@TMefford

Ревматолог. Живу в Киеве. Люблю путешествовать. Rheumatologist living in Kyiv. Like to travel.

[Laurent ARNAUD @Lupusreference]

✅ 10 YEARS of randomized #TRIALS in #LUPUS summarized on a single slide. The least I can say is that we have collectively put A LOT of EFFORTS in the development of new #treatment.
As I only used my natural intelligence feel free to let me know if something is incorrect. #NoAI

[Rheuma Doc @LastManStand85]

The 2026 British Society for Rheumatology guideline for the management of children, young people and adults with systemic lupus erythematosus #Rheumatology #MedTwitter Full Ref Link below 👇

[Dr. John Cush @RheumNow]

MTX: SC vs Oral? Metanalysis of 9 RCTs, 974 RA pts. Compared w/ oral, SC MTX signif. incr odds of ACR20 (RR=1.15), ACR50 (RR=1.14) & reduced GI adverse events (RR=0.58), diarrhea (RR=0.42): BUT no difference in ACR70, DAS28-ESR, bioavailability AUC, or other AE https://t.co/9yHhy2ibGW

[Dr. John Cush @RheumNow]

RA-ILD in the Age of Treat-to-Target: Put the Probe on the Chest

RA inflammation may be under control, but RA-associated ILD remains a major challenge. At #EULAR2026, experts highlighted that ILD is one of the few RA outcomes not improving in the biologic era. Three new abstracts strengthen the case for a practical, low-cost screening tool already available to most rheumatologists.

https://t.co/TsqxnEspkA

[Dr. John Cush @RheumNow]

What’s New in Psoriatic Arthritis: A Whirlwind Tour

At #EULAR2026, Prof. Dennis McGonagle highlighted three key PsA trends: the rise of single-cell and spatial transcriptomics, progress toward personalized care (though not yet fully realized), and the next frontier of defining biologically refractory disease and exploring combination therapies.
https://t.co/JAkyC3HqJe

[Circulation @CircAHA]

2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome
https://t.co/0POS80XBM2

[Dr. John Cush @RheumNow]

Beyond the Scale: Do GLP-1RAs Offer More Than Weight Loss in PsA?

Over 70% of patients with psoriatic arthritis (PsA) struggle with excess weight, amplifying synovio-entheseal inflammation and blunting biologic response.

https://t.co/pAIXkdazci

[Annals of the Rheumatic Diseases @eular_ARD]

#HOTsession #EULAR2026: Treatment of ICI-induced rheumatic #irAEs by Prof Koops
Key points:
✅ From mild to life-threatening
✅ Treat early, don't await the full diagnostic picture
✅ Control symptoms while supporting cancer therapy
✅ Collaboration with oncologist
@ElvisHysa

[Dr. John Cush @RheumNow]

HCQ: 5 mg/kg/day Is Only the Starting Point

HCQ is one of the most important drugs in rheumatology, especially for SLE. It reduces flares, organ damage, cardiovascular events, and pregnancy complications, and it improves survival. Yet many clinicians still prescribe HCQ as if body weight reliably predicts drug exposure. It does not.

https://t.co/PMvEwWD8NP

[Dr. John Cush @RheumNow]

APR: Still's Disease

Companion slide deck for the Advanced Practice Rheum: Still's Disease and Fever video, featuring Dr. Jack Cush.

https://t.co/wsUP2zEulC

[Dr. John Cush @RheumNow]

Knee pain: JAMA review
- 5% PCP visits knee pain
- Knee OA ~654 million worldwide
- Patellofemoral pain: <40 yrs & physically active; pain on squat
- Meniscal tears in 12% adults (McMurray 61% sensitive; 84% specific; Joint line tender 83% sensitive; 83% specific) https://t.co/qhbaLf97xm

[Donald Thomas, MD @lupuscyclopedia]

❤️‍🔥Many of my patients have been asking me about GLP-1 agonists and if they are safe in autoimmune diseases like #SLE #lupus and #Sjogrens. I go over the medical studies in my latest post:
https://t.co/TULfsvm6sZ

[Dr. John Cush @RheumNow]

Machine learning predicts macrophage activation syndrome in adult Still's disease - 312 AOSD - XGBoost model had 5 predictors: ferritin, splenomegaly, Plt#, cholesterol, &amp; ESR (AUC 0.839, sensit 0.824, specificity 0.710. https://t.co/QrogaCYPCT

[Dr. John Cush @RheumNow]

ILD in RA - Recent Advances. Dr. Jeffrey Sparks

ILD in RA – Dr. Jeffrey Sparks
In this https://t.co/WsUomrjFmk 2026 podcast, Dr. Jeffrey Sparks reviews the latest advances shaping diagnosis and management of ILD in RA.
🎧 Listen here: https://t.co/0YsTdP4Ykt
#Rheumatology #ILD #RNL2026

[Dr. John Cush @RheumNow]

NEJM: Polymyalgia Rheumatica

Drs. Dejaco and Matteson have published and update and review of polymyalgia rheumatica (PMR) in the NEJM. They lay out the initial approach to diagnosis, initial steroid dosing, management over time and when to use steroid sparing therapy.

https://t.co/lW9DIHTmUt

[Dr. John Cush @RheumNow]

Diacerin, an IL-1β blocker, compared to placebo in a 262 pt RCT of knee pain, Knee #OA w/ inflammation. After 24 wks, 88% completed the trial & (vs PBO) diacerein did not improve knee pain (−19.9 vs −18.6 mm). 42% had AE/ GI Sxs were more w/ diacerein (42% vs 25% PBO https://t.co/wxFFiBbcJE

[Donald Thomas, MD @lupuscyclopedia]

Dr. Mithu Maheswaranathan did an excellent job summarizing the AAO 2025 revision. This is so important to disseminate to rheumatologists as very few of us get the AAO's journal (where the guideline was published).

NOTE: many ophthalmologists do not know the guidelines well, and not all ophthalmologists have both an OCT and an FAF machine. Rheumatologists should specific "SD-OCT and FAF" then actually see the results on the visit note. Another option would be to get an SD-OCT + VF 10-2 + VF 24/2 or 30-2, but getting 3 tests yearly is tedious for patients.

Also... use up to 6.5 mg/kg/d initially of HCQ so it works faster! This is in line with the latest @ACRheum SLE Management guidelines. I've done this for over 2 decades with great success.

ALSO... ignore the bottom middle about HCQ drug levels not being helpful. That is the unfounded opinion of the authors. HCQ has a very wide bioavailability. It is ridiculous to dose such a drug by body weight. Drug levels are the only way to go. Keep the level < 1150 ng/mL and you will do your patient a favor. I have many very obese patients who have levels of 2000-3000 ng/mL and need to be on only 200-300 mg daily

[Dr. John Cush @RheumNow]

Nice simple overview of SCLERITIS. https://t.co/BOgZK8y4Qq

[Dr. John Cush @RheumNow]

Full read review & update on Rhabdomyolysis. 26K cases/Yr in USA. Muscle damage leading to weakness, myalgias, swelling, myoglobinuria, electrolyte probs, AKI. Causes: 1) exogenous toxins (46%); 2) trauma; 3) myopathies/metabolic muscle dz (10%), infxn. AKI in 46%, & death in 3.4%. https://t.co/lAASuyEzpS

[BSR @RheumatologyUK]

Guideline consultation OPEN! Our update to the lupus clinical guideline is available for your review for a limited time only and we would greatly value your feedback. Learn more here - https://t.co/q1e40MYeXw