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Save the date! We’ll be covering #EULAR24! https://t.co/HGjP2SFyOp
Dr. John Cush @RheumNow( View Tweet )

"Don't You Know Who I am?" (5.17.2024)

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?

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TNFi mAbs, JAKi, –IL-17 are protective against Anterior Uveitis (AU) in AxSpA. Metanalysis of 44 RCTs shows AU IR: - TNF mAbs: 4.1 - etanercept 5.4 - IL-17i: 2.8 - JAKi: 1.5 - placebo: 10.8 https://t.co/qN9UL16YPO https://t.co/5WOjAq9ty6
Dr. John Cush @RheumNow( View Tweet )
This study examined the risk of neuroinflammatory disease after initiation of b/tsDMARDs Overall risk of neuroinflammatory events among new users of TNF inhibitors did not differ substantially as compared to new users of other b/tsDMARDs In AC&R https://t.co/8rGgZmpq9c https://t.co/5gxuWBctBL
ACR_Journals @ACR_Journals( View Tweet )
#RNL2024 @RheumNow @AlexisOgdie Many therapies for SpA - but ONLY TNFi, IL17i, and JAKi for AxSpA Check out https://t.co/3918uYvdFj to help guide treatment decisions: Prior therapies? enthesitis? concomitant IBD/uveitis? comorbidities? Pt preferences? https://t.co/6ugueBPMTy

Dr. John Cush @RheumNow( View Tweet )

#RNL2024 @RheumNow @_AprilArmstrong Choosing a biologic in Psoriasis TNF - great in PsA, pregnancy. Avoid in demyelinating, hep B IL-17 - robust skin, PsA (axial too). Avoid in IBD IL-23 - robust skin, PsA evidence, fewer injections https://t.co/42kUaIZxKs

Dr. John Cush @RheumNow( View Tweet )

ICYMI: Co-management of Psoriatic Disease

It is a common clinical scenario to see someone with both severe psoriatic arthritis and skin psoriasis. In an ideal world this would involve a combined clinic with our local friendly dermatologist. For many of us, however, this is not practical for many reasons. The excellent Saturday morning

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vedolizumab-induced enthesitis @lihi_eder #RNL2024 @RheumNow 11/90 (12.2%) of pts on VDZ for IBD w/ develop new-onset enthesitis Is this true drug rxn or previously masked by prior meds (TNF)? Usually unilateral +/- oligo, dactylitis Most respond to NSAID or injxn, 27% change Rx

Dr. John Cush @RheumNow( View Tweet )

Staph. aureus bacteremia (SAB) is assoc w/ poor outcomes & Osteoarticular infection. Danish study of 18 274 SAB pt (367 w RA). 90d SAB risk in RA was 23% vs 12.5% in non-RA (HR 1.93). Higher w/ Jt implants (29%) & TNFi use (42%). 90d Mortality was 35% https://t.co/hjaPnTbE0E https://t.co/7t7omiUVYf
Dr. John Cush @RheumNow( View Tweet )
Oral Surveillance study revisited: the risk of Venous thromboembolism & Pulmonary emboli were higher with tofacitinib (10>5 mg BID) versus TNFi and were generally consistent over time. VTE & PE risk incr by age, BMI, and VTE Hx https://t.co/v7ISjw5Rvd https://t.co/10oE7MiAAj
Dr. John Cush @RheumNow( View Tweet )

1/600 Falls May Die (4.5.2024)

Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com -  including problems w/ falls, pain and treatment of Dupuytren’s contractures.

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soluble Fms‐like tyrosine kinase‐1 (sFlt-1)/placental growth factor (PlGF) ratio, biomarkers of placental function and adverse pregnancy outcomes. Study of 158 RA pts, 1/2 on TNFi during Preg. TNFi assoc w/ incr birthweight; no effx on sFlt‐1 & PlGF https://t.co/JFvDxrTAfr https://t.co/CRxSEbm2Ru
Dr. John Cush @RheumNow( View Tweet )
Korean biologics registry study 526 Ank Spondylitis pts on TNFi > 1yr and tapered; 24.1% experienced flares. Predictors of flare included B27+, inflammatory LBP, psoriasis, SpA Fam Hx, DM, ≥50% TNFi tapering, Dz activity (ASDAS-CRP, BASFI) at tapering https://t.co/jjyMX3borT https://t.co/u0lbtfCyz1
Dr. John Cush @RheumNow( View Tweet )

Activity & Pain Tolerance (3.29.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including where you should sit in clinic and why you should worry about secondary Sjogren's in RA.

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Naysayers & Disrupters (3.22.2024)

Dr. Jack Cush reviews the news and journal reports from the past week - including a few contrary reports on infection, seropositivity and plasmapheresis.

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2023 EULAR Psoriatic Arthritis Recommendations

EULAR has updated its treatment recommendations from the prior 2019 guidelines, since which there have been several newly developed agents. The updated guidance includes 7 overarching principles and 11 recommendations regarding treatment strategy and pharmacological therapies.

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Expert Panel Guidance on Managing Psoriatic Arthritis and Comorbidities

An expert panel has published their consensus guidelines for the management of psoriatic arthritis (PsA) and it's comorbidities in the journal Rheumatology. 

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Japanese study of 672 autoimmune pts on TNFi & tocilizumab - 1.6% (n=9) developed non-tuberculous Mycobacteria (NTM) infx post biologics. 2 disseminated NTM, 2 died. NTM pts had higher mortality [(22% vs 2.6%) & took more steroid (17 vs 3 mg, P=0.004).https://t.co/fGGafrTeiL https://t.co/DkmiC2hVEA
Dr. John Cush @RheumNow( View Tweet )
JAK-pot: 46913 Rx courses on JAKi, TNFi, other MOA. Rx D/Cs for AEs: - TNFi = JAKi (HR 1.0) - Other MOA > JAKi (HR 1.11) - TNFi < tofacitinib (0.81) - TNFi > baricitinib (1.15) - TNFi < JAKi; if >65yrs w/ CV risk (0.79) https://t.co/jCtLG3SNvP https://t.co/FN5U5Z1M9M
Dr. John Cush @RheumNow( View Tweet )

Ides of March (3.15.2024)

Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.





  1. Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory

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US Trends in RA DMARD Use 2017-2021

A trend analysis of DMARDs shows that only half of rheumatoid arthritis (RA) patients are taking DMARDs, and that the COVID-19 pandemic substantially affected DMARD use. Despite numerous DMARD advances and evolving treatment guidelines since 1990, older therapies are still commonly used and

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Depression and RA Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week. https://t.co/nJZD4D2ByC https://t.co/ET3Xp9cK62
Dr. John Cush @RheumNow( View Tweet )
Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/a3XeAa2lcG https://t.co/dTZa2uQF97
Dr. John Cush @RheumNow( View Tweet )

Many with Psoriatic Arthritis Fail to Achieve Minimal Disease Activity

Despite the availability of numerous advanced therapies for psoriatic arthritis (PsA), there remains a substantial burden and unmet need for improved therapies, according to a newly published Canadian study.

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DMARDs, MTX & TNFi can lower CV risk in RA pts. #RWCS24 https://t.co/Un457RYL8R
Dr. John Cush @RheumNow( View Tweet )