I like this project a lot @RheumNow #ACR25 https://t.co/FQcphRvyHK

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Mike Putman @EBRheum( View Tweet )
In a PsA cohort (n=1291), higher BMI was independently linked to lower odds of achieving MDA—especially in TNFi-treated patients. Impact was strongest in pain, skin, enthesitis, and PRO domains, not swollen joints. Each unit increase in BMI reduced MDA odds by 4–7%. Highlights https://t.co/TxO3HP51uk

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
#2686 Using HR-pQCT, researchers tracked bone changes in RA & PsA. Seropositive RA showed worst bone density & microstructure, worsening with disease activity. TNFi, RTX & BARI improved MCP bone density, highlighting the impact of inflammation and treatment. @RheumNow #ACR25

Mrinalini Dey @DrMiniDey( View Tweet )

#2662 Using Medicare data to emulate real-world RA-ILD trials, investigators compared RTX vs ABA, TOC, JAKi & TNFi No sig differences in mortality, resp, hospitalisation or lung transplant across groups, suggesting other b/tsDMARDs may be as safe as RTX for RAILD @RheumNow #ACR25

Mrinalini Dey @DrMiniDey( View Tweet )

Biologic choice in PsA: consider factoring in obesity ⚖️ Abstract 2691: In a longitudinal cohort study, obesity associated with ↓ odds of achieving minimal disease activity (MDA) among pts on TNFi, but not with other DMARDs @RheumNow #ACR25 https://t.co/p4KaH6HKYj

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Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
In a 5-year EHR-based cohort, PsO patients initiating IL-17i had significantly lower incidence of PsA/IA vs IL-23i, IL-12/23i, or TNFi. IL-17i reduced time with PsA/IA by 45% vs IL-23i, 61% vs IL-12/23i, and 74% vs TNFi. Further research need investigate if IL-17i may delay https://t.co/0PTbXZpLbu

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
#ACR25 Clinical Preview by Prof Coates to be applied tomorrow! Early Tx Abstr#1677 First-line TNFi for 12-mth vs step-up = better outcomes at 5-Yr Abstr#2662 Target emulation trial = No differences in hospitalization, death/transplant RTX vs TNFi, ABA, JAK, IL-6i @RheumNow https://t.co/yostJyc5T9

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
#ACR25 Clinical Review by Prof Coates @DrLauraCoates to be applied tomorrow! Early Diagnosis/Tx Abstr#2689 EHR study = IL-17i could prevent #PsA vs IL-23/TNFi Abstr#576 Oligo → Polyarthritis progression in women, no DMARD, enthesitis, dactylitis, nail psoriasis @RheumNow https://t.co/e1hCERpCNW

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Clinical Year in Preview SpA: no difference in efficacy rotating vs switching bDMARD MoA for next steps @RheumNow #ACR25 #LB09 https://t.co/shCLgk7Yqz

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Jiha Lee @JihaRheum( View Tweet )
Do biologics prevent PsA? Retro cohort analysis EHR through natural language processing 5 years trends PsO treated w/ IL-17i had lower incidence of PsA/IA than pts treated w/ IL-23i, IL-12/23i, or TNFi therapies Adjustment on several confounding Prospective data heavily https://t.co/W9MFaWNbWC

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Aurelie Najm @AurelieRheumo( View Tweet )
In a U.S. axSpA cohort (n=4,799), women had a 24% higher adjusted risk of TNFi discontinuation vs men especially under age 65. No sex differences seen for IL-17i or JAKi, though sample sizes were small. Highlights need for sex-informed treatment strategies. Abstract#2634 https://t.co/58Dw3nFCsf

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Antoni Chan MD (Prof) @synovialjoints( 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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