TNF inhibitor

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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
Dr. John Cush @RheumNow( View Tweet )
lung,cancer,blue,mass

BIOBADASER III Registry shows No Cancer Risk with b/tsDMARDs

Jack Cush, MD

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,

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Advanced Practitioner Biologic Prescriptions for Psoriasis

Jack Cush, MD

Advanced practice clinicians (APCs; nurse practitioners and physician assistants) deliver a large share of US dermatologic care, accounting for 37% of clinicians and 27% of dermatology visits by 2020. A current JAMA Dermatology reports APC drug spending trends in dermatology, with a focus on

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Best of 2025: 2025 BSR Guideline for Treatment of Axial Spondyloarthritis

Jack Cush, MD

Editor's note: This article was originally published April 22, 2025, and is being shared again as part of RheumNow's 'Best of 2025' series as we close out the year. Enjoy!

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hospital,surgery

Best of 2025: Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients

Jack Cush, MD

More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the

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Lancet review of skin cancer risk w/ inflammatory arthritis - both melanoma and Non-melanoma skin cancers are increased in RA & inflammation. Also Package inserts for TNFi say all TNFi Rx pts should have complete skin exams "periodically". Skin cancer screening advised. https://t.co/XddFDe0xh8
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Lancet review of skin cancer risk w/ inflammatory arthritis - both melanoma and Non-melanoma skin cancers are increased in RA & inflammation. Also Package inserts for TNFi say all TNFi Rx pts should have complete skin exams "periodically". Skin cancer screening advised. https://t.co/MNuQO6Dw5b
Dr. John Cush @RheumNow( View Tweet )
IN RA: IgA-RF seen in 50%, IgA-ACPA in 20-40% (& are very specific). IgA-RF or -ACPA found in serum, saliva & syn.fluid.& may underlie "mucosal hypothesis" of RA. IgA-RF assoc w/ more severe RA, worse outcomes, Xtra-articular manifestations, & blunted TNF inhibitor responses https://t.co/SVUJmrIy2F
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Taiwanese retrospective study (2001-2022) of 2,383 PsA pts Rx w/ 1+ DMARDs. Comparing 1,190 bDMARDs vs 1,193 cDMARD Rx pts, bDMARDs assoc. w/ signif lower risk of MACE (HR 0.65), all-cause mortality (0.44), CV mortality (0.54), but more infx related Hosp (1.45) https://t.co/eu7fSVkjZl
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The countdown is on! ⏱️ Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one. ✅ Register now at https://t.co/4UQlqwujiR 🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu

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

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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
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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 )

Recent Blogs

Advanced Practice Rheum

Difficult to Treat Rheumatoid Arthritis

Jack Cush, MD
D2T RA Cover
Dr. Cush addresses the management of difficult-to-treat rheumatoid arthritis (D2TRA). Read Post

Infections Rheums Should Worry About

Cassandra Calabrese, DO
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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
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Rx Updates (filtered for Topic)

Therapeutic Updates

Advancing the Treatment Landscape for Pediatric Psoriatic Disease

J&J January 2026
Learn more about a treatment offering pediatric patients 6 years and older who also weigh at least 40 kg, and their physicians and adult caregivers, an option that may improve skin clearance for moderate to severe plaque psoriasis or treat active psoriatic arthritis, collectively known as psoriatic disease.
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