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Hidden in Plain Sight: IBD
As a PA with six years of experience in rheumatology and a background in gastroenterology, today I'm discussing the clinical overlap between inflammatory arthritis—particularly psoriatic arthritis and spondyloarthropathies—and inflammatory bowel disease.
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Disease Activity Criteria for Adult-Onset Still's Disease: EULAR Points to Consider
EULAR has published a "points to consider" (PtCs) guidance on the development of criteria for the assessment of the disease activity in adult-onset Still’s disease (AOSD).
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ACR: New Data Highlights Urgent Need to Address Arthritis Burden
New findings from national U.S. surveys reveal the profound impact of arthritis on millions of adults, especially those facing social and economic challenges. These data will be featured in an upcoming issue of Arthritis Care & Research, an official journal of the American College of Rheumatology.
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Role of the Nurse in the Care and Management of Rheumatic Diseases - EULAR Review
In 2023, a EULAR subcommittee set out to assess the roles of nurses and Advanced Practice Nurses (APN) in the care of arthritis as outlined in published EULAR guidelines. The scope of APN practices was first proposed in 2012 and revised in 2018.
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Antinuclear Antibodies (ANA)
Dr. Jack Cush reviews autoantibody testing in rheumatology.
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Recent study shows that betw 2018-2023 # of Concierge medicine practices in the USA has increased 78.4% (3,935 to 7,021); mostly in Texas (402), California (387), Florida (352), Georgia (139).” Notably a signif growth of corporate owned practices, increased from 9.2% to https://t.co/nVRPfnwjZv
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IN RA: IgA-RF seen in 50%, IgA-ACPA in 20-40% (& are very specific). IgA-RF or -ACPA found in serum, saliva & syn.fluid.& may underlie "mucosal hypothesis" of RA. IgA-RF assoc w/ more severe RA, worse outcomes, Xtra-articular manifestations, & blunted TNF inhibitor responses https://t.co/SVUJmrIy2F
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Wolters Kluwer surveyed 203 PAs:
- 62% wish for more clinical experience prior to
- Most adopted AI, majority need more AI training
- 45% prefer title of “physician associate” https://t.co/96Hkh21wSr https://t.co/j7Xep47qMN
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Japanese retrospective study-194 #RA pts Rx w/ JAK inhib (74 vaccinated w/ recombinant zoster (RZV) & 120 Not-Vax). H.zoster lower w/ RZV (4.8/100PY) vs UnVax (7.8/100PY) w/ overall efficacy of 59.1%. RSV Vax pts who got HZ had signif lower lymphocyte #s, higher SDAI & CDAI. https://t.co/4VMWPhzXeL
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French ESTIVAL study - DB, sham trial of auricular vagal N stimulation in 148 Erosive hand OA (eHOA) pts w/ erosion + synovitis by US. @12wks, no signif difference in VAS pain (–16·0 vs –6 sham; p=0·22) w/ no safety issues. Was this a failed study or encouraging outcome? https://t.co/KI86H9izYS
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76 PsA pts asked 32 questions submitted to Chat-GPT4 & 12 specialists. Answers were scored (accuracy, completeness). Both equally accurate, ChatGPT scored lower in completeness. Other pts reviewed answers; they preferred ChatGPT 49% vs clinician 34%. ChatGPT was more readable.
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Study of 177 #SSc pts (116 w/ SSc-ILD vs 61 without ILD). SSc-ILD had more dcSSc, Raynaud’s & GI Dz. SSc-ILD predicted by triad of elevated NLR, PT, anti-SCL-70 (AUC of 0.879; sensitivity 82.6%; specificity 85.0%). NLR: neutrophil to lymphocyte ratio; PT: prolonged prothrombin https://t.co/iI6ZnZgJE7
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Austrian 1K Paracelsus cohort study; from 9,665, 296 (3.1%) had RA. CKD prevalence was higher in RA vs controls (11.8% vs. 6.7%, p<0.001). Albuminuria was dominant renal dz in RA (6.8% vs 4.2%, p=0.027), but missed signif after adjustments (OR 1.43; 0.96–2.13) https://t.co/qf0IpZC50Q
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Reefer Madness (12.12.2025)
Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow. B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.
https://t.co/SKEYlhTfLz https://t.co/mBX4GIQxKe
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Evaluation of Rheumatic Complaints
https://t.co/cdizOgFqYf https://t.co/sqbrY2oGcH
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RheumaKnowledgy Card
https://t.co/ZPTmT8kgDX https://t.co/E3IREKimx6
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AANP survey of US 2338 Nurse Practitioners (mostly primary care) re: shared pts w/ rheumatologists. NPs managing RA want improved communication w/ rheums, & education on RA management. PC NP confidence w/ RA was 47% Somewhat confident, 6% very confident, 19% not confident. https://t.co/YVEpJua9hj
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Top 10 States to Practice Rheumatology
1 North Dakota
2 Wisconsin
3 Alaska
4 Montana
5 South Dakota
6 Nebraska
7 Minnesota
8 Washington
9 Utah
10 Maine https://t.co/x2tKflV2S7 https://t.co/fLMEhQV0js
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Tarsal Tunnel Syndrome - review and quiz.
A compressive neuropathy of the posterior tibial nerve within the tarsal tunnel. 80% caused by lipoma, ganglion, varicosity, trauma, tenosynovitis, rheumatoid arthritis, diabetes, etc https://t.co/zCyeVIJEuy https://t.co/f4jA13FDvN
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In US, Tofacitinib loses patent exclusivity & goes generic in 2026. Worldwide Tofa sales in 2024 were $3.08 billion (55% use in RA; N. America 1st w/ ~38% of market). Tofa sales projected to rise to $5.7 bill in 2029 https://t.co/nKPaQdglYw https://t.co/DdMymmk8go
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