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Integrating D2T into T2T Practices in RA
EurekAlert!
Researchers at Semmelweis University analyzed how depression, smoking, obesity, sleep disorders, and other health problems are linked to difficult-to-treat rheumatoid arthritis (D2T-RA) and how this can inform treat-to-target (T2T) and individualized therapy.
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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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US telehealth utilization rose 10.1% in 1st quarter of 2026 (5% to 5.51% medical claims). Most use in mental health conditions (52%) w/ joint/soft tissue dz at 3% overall, higher in west & NE states. 57% for outpt visits, only 7.7% for new visits. 35% for psychotherapy services. https://t.co/L8c7p3iQPL
Dr. John Cush RheumNow ( View Tweet)
#OP0159 #EULAR2026
Multimodal study in D2T RA identified altered brain connectivity patterns linked to pain, psychological features & peripheral transcriptomics. Supports neuroimmune component in D2T RA & need for personalised approaches beyond inflammation control. @RheumNow https://t.co/qMQbkiMCwX
Mrinalini Dey DrMiniDey ( View Tweet)
Depression at RA diagnosis did not predict short-term CV events in a nationwide early RA cohort
-17,669 early RA pts
-7.3% BL depression
-Median follow-up 1.2 years
-No association w/ CV hospitalisation after adjustment (sHR 1.05)
Reassuring short-term data, longer follow-up https://t.co/XmMVGY1VlI
Aurelie Najm AurelieRheumo ( View Tweet)
Using AI to integrate EHR, SDOH , psychological data - can help finding psychosocial risk factors.
Complex cases can be diagnosed using solutions (iceberg health) like this. #EULAR2026 @rheumnow https://t.co/t4keRbpkrx
Links:
Bella Mehta bella_mehta ( View Tweet)
#EULAR2026 OP0220 How can we improve physical function of #SLE patients? Cross-sectional study of 2 US cohorts: poor physical function was associated with Fatigue, depression, learned helplessness and perceived stress. We should focus on improving fatigue & wellbeing @RheumNow https://t.co/vAFqYyuzgN
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
🔍 Do posterior element lesions progress over 10 years in axSpA?
Data from the DESIR inception cohort (n=320) says RARELY!
But baseline PE inflammation raises facet ankylosis risk ~70-fold
#POS0189 #EULAR2026 @RheumNow https://t.co/PdwlPGjKqK
Nelly ZIADE 🍀 Nellziade ( View Tweet)
D2T RA shows a linked brain–psychology–immune signature
Cohort D2T RA vs non-D2T RA vs HC
91% D2T RA
Higher catastrophizing
Higher pain sensitivity
More emotion-focused coping strategies
“Chronic pain-like” profile
Associated with higher CNS related gene expression NRG1 https://t.co/nkQco73vqI
Aurelie Najm AurelieRheumo ( View Tweet)
Sad to see this but important to be aware. Increasing risk of suicide using colchicine in Familial Mediterranean Fever. #POS0768 #EULAR2026 @rheumnow.
Average age 28! 87%female, only 7 % with psychiatric referral!
Retrospective 15 pts. https://t.co/241SE6O395
Links:
Bella Mehta bella_mehta ( View Tweet)
RA comorbidities are changing. ILD, anxiety, depression increasing. Less extraartic. manifestations, CA & CV dz. Consider screening for cervical CA, ILD, CV dz & OP (for pts on steroids) https://t.co/WVITFXNva7 https://t.co/tggdaO9RJB
Dr. John Cush RheumNow ( View Tweet)
Integrating D2T into T2T Practices in RA
Researchers at Semmelweis University analyzed how depression, smoking, obesity, sleep disorders, and other health problems are linked to difficult-to-treat rheumatoid arthritis (D2T-RA) and how this can inform treat-to-target (T2T) and https://t.co/buCXeK2jNS
Dr. John Cush RheumNow ( View Tweet)
"Courage is resistance to fear, mastery of fear, not absence of fear."
- Mark Twain https://t.co/xyJqiV7biI
Dr. John Cush RheumNow ( View Tweet)
Depression screening (PHQ-8) equally accurate in pts w/ & w/o chronic pain. Depression screening is not biased by overlapping symptoms in depression and chronic pain. https://t.co/UWf97NDPAK https://t.co/7dvt35RT9E
Links:
Dr. John Cush RheumNow ( View Tweet)
"Everything will be alright in the end; and if its not alright, then its not yet the end"
– Suni Kapoor Best exotic Marigold Hotel https://t.co/Yua7t4yoZe
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)
More Comorbidity in Difficult-to-Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
https://t.co/guMm6mqJGr https://t.co/xiykw5tBlJ
Dr. John Cush RheumNow ( View Tweet)
Do patients with chronic pain have double the rates of smoking compared to those without pain? Take this week's RheumIQ quiz to find out.
https://t.co/rmB55KC7Zh https://t.co/ms3G9uBMd5
Links:
Dr. John Cush RheumNow ( View Tweet)
NHIS 10yr survey of 195,600 Americans shows Chronic pain assoc w/ double rates of smoking & vaping. Smoking decr over time, but always higher in chronic pain pts (17.7% 2014, 13.1% in 2023) than w/o pain (12.5% 2014, 7.5% 2023). E-cigs incr over time, more w/ chronic pain https://t.co/iW7IDwHyJa
Dr. John Cush RheumNow ( View Tweet)
UK Our Future Health study of 1,563,155 finds affective Dz (depression, bipolar, anxiety) signific higher (p<0.001)in autoimmune pts vs gen. pop. (29% vs 18%) - dx by PHQ-9, GAD-7. (OR 1.86), even after adjustments income and pain, etc. https://t.co/HoKBeAZxbS https://t.co/NtJhaf7WCo
Dr. John Cush RheumNow ( View Tweet)
