Influential Rheumatoid Factors (5.8.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com
Read Article
Taiwan, real-world study 267 RA new DMARD starts w/ tofacitinib (145) or TNFi (122). Post adjustments; no significant difference in Efficacy, AEs, Serious AE (20 v 21%), MACE (0 v 0.8%), CA (2% vs 0.8%), deaths (1.4% vs 3.3), SIE (13% vs 8.2%) or H zoster (12% v 3%) https://t.co/XLsdfKyeGx
Dr. John Cush @RheumNow( View Tweet )
Breaking the Rules: Dual-Advanced Combinations in Rheumatology
For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes.
Read Article
Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA
After the first tumor necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid arthritis (RA) responded by switching to upadacitinib, compared to cycling to a second TNFi, adalimumab. https://t.co/Cml3Z7ZyQP
Dr. John Cush @RheumNow( View Tweet )
Great Lectures; Great Presentations
Dr. Jack Cush lectures on giving a great presentation; based on 40 years of lecturing in Rheumatology.
Read Article
TRACE study of 90 axSpA pts Rx w/ either TNFi or secukinumab (150 or 300 mg)- at wk 56, 59% achieved clinical-remission & 43% achieved w56-MRI-remission (SPARCC) w/ benefits by wk 4. Predictors of clinical remission: ASDAS & BMI (@wk16); none @wk56 https://t.co/CEsAeRMvUE https://t.co/SfSAm3u4IM
Dr. John Cush @RheumNow( View Tweet )
Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA
After the first tumour necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid arthritis (RA) responded by switching to upadacitinib, compared to cycling to a second TNFi, adalimumab.
Malignancies Not Increased with Biologic Therapies
The risk of malignancy in RA patients receiving biologic agents was evaluated by metanalysis of RCTs and found no significant increased risk of malignancy compared with other DMARDs or with placebo.
https://t.co/ZEO4jP5RwA https://t.co/C1YeTSh7ZN
Dr. John Cush @RheumNow( View Tweet )
TRACE study in 90 active axSpA, biologic-naïve, Rx w/ secukinumab 150 mg; @wk16 ASDAS remission in 30 (35%)& 55 incr SEC to 300 mg. By wk 24, 22% of 300 mg achieved ASDAS remission; but without signif change in MRI inflamm (SPARCC). Most MRI changes in 1st 4wks https://t.co/pMMtrxxDLh
Dr. John Cush @RheumNow( View Tweet )
Couldn’t attend https://t.co/4UQlqwujiR 2026?
You can now watch the entire meeting On Demand.
This high-impact program features leading experts discussing:
• RA outcomes and pathogenesis
• Obesity, inflammation, and rheumatic disease
• Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3
Links:
Dr. John Cush @RheumNow( View Tweet )
Updated CRA/SPARCC Recommendations for Axial Spondyloarthritis
The original CRA/SPARCC recommendations endorsed IL-17i and TNFi as equivalent second-line options for adults with active axSpA who fail an adequate NSAID trial. JAK inhibitors were reserved for patients with prior https://t.co/e1iLSksgYj
Dr. John Cush @RheumNow( View Tweet )
Malignancies Not Increased with Biologic Therapies
The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo
Read Article
JAMA Guideline on the Management of Crohn Disease
JAMA has published a current Clinical Guidelines Synopsis on the Management of Crohn Disease (CD) in Adults.
Read Article
Updated CRA/SPARCC Recommendations for Axial Spondyloarthritis
In 2024, the Canadian Rheumatology Association (CMA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) published a comprehensive set of 56 treatment recommendations for the management of axial spondyloarthritis. This first update is focused on the reassessment of IL-17i
Read Article
Ixekizumab With Tirzepatide Efficacy in Obese Psoriatic Arthritis
The TOGETHER-PsA trial has demonstrated the efficacy and safety of ixekizumab (IXE) administered with tirzepatide (TZP) in adult active psoriatic arthritis (PsA) patients who were overweight or obese. https://t.co/KFwfi9FaAh
Dr. John Cush @RheumNow( View Tweet )
AFFINITY Study - Combination Biologic Therapy in PsA
A pilot trial assessed the efficacy and safety of the guselkumab+golimumab (COMBO) combination versus GUS monotherapy in active PsA (failing a prior tumor necrosis factor inhibitor (TNFi-IR) and showed superiority in ACR 50 https://t.co/f2CB8FnZMB
Dr. John Cush @RheumNow( View Tweet )
AFFINITY Study - Combination Biologic Therapy in Psoriatic Arthritis
A pilot trial assessed the efficacy and safety of the guselkumab+golimumab (COMBO) combination versus guselkumab (GUS) monotherapy in active PsA (failing a prior tumor necrosis factor inhibitor (TNFi-IR) and showed superiority in ACR 50 responses but not
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 )
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.
Read Article
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.
Read Article
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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.
Read Article
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
Dr. John Cush @RheumNow( View Tweet )
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”.
Read Post
Podcasts
ACR 2025 SpA Topic Podcasts Compilation 1
ACR 2025 Daily Podcasts Day2d
EULAR 2021 - Day2a00:38:00
