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Lupus,flare,malar,DermNetNZ

Subcutaneous Anifrolumab Effective in Lupus

d ACR

A new study published in Arthritis & Rheumatology demonstrates that subcutaneous administration of anifrolumab provides efficacy comparable to intravenous administration, offering a promising alternative for at-home care of patients living with moderate-to-severe systemic lupus erythematosus.

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memorium.2

2025 Rheumatologists, In Memorium

d Jack Cush, MD

In 2025, Rheumatology lost many of our greatest clinicians, compatriots, and mentors. This is an honor roll for those who cared, taught, advised and supported many patients, and many of us.

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Knee,injection

Glucocorticoid Injections in Knee Osteoarthritis

d Jack Cush, MD

A randomized clinical trial of 60 patients found that glucocorticoid injections into the infrapatellar fat pad (IPFP) did not significantly reduce pain scores in patients with inflammatory knee osteoarthritis (compared to placebo).

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Obesity and Low Back Pain

d EurekAlert!

A large patient population study finds weight gain,  increases risk for low back pain - the risk increased 7% for every BMI unit or 10 pounds over ideal weight. 

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couple holding hands with baby shoes

Assess Reproductive Health in SLE Clinic Visits

d Jun Chu , MSN, CRNP

Due to the complexity of SLE, rheumatology providers should take an active role in assessing reproductive health, providing education on how SLE may affect pregnancy, and taking a collaborative, multidisciplinary approach with the patient’s gynecologist.

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Obesity and Low Back Pain A large patient population study finds weight gain, increases risk for low back pain - the risk increased 7% for every BMI unit or 10 pounds over ideal weight. https://t.co/EZQwhLpNjg https://t.co/tIlEQmedp7

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Dr. John Cush RheumNow ( View Tweet)
58 newly Dx #PMR pts (on <8 wks steroids/GC) randomised 1:1 MTX 25 mg/wk or placebo, w/ 24-week GC-tapering protocol. @wk 52 GC-free remission achieved in 80% of MTX vs 46% of placebo pts (risk difference 34%, 1-sided 95% CI: 14%, 1-sided P = .0042) https://t.co/75SLx5LtqZ https://t.co/HtDAJe5VI2

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Dr. John Cush RheumNow ( View Tweet)
Adult co-twin study of 1261 pairs, 1/2 Rx w/ metformin. Although metformin Rx Twin had higher BMI, they had significantly less incident peripheral OA (adjusted HR 0.60; 0.44–0.82). @ 10 yrs, 6.7% of treated twins, vs 9.7% of non-treated twins had incident OA, with difference of https://t.co/7KpiGssFSo
Dr. John Cush RheumNow ( View Tweet)
Systematic review of Difficult-to-treat RA (D2T-RA): 23 articles, 27,987 RA pts from 13 countries - pooled prevalence of D2T-RA was 11.7% (10.9% overall; 13.2% in b/tsDMARDs-treated RA). 47% D2T-RA had persistent inflammatory refractory RA (PIRRA). Prevalence decreased w/ https://t.co/0Gatzbfxid
Dr. John Cush RheumNow ( View Tweet)
Anti-mitochondrial M2 Ab (AMA-M2) in 987 IIM pts-- 55 (6%) were AMA-M2 positive. AMA-M2+ had signif. higher rates of polymyositis (56% vs 23.5%), GGT, alk phos levels, & 3 fold more cardiac involvement (60 vs 13%) (arrhythmias, CHF, pulm HTN (31-56%), but no effect on survival https://t.co/WYWeDpiYOh
Dr. John Cush RheumNow ( View Tweet)
DPC - direct primary care offices run by nurse practitioners - states that allow independent NP practices have NPs opening DPC offices, that operate under a membership model, with pts paying for access to the office services, tests, and imaging. Over 2,300 DPC offices currently

Dr. John Cush RheumNow ( View Tweet)

APP Pearls “Steroids: Set a stop date upfront, educate on side effects, and teach "every milligram matters." Prevents dependence and eases tapering” - Barbara A. Slusher, MSW, PA-C, DFAAPA, DipACLM

Dr. John Cush RheumNow ( View Tweet)

Congratulations to Dr. Proton Raman - a world class rheumatologist and research scientist!!! https://t.co/ofzGLsofi0

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Dr. John Cush RheumNow ( View Tweet)

Best of 2025: 2025 BSR Guideline for Treatment of Axial Spondyloarthritis The British Society of Rheumatology's 2025 Guidelines for treating axSpa focus on both axial and extra-musculoskeletal issues like uveitis, psoriasis, and IBD. They evaluate the effectiveness and safety of https://t.co/fxFcqy13g7
Dr. John Cush RheumNow ( View Tweet)
Comorbidity and Health Management: Tuesday Night Rheumatology Join panelists Vanessa Hill, NP-C, Lindsay Tom, PA-C, Barb Slusher, MSW, PA-C and Jack Cush, MD as they discuss comorbidity and health management in rheumatic disease. https://t.co/3KMgBW1Q4W https://t.co/4dVfKd7uy5

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Dr. John Cush RheumNow ( View Tweet)
UK study of 1846 RA pts starting a b/tsDMARDs, ~30% on steroids & majority (2/3) continued use over the first year of new novel treatment. This suggests these aer either severe RA pts or that we are not vigilant in limiting/weaning/stopping steroids in RA patients - which is it? https://t.co/7NWeAWTjSy
Dr. John Cush RheumNow ( View Tweet)
Lupus Guidelines 2025 Monica Richey, ANP, New York, reviews the 2025 ACR lupus guidelines as part of RheumNow's "Mission: APP Partners in Care" campaign during the month of December. https://t.co/D1LE1H4zyi https://t.co/myPnT3ibKd

Links:

Dr. John Cush RheumNow ( View Tweet)
Japan retrospective study of 38 RA pts who developed MTX assoc lymphoproliferative disorder (LPD) - 22 w/ spontaneous regression (SR) vs 16 non-SR (w/ 5 deaths). non-SR Pt had higher LDH levels at Dx & lower lymphocyte recovery 1 mo. post MTX withdrawal & higher mortality risk https://t.co/SsBQRxFvD1
Dr. John Cush RheumNow ( View Tweet)
APP Pearls “It’s okay not to “fix” the complaint right away. Validate the patient, then watch and wait when appropriate. The urge to intervene quickly without confidence can be dangerous. See the patient back, keep listening, & continue good history-taking” - Jeannette Hart PA-C

Dr. John Cush RheumNow ( View Tweet)

JAMA teaching case: 57 yoF w/ RA Rx w/ HCQ, NSAID, TNFi (ETN -->ADA) develops a new rash - pruritic vesicles/papular on neck, mouth, ears, chest, hands w/ some becoming ulcerated plaques, ESR >100. WHAT TO DO? A) steroids; B) stop ADA; C) Benadryl or D) Read more? Pt had https://t.co/DQpeUOC5I3
Dr. John Cush RheumNow ( View Tweet)
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