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TNF inhibitor

MTX or TNFi use in elderly #RA pts w/in a year of Dx of melanoma was not associated with increased mortality. This included melanoma in situ (48%), localized (47%) and regional (5%) melanoma. Steroid use however was assoc w/ reduced survival. https://t.co/QOXfEf51S1 https://t.co/GZ5dedEMfM
Dr. John Cush @RheumNow( View Tweet )

A New RA Approval (8.1.2025)

Dr. Jack Cush reviews the news, journal reports and a new treatment for RA from the FDA.

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Pregnant Women on TNFi more likely to use throughout gestation, w/ less steroids. 3711 preg on TNFi in 49,925 F (w/ RA, AS, PsA, PsO, IBD) -- 64% had 3 trimester TNFi use. 89% exposed preconception & 68% cont postpartum. TNFi use incr from 55% to 73% i(20111-21) https://t.co/DVvbwx6MoW
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FDA Approves Vagal Nerve Stimulator for RA

SetPoint Medical announced that the FDA has approved the company’s SetPoint System, a first-in-class neuroimmune modulation innovation for treatment of moderate-to-severe rheumatoid arthritis (RA) for those who are not adequately managed by—or cannot tolerate—existing advanced RA therapies, such

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Factors Affecting Biologic Use in Rheumatoid Arthritis

A San Francisco Rheumatoid Arthritis Panel cohort survey between 1999–2011, showed numerous sociodemographic, disease, and health characteristics that influenced the initiation of treatment with biologic agents for rheumatoid arthritis (RA).

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MTX or TNFi use in elderly #RA pts w/in a year of Dx of melanoma was not associated with increased mortality. This included melanoma in situ (48%), localized (47%) and regional (5%) melanoma. Steroid use however was assoc w/ reduced survival. https://t.co/QOXfEf51S1 https://t.co/6BPtEV6sOU
Dr. John Cush @RheumNow( View Tweet )
TNFi are relatively contraindicated in RA pts w/ #MS. Literature review suggests for pts w/ MS and RA, teriflunomide and anti-CD20 therapies are the most suitable, and Cladribine may also be considered https://t.co/gIVaJ7Kwn0 https://t.co/1ar0q2OnzB
Dr. John Cush @RheumNow( View Tweet )

CKD & Osteoporosis Rx Revisited (7.25.2025)

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

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Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors

Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer.
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Diminishing trend in serious infections assoc w/ TNFi use in inflammatory arthritis over the years. ICEBIO study 1387 Rx w/ 1st TNFi 2003–2018 (vs 6936 comparators. Over tme the SI rate dropped 52% (IRR 0.48; 0.25–0.94), but not for controls (Abx use stable) https://t.co/jDsKlCrd0p
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FDA has accepted BLA for BAT2506, a biosimilar of Simponi (golimumab) for all approved doses, formulations, & indications of reference product, with a request for interchangeability (BsUFA: May 16, 2026) https://t.co/kVFAz9ltlr https://t.co/LqdzsXlqER
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Biologic survival study of British Assoc. of Dermatologists Biologics Register (11/07-6/23) looked at 19,034 Rx courses (median F/U 2.3 yrs), of TNFi, IL-12/23i, IL-17i, & IL-23i. IL-23i (GUS & RIS) had best survival (~1.93yrs) for efficacy & safety (broadalumab the least) https://t.co/uhomYmiUZy
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10-20% of IBD pts have IBD-assoc. spondyloarthritis, as either peripheral arthritis or axial Dz, subclinical gut inflammation w/ IL-23–IL-17–TNFα playing central roles. TNFi & JAKi Rx is effective, but IL-17i may exacerbate IBD (vedolizumab??) Review here>> https://t.co/EL0sL2M3YX
Dr. John Cush @RheumNow( View Tweet )
Biologic survival study of British Assoc. of Dermatologists Biologics Register (11/07-6/23) looked at 19,034 Rx courses (median F/U 2.3 yrs), of TNFi, IL-12/23i, IL-17i, & IL-23i. IL-23i (GUS & RIS) had best survival (~1.93yrs) for efficacy & safety (broadalumab the least) https://t.co/aAULb0e3o9
Dr. John Cush @RheumNow( View Tweet )

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

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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10-20% of IBD pts have IBD-assoc. spondyloarthritis, as either peripheral arthritis or axial Dz, subclinical gut inflammation w/ IL-23–IL-17–TNFα playing central roles. TNFi & JAKi Rx is effective, but IL-17i may exacerbate IBD (vedolizumab??) Review here>> https://t.co/kNIAi55Y7z
Dr. John Cush @RheumNow( View Tweet )
No Increased Malignancy Risk with Ixekizumab A pooled analysis of 25 randomized clinical trials affirms the safety of ixekizumab (IXE) when used to treat patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA). The observed incidences of https://t.co/7dAoQyeq5x
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Rheums! Question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. https://t.co/HsqM9xLNtP https://t.co/voONsOLeSK
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Reducing Progression of Psoriasis to Psoriatic Arthritis Tumor necrosis factor (TNF) inhibitor therapy was effective in reducing the likelihood that psoriasis would progress to psoriatic arthritis (PsA), a retrospective study indicated. https://t.co/xOtA2Hrgue https://t.co/S522IYnFgz
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Biologic experienced ankylosing spondylitis patient show better retention on TNF compared to IL-17 inhibitors. 148 AS pts (F/U 31 mos), IL-17i drug survival trended better but only signif after 3yrs. More D/C w/ higher BASDAI (HR: 1.3) & ^# prior biologics (HR 1.62) https://t.co/5HXGsV4xol
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Granzyme expression is upregulated in RA, esp early RA. Blood & synovium from early arthritis & TNFi nonresponders (R4RA RCT) gene expression five granzymes, perforin, & serglycin determined by bulk RNA-sequencing data. GZM A, B, H, K, M, PRF-1, SRGN was higher in lymphoid https://t.co/v1rdFZHuuh
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Early DMARD Initiation Benefits in Psoriatic Arthritis

Mease et al has published the results of a cohort study showing early initiation of disease-modifying antirheumatic drugs (DMARDs) in patients with psoriatic arthritis (PsA) resulted in better outcomes compared to late initiation.

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Immunomodulators in the Treatment of Autoimmune Hepatitis

EurekAlert!

Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on histology. With an annual global incidence of 1.37 per 100,000, AIH can lead

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❓️Is early intensive therapy with combination csDMARDs or TNFi superior to standard step care for the treatment of moderate to severe #psoriatic_arthritis? 🅰️ Yes 🔅Check out the SPEED RCT presented by @DrLauraCoates at #EULAR2025 OP0089 @RheumNow #Strategy

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Efficacy and safety of deucravacitinib up to week 52 in the POETYK PsA-2 study •ACR20 at W16: 54.2% (deucravacitinib) vs 39.4% (placebo), p=0.0002 •PASI75: 40.9% vs 15.4%, p<0.0001 •MDA: 25.6% vs 14.7%, p=0.0007 •FACIT-F: +2.5 vs +1.8 •SAE: 1.9% (low) TYK2 inhibition shows https://t.co/PLJytueZDt
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