Vasculitis

EULAR.Docs.APP

Day 4 EULAR Report

Jack Cush, MD

The last day in London was exciting as both the Late-Breaking abstracts and new EULAR guidelines were presented. Guidelines presented addressed several significant unmet need areas including PMR, GCA, Takayasu’s arteritis, Vaccinations in Rheumatic patients, Imaging in spondyloarthritis and

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Prospective study of RVZ immunogenicity = heterogeneous cellular immunity across RMDs 12mo 150 pts -CD4+ gE-T-cell response peaks mo 3 -Response seen in axSpA + GCA, but not RA -25% of patients no CMI increase after vaccination Consistent w/other vaccine cellular imm profiles https://t.co/yvDLSHh4Bj

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Aurelie Najm @AurelieRheumo( View Tweet )
EULAR.Docs.APP

Day 2 Report from EULAR 2026

Jack Cush, MD

Day two at EULAR 2026 was jammed with sessions on advances in immune checkpoint inhhbitors (and irAEs), Lupus, Scleroderma, RA and IgG4 related disease.  Here are a few of my favorites from Day 2. 

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EULAR flags

Vasculitis Updates: Glucocorticoid use in AAV and GCA

2026 EULAR Press Release

Glucocorticoids are the cornerstone of initial vasculitis treatment, used to rapidly control inflammation and protect vital organs. EULAR has recommendations that cover glucocorticoid use in ANCA associated vasculitides (AAV) and large vessel vasculitis, including giant cell arteritis (GCA).1,2

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#EULAR2026 OP028 In 16 patients with AID (SSc,IIM, RA, IgG4,SjD, Grave’s), CD3xBCMA BiTE, Teclistamab was effective in 15/16. Duration of GC & DMARD-free was 11 mths. 2/16 need retreatment. All had low IgG and needed IVIG. Need long-term safety data & comparative study @RheumNow https://t.co/97MUPnXRua

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
DERM on RheumNow PODCAST (May 2026) The Derm on RheumNow podcast is a collection of Citations and Content curated for dermatologists – addressing Psoriasis, PsA, CLE, vasculitis, HS, and other CTD skin disorders. Dermatology drugs, biologics, JAKs - their use, efficacy, and https://t.co/0AEAxadBFT
Dr. John Cush @RheumNow( View Tweet )
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Quiz Talk (5.22.2026)

Jack Cush, MD

Dr. Jack Cush talks of birthdays, Quizzes and journal articles this week on the podcast.

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Kissei Pharmaceuticals announced 20 deaths related to receiving avacopan (Tavneos), a vasculitis drug sold by the firm in Japan. Drug was released in June 2022, since its been given to ~8,500 pts. Avacopan safety is being reviewed by FDA with Amgen. https://t.co/ri0nROCL5U https://t.co/jbksrWMFwI

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Dr. John Cush @RheumNow( View Tweet )
ANCA-Assoc. Vasculitis has great Rx optionis, BUT still no reliable biomaker to predict relapse or renal outcomes, this includes IL-6. But there is hope for CD163 in the future. https://t.co/lFyfTPj5vG https://t.co/wLfOPz76JC

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Dr. John Cush @RheumNow( View Tweet )
Eosinophil

EGPA Review

Jack Cush, MD

A current review of eosinophilic granulomatosis with polyangiitis (EGPA) provides current recommendations on diagnosis and management.

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ANCA assoc. pachymeningitis (AAP) is rare. 230 systemic vasculitis, from 177 reports (108 MPO+, 71 PR3+); age~60; HA & cranial neuropathy (hearing/visual loss, diplopia) common. 89% w/ systemic Sxs (ENT, lungs, orbits, kidneys). Look for abnl ESR/CRP, CSF https://t.co/bHQegYYl5V https://t.co/hpfu8iaIkx

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Dr. John Cush @RheumNow( View Tweet )
24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/hwkpeav4MQ
Dr. John Cush @RheumNow( View Tweet )
Tavneos

FDA Targeting the Safety of Avacopan

Jack Cush, MD

The future of avacopan is up in the air. In April, the FDA issued a drug safety warning, previously requesting that Amgen to pull its rare disease drug Tavneos from the market. Now, there appears more pressure to remove it from the market.

The FDA’s concern is that the data, orginally

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GI involvement occurs in 37-65% of adult IgA (IgAV) cases, w/ Sxs of abdominal pain, hematochezia, severe complications of perforation & ischemia. Dx w/ CRP, NLR, D-dimer, imaging (CT, endoscopy). Steroids w/ Mod-to-severe Dz. MMF or IVIG for refractory cases. https://t.co/vgvZnYXIOI
Dr. John Cush @RheumNow( View Tweet )
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Follow the Money (4.23.2026)

Jack Cush, MD

Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week. 

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Aspirin Cardiovascular Prevention in Giant Cell Arteritis A retrospective target trial emulations has shown that low-dose aspirin (ASA) given with a giant cell arteritis (GCA) diagnosis is associated with a lower risk of major adverse cardiovascular events (MACE), but a higher https://t.co/dpGzjKZYkA
Dr. John Cush @RheumNow( View Tweet )
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Aspirin Cardiovascular Prevention in Giant Cell Arteritis

Jack Cush, MD

A retrospective target trial emulations has shown that low-dose aspirin (ASA) given with a giant cell arteritis (GCA) diagnosis is associated with a lower risk of major adverse cardiovascular events (MACE), but a higher risk of GI bleeding.

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Retrospective study of 374 newly diagnosed microscopic polyangiitis (MPA) pts - 97 (26%) had severe infections w/in 6 mos - signif higher risk w/ high dose prednisone & chronic lung Dz. most common: bacterial (43%) & lung infx https://t.co/XXAxUZw7kx https://t.co/atK8Ob9zyQ

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Dr. John Cush @RheumNow( View Tweet )
Retrospective clinicopathologic review of 170 AORTIC surgical pathology cases (2009-16) - showed 87% w/ atherosclerosis, 13% aortitis/periaortitis and 2.4% atherosclerosis w/ excessive inflammation. Lymphoplasmacytic inflammation was most common w/ aortitis/periaortitis. https://t.co/CuP30dqRQU
Dr. John Cush @RheumNow( View Tweet )
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Adjunctive Prednisolone for Kawasaki Disease

Jack Cush, MD

An NEJM study has shown that glucocorticoids provide no added benefit when added to standard primary treatment in Kawasaki disease patients.

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Asia-Pacific Lupus study of Mucocutaneous activity (MC-A) in 4102 SLE pts. 36% had MC-A (rash 1055; alopecia 731; m ulcers 352); 15% persistently. MC-A assoc w/ W, smoking, +serologies, vasculitis, myositis, serositis, nephritis, NP-SLE https://t.co/XeBc4DJon9 https://t.co/n2wAq2OIGt

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Dr. John Cush @RheumNow( View Tweet )
Update on Primary CNS Angiitis The Journal of Neurology has posted a review and update of Primary CNS vasculitis (PCNSV), also termed primary angiitis of the CNS (PACNS). PCNSV is rare, potentially fatal, and highly treatable, making timely recognition and accurate diagnosis https://t.co/cjGX1ig8Lp
Dr. John Cush @RheumNow( View Tweet )
brain.MRI_.jpg

Update on Primary CNS Angiitis

Jack Cush, MD

The Journal of Neurology has posted a review and update of Primary CNS vasculitis (PCNSV),  also termed primary angiitis of the CNS (PACNS). PCNSV is rare, potentially fatal, and highly treatable, making timely recognition and accurate diagnosis critical. 

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FDA Safety Warning: Avacopan and Serious Liver Injury

Jack Cush, MD

Yesterday the FDA issued a Drug Safety Communication alerting patients and health care professionals about postmarketing identification of serious (drug induced) liver injury, including fatal cases, associated with the use of avacopan (Tavneos) in patients with ANCA- associated vasculitis.

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Moral Distress (3.27.2026)

Jack Cush, MD

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.

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Therapeutic Updates

Physician Case Reports: Manifestations in Patients with Severe Active GPA/MPA

Sponsored by Amgen
Amgen 2024 October RX Update
A review of two physician case reports. These cases are patients who presented with severe active manifestations of granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA).
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Recent Blogs

Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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Best of 2023: PMR: glad or bad tidings?

Sarah Mackie, MRCP, PhD
Smile feedback opinion yes no good back opinion
Please don’t tell your patient that PMR “typically” lasts two years. According to real-world data from the UK, one in four patients with PMR is prescribed steroids by their primary care physician for over four years. But nobody tells them this at the start, and that causes big problems later on.
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When PMR Strikes Young, It Hits Hard

Sarah Mackie, MRCP, PhD
figure pushing a ball uphill
Narratives around polymyalgia rheumatica (PMR) often centre around “older people” or even “elderly”. And, indeed, the peak of the age distribution is in the mid-70s – not that everyone that age considers themselves old. Treating “young PMR” can be a very different proposition to treating someone in their seventies or eighties. It’s worth taking time to think this through.
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