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Chronic Low Back Pain Disappointments in a Randomized Trial

Annals of Internal Medicine reports that patients with chronic low back pain (cLBP) may benefit from physical therapy (PT); but when that fails, other secondary measures (cognitive behavioral therapy (CBT) or mindfulness) may not be effective.

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FDA has published final guidance on Postapproval Pregnancy Safety Studies; how to study outcomes in pregnant women exposed to drugs & biologics- updates on registries,statistical methods, complementary studies, rare Rx exposures https://t.co/NWxrgB0dPQ https://t.co/ckyaJ07MQ0
Dr. John Cush @RheumNow (  View Tweet)
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
Dr. John Cush @RheumNow (  View Tweet)
CorEvitas RA registry study of 9601 RA pts starting b/tsDMARDs (52K yrs F/U) - 10.4% had eGFR<60 9CRI). Achieving CDAI remission was lower w/ CRI - 28% vs 19%(adj HR 0·76 [0·66–0·88]) https://t.co/E42N3PQHwG https://t.co/WNIGGCpCfZ
Dr. John Cush @RheumNow (  View Tweet)
Gout Control Lowers Cardiovascular Events A large target emulation trial suggests that gout patients prescribed urate-lowering treatment who achieve a serum urate level lower than 6 mg/dL significantly lower their risk of cardiovascular events. https://t.co/LcBg7yCw4c https://t.co/dBYdnq9XLJ
Dr. John Cush @RheumNow (  View Tweet)
A Review of Hydroxychloroquine Ocular Toxicity While HCQ is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal https://t.co/BrENoaBAVx
Dr. John Cush @RheumNow (  View Tweet)
This is the book of my origins in Medicine; my medical school, St. Georges University (#SGU) that I went to in 1977. A great stroy of unlikely characters, with shared missions and dreams that developed me and thousands of other great Physicians who dramatically changed medical https://t.co/zGZXt6qcUm
Dr. John Cush @RheumNow (  View Tweet)
“60-40-20” - Ed Keystone (rumor has it he was actually bidding on a copy of my textbook!)

Dr. John Cush @RheumNow (  View Tweet)

Full read review of Preclinical Rheumatoid Arthritis: - Mucosal Origin Hypothesis - Gut Microbiota - Smoking & environment - Periodontitis - Immunosenescence - T cell abnormalities - Drug prevention https://t.co/SdcDtYGObO https://t.co/2UYGs5eTsu
Dr. John Cush @RheumNow (  View Tweet)
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/8VnmVsuU2h
Dr. John Cush @RheumNow (  View Tweet)
In Still's disease, what is the primary life-threatening complication clinicians must monitor for? If you think you know the answer, prove it in this week's RheumIQ quiz at https://t.co/KVK8J2iaFQ https://t.co/O62ZpIciWW
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)
JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/SgVyk9fSCd
Dr. John Cush @RheumNow (  View Tweet)
Steroids Corticosteroids remain a cornerstone of rheumatologic therapy — rapidly effective but chronically dangerous, as their power to suppress inflammation through inhibition of prostaglandins, lipoxygenase, pro-inflammatory cytokines, and proteases comes at the cost of a https://t.co/PKdnFi1XSr
Dr. John Cush @RheumNow (  View Tweet)
True or False: HLA-B27 positivity in psoriatic arthritis is associated with earlier disease onset and a higher prevalence of axial involvement. Put your knowledge to the test in this week's RheumIQ quiz at https://t.co/KVK8J2iaFQ https://t.co/SZZqaNvO2Z
Dr. John Cush @RheumNow (  View Tweet)

Influential Rheumatoid Factors (5.8.2026)

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

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Have a Rheumatology question or case for Jack Cush? Record it here, and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/yyGRvXx3lL https://t.co/MgPqpaFLOc
Dr. John Cush @RheumNow (  View Tweet)
Review of Toll-like Receptor Research A new review on TLRs systematically summarizes 40 years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding of multilayered regulatory mechanisms that https://t.co/Rvy24nmuTj
Dr. John Cush @RheumNow (  View Tweet)
Nurses - the calm through chaos Nurses are a unique breed. When they appear, it’s always a blessing. But who goes into nursing? What kind of person choose nursing over doctoring? https://t.co/smUWg06nVh https://t.co/swQYJ3NfZF
Dr. John Cush @RheumNow (  View Tweet)
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