TNF inhibitor

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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Dr. John Cush @RheumNow( View Tweet )
POSTER HALL PRESENTATION: Sponsored by AbbVie Medical Affairs + Health Impact. Real-world study of patients with RA on first-line TNFi who did or did not achieve treatment response at 3 or 6 months 🎯 See Dr. Charles-Schoeman discuss results at 12 months on first-line TNFi https://t.co/wo96bTIYQt
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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Early DMARD Initiation Benefits in Psoriatic Arthritis

Jack Cush, MD

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

Dr. John Cush @RheumNow( View Tweet )

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
Dr. John Cush @RheumNow( View Tweet )
Sex differences in biologic response in PsA. DISCOVER-2 post hoc analysis showed: •Radiographic progression at Week ♂️: 2.22 units ♀️: 1.10 units •Early ACR-like response (cDAPSA LDA at 8wks) linked to less damage in men (0.39 vs 2.24) Women less likely to progress https://t.co/hvRxKTMJT5
Dr. John Cush @RheumNow( View Tweet )
Early intensive therapy in PsA. STAMP RCT in early PsA: •ACR50 at 3mo: 43% (early secukinumab) vs 22% (SoC) •MDA at 3mo: 48% vs 25% •PASI90 at 3mo: 60% vs 22% By 12months: outcomes similar, but early secukinumab led to faster control and fewer therapy escalations. https://t.co/Mn0uW3cckf
Dr. John Cush @RheumNow( View Tweet )
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ICYMI: Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs

Jack Cush, MD

A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (

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Hepatitis B (Keep)

ICYMI: AGA Guideline: Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals

Jack Cush, MD

The American Gastroenterology Association has published its revised clinical practice guidelines for the prevention and treatment of hepatitis B virus (HBV) reactivation in at-risk patients, particularly those with immune-mediated disease, receiving immunomodulatory therapy and steroids.

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ICYMI: TNF Inhibitor Drug-Induced Lupus

Jack Cush, MD

A study from the FDA's adverse event reporting system (FAERS or Medwatch) database identified cases of drug induced systemic lupus erythematosus (SLE) in patients receiving tumor necrosis factor-α (TNF-α) inhibitors - a paradoxical reaction to common antiinflammatory biologic agents.

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ICYMI: Axial Involvement in Psoriatic Arthritis

Jack Cush, MD

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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Remission in Axial Spondyloarthritis Unrelated to Gut Inflammation Most patients with early, active axial spondyloarthritis (axSpA) who quickly received a tumor necrosis factor (TNF) inhibitor experienced remission, and it didn't matter whether or not they had intestinal https://t.co/Sa10k6neRP
Dr. John Cush @RheumNow( View Tweet )
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PCR: Prevalence, Cost, & Risk (6.27.2025)

Jack Cush, MD

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

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What would it take for JAKs to ROCK the boat? JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. https://t.co/tgfsU3uFVo
Dr. John Cush @RheumNow( View Tweet )
Increasing costs of biologics. X-sectional study of 76 781 psoriasis pts on biologics (TNFi, IL12/23, IL-17i, IL-23i) saw annual treatment cost increase from $21 236 in 2007 to $47 125 in 2021. AVG cost could have been 44% lower if lowest-cost Rx in same class was used https://t.co/IOaK75zsgg
Dr. John Cush @RheumNow( View Tweet )
What would it take for JAKs to ROCK the boat? JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. Once the https://t.co/JgmfxGa6TY
Dr. John Cush @RheumNow( View Tweet )
SI AS SpA ACR

Remission in Axial Spondyloarthritis Unrelated to Gut Inflammation

MedPage Today

Most patients with early, active axial spondyloarthritis (axSpA) who quickly received a tumor necrosis factor (TNF) inhibitor experienced remission, and it didn't matter whether or not they had intestinal inflammation at baseline, a small single-arm study found.

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Secukinumab & Uveitis = Unclear? Post hoc study of 11 SEC RCTs finds lower uveitis risk in AxSpA (N 1980; SEC 150 1.29/100PYs vs 1.72/100PY in PBO), but not in PsA (N 2453; SEC 300 0.71/100PY vs  zero w/ placebo) https://t.co/Gv9HheBU7l https://t.co/SlnrLRwmmn

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Dr. John Cush @RheumNow( View Tweet )
Psoriatic Arthritis: Hit hard and Early Two studies found no significant benefit of early biologics over standard methotrexate treatment, but they did not focus on poor prognosis cases. The SPEED trial, funded by the NIHR, aimed to compare disease activity in 192 PsA patients https://t.co/pS9DdOOVCV
Dr. John Cush @RheumNow( View Tweet )
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Add-on certolizumab in pregnant women with APS

Md Yuzaiful Md Yusof, MRCP(UK), PhD

Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). Despite these therapies, APO have been reported up to 40%. An important

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Combination treatments in Psoriatic Arthritis Psoriatic arthritis (PsA) is a complex inflammatory arthritis with multiple domains and associated comorbidities. Despite the advances in the treatment of PsA with biologic (bDMARD) and targeted synthetic (tsDMARD), less than half https://t.co/rSkoE236hR
Dr. John Cush @RheumNow( View Tweet )
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From Domains to Decisions: Personalizing PsA Care with Data

Jiha Lee, MD

At EULAR 2025, Dr. Laura Coates (Oxford) took the plenary stage to reframe how we think about treating psoriatic arthritis. The message was clear: in 2025, PsA treatment is no longer about following a linear algorithm; it’s about understanding the unique constellation of domains, comorbidities,

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Recent Blogs

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

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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