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Everyone is entitled to his own opinion, but not his own facts. - Daniel Patrick Moynihan https://t.co/VQTvdtm9cw
Dr. John Cush @RheumNow (  View Tweet)
Distinguishing Septic and Gouty Arthritis A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal threshold of 50,000 https://t.co/ye69mRooSh
Dr. John Cush @RheumNow (  View Tweet)
Predictors of Developing RA A prospective cohort study of seropositive arthralgia patients demonstrated that baseline characteristics and labs can be used to predict which arthralgia patients are at highest risk of developing RA. These studies underscore the influence of https://t.co/wpSHDfwCL7
Dr. John Cush @RheumNow (  View Tweet)
Is High Dose Aspirin Needed in Kawasaki Disease (KD)? Does aspirin add any advantage to intravenous immunoglobulin (IVIG) alone in children with KD? A randomized clinical trial IVIG alone was not inferior to IVIG plus aspirin, suggesting that high-dose aspirin during initial https://t.co/uuCgDmgNif
Dr. John Cush @RheumNow (  View Tweet)
Should Lupus Nephritis Receive PJP Prophylaxis? A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and https://t.co/QGHxk3O8q4
Dr. John Cush @RheumNow (  View Tweet)
An emulation trial shows that Humira biosimilars (Amjevita & Imraldi) were equivalent to Humira in psoriasis & achieving PASI <=2, both for new biologic starts and for biologic switchers. https://t.co/zLnPbtXKie https://t.co/ispbmxd8dv

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CDC's Committee on Immunization (ACIP) met and recommended: 1. Expand strains for meningococcal vax 2. Lower age for RSV vax > 50y 3. Rec. chikungunya vax for certain travelers - Flu & Covid Vax to be up next mtg 6/25 https://t.co/jInnR5JSxS https://t.co/PXg0HDLgnL https://t.co/4pfZSRrEzi

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Genetic Analysis of Asymptomatic Antinuclear Antibody Positive Patients A large scale genomic population study found antinuclear antibodies (ANA) in up to 14% of the population; most with ANA are asymptomatic, and ANA production is not associated with significant genetic risk. https://t.co/Ltqf1yaaoy
Dr. John Cush @RheumNow (  View Tweet)
Genomics and Future Drug Targets for Osteoarthritis A Nature article details the results of an osteoarthritis, genome-wide association study meta-analyses across up to 489,975 cases and 1,472,094 controls, establishing 962 independent associations, 513 of which have not been https://t.co/OYyePkAeAM
Dr. John Cush @RheumNow (  View Tweet)
2001–2015 Danish national health registry study of 1.8 million adults, including 290,781 w/ knee or hip #OA & 1.5 million age-, sex-, education-matched controls. Women w/ knee or hip OA had 44% higher risk of CV Dz (HR 1.44), while men w/ HOA/KOA lesser incr (HR 1.24) CV risk https://t.co/P9V7m9rqAa
Dr. John Cush @RheumNow (  View Tweet)
In a murine model of Kawasaki Dz vasculitis- depleting gut microbiota reduces KD like vasculitis. CV lesions were assoc w/ decrease in Akkermansia muciniphila and Faecalibacterium prausnitzii. Replacement attenuated these findings. https://t.co/uAfInA5MAq https://t.co/3AjMRQnmts

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Dr. John Cush @RheumNow (  View Tweet)
Systematic review of >90 studies on Pregnancy and RA risk indicates that parity, gravidity, infertility, pregnancy loss do not adversely affect RA development. But low birthweight was assoc w/ RA Dx/severity, and pre-eclampsia incr risk of subsequent RA Dx. https://t.co/nw8FfWyM8A
Dr. John Cush @RheumNow (  View Tweet)
DNA,genetics,sequencing

Genetic Sequencing in Rheumatology

Jack Cush, MD

Genetic sequencing as a research and diagnostic tool has expanded in medicine and rheumatology. An interesting review in Arthritis and Rheumatology suggests that despite currently modest use, there will be an expanded role for genetic sequencing in the field of rheumatology. 

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The Increasing Cost of First-Line Biologics for Plaque Psoriasis

Jack Cush, MD

A national commercial claims analysis of first-line use of biologics in biologic−naive plaque psoriasis patients found a near doubling of net treatment costs from 2007 to 2021 ($21 236 to $47 125). Despite the increasing costs, the 2021 average cost could have been 44% lower if the lowest-cost drug in the same mechanistic class were chosen.

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Recent Medscape Physician Compensation Report 2025, MD Salaries dropped by: Dermatology: -11% Neurology: -6% Urology: -6% Plastic surgery: -4% Cardiology: -4% Ophthalmology: -4% Gastroenterology: -3% Rheumatology: -3% https://t.co/kNKuBwbL8J https://t.co/fA7d5A3wJp

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Dr. John Cush @RheumNow (  View Tweet)
Distinguishing Septic and Gouty Arthritis A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal threshold of 50,000 https://t.co/00kNogjRdr
Dr. John Cush @RheumNow (  View Tweet)
Predictors of Developing RA A prospective cohort study of seropositive arthralgia patients demonstrated that baseline characteristics and labs can be used to predict which arthralgia patients are at highest risk of developing RA. These studies underscore the influence of https://t.co/WAohoaiBwY
Dr. John Cush @RheumNow (  View Tweet)
Enzyme Porcupine inhibition of Wnt signaling is a promising treatment forsclerosteosis - rare Dz caused by SOST mutations & loss of functional sclerostin. Results in high bone mass & skeletal overgrowth (Sxs of facial paralysis, hearing loss, incr intracranial pressure https://t.co/9DYO82quiC
Dr. John Cush @RheumNow (  View Tweet)
JAMA Pt Education handout - Scleroderma https://t.co/UpK24WfyNF

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Dr. John Cush @RheumNow (  View Tweet)

Ultrasound lesions of dactylitis associ w/short-term development of PsA. Study of 64 PsO +arthralgia pts. IUS PD synovitis & B mode enthesitis predicted PsA Dx (p < .001) w/ an accuracy of 89.1 %, a sensitivity of 86.7 % and a specificity of 89.8 %. https://t.co/Ij6oYP1TuK https://t.co/55sO4uFXNI

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Dr. John Cush @RheumNow (  View Tweet)

From the blog

The War Rheum

Kathryn H. Dao, M.D.
blue and yellow arms and hands
The effects on rheumatologists and their patients living in Ukraine largely have been unseen by the world. At ACR Convergence 2024, I met Dr. Marta Dzhus who practices at St. Michael's Clinical Hospital in Kyiv; she shared her story with me about the humanitarian crisis in rheumatologic care in Ukraine because of the ongoing war. Here is an excerpt of our conversation.
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Podcasts

  • Osteoarthritis Risky Business (4.18.2025)
  • EMR Messaging Woes (4.11.2025)
  • An Epidural Letdown (4.4.2025)
  • Biomarkers in RA
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Therapeutic Updates

Biomarkers in RA

Sponsored by Augurex
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Rheumatologist Dr. Walter Maksymowych discusses the role of biomarkers in RA care, with a focus on 14-3-3eta as a modifiable marker for diagnosis and monitoring disease progression.
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