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Methotrexate (MTX) is the most commonly used DMARD in rheumatoid arthritis (RA); however, there is significant intolerance to this drug among adult RA patients - especially at doses above 15 mg per week.
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The FDA has approved nerandomilast (Jascayd), a PDE4b inhibitor, to treat adults with progressive pulmonary fibrosis (PPF). Nerandomilast was approved to treat idiopathic pulmonary fibrosis (IFP) in October 2025.
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A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.
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As the utilization of APPs (nurse practitioners and physician assistants) in rheumatology becomes more prevalent, here are three things to consider if you are thinking about adding an APP to your practice.
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Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Who would've thunk - a PsA FMF connection? Labs to diagnose SSc-ILD? IgA-RF may be important or RZV may not work in JAK inhibitor treated patients?
Dr. John Cush
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Lancet review of skin cancer risk w/ inflammatory arthritis - both melanoma and Non-melanoma skin cancers are increased in RA & inflammation. Also Package inserts for TNFi say all TNFi Rx pts should have complete skin exams "periodically". Skin cancer screening advised. https://t.co/XddFDe0xh8
Dr. John Cush
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“Absence of proof of efficacy does not equal proof of absence of efficacy”
- Arthur Kavanaugh, MD
Dr. John Cush
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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/vJJRflJ23x
Dr. John Cush
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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/9DnErwT4rX
Dr. John Cush
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Evaluation of Rheumatic Complaints
https://t.co/cdizOgFqYf https://t.co/YHLAllxpO4
Dr. John Cush
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FDA has approved nerandomilast (Jascayd) for the treatment of progressive pulmonary fibrosis (PPF) in adults, based on the results of the phase 3 FIBRONEER trial. Nerandomilast is PDE4 inhibitor,, in Oct 2026 it was approved for use in diopathic pulmonary fibrosis (IPF) https://t.co/WVrGj7q7hB
Dr. John Cush
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2025 Adult Rheumatology Fellowship Match is Strong (Again)
The ACR announced today that 2025 Medicine and Pediatric Specialties Match results show rheumatology fellowship positions continuing to fill at high rates. The Match uses a computerized process to pair applicant and https://t.co/ynP46pEKCa
Dr. John Cush
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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 https://t.co/3LlNQ3tx90
Dr. John Cush
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Role of the Nurse in the Care and Management of Rheumatic Diseases - EULAR Review
In 2023, a EULAR subcommittee evaluated the roles of nurses and Advanced Practice Nurses (APNs) in arthritis care per EULAR guidelines. Initially proposed in 2012 and revised in 2018, the scope of https://t.co/w1IOQxcACR
Dr. John Cush
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Optimizing Hydroxychloroquine Blood Levels in Lupus
A large observational cohort study suggests that monitoring hydroxychloroquine (HCQ) blood levels is effective in systemic lupus erythematosus (SLE) patients with a target therapeutic range (for HCQ level monitoring) of https://t.co/7pggMk2pTO
Dr. John Cush
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Five Fractures You Don’t Want to Miss
In orthopedic practice, missing the wrong fracture can significantly alter a patient’s outcome. Certain injuries may appear subtle on initial imaging yet carry serious consequences if not promptly recognized and managed. https://t.co/zyCRdUkMua
Dr. John Cush
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Cases & Guidelines: Tuesday Night Rheumatology
Panelists discuss their approaches to a range of difficult cases in multiple areas, including RA, PsA and PMR. Panelists: Audrey Gibson, PA-C; Benjamin A. Smith, PA-C; Emma Bavage, ANP; Jack Cush, MD
https://t.co/vl5J9NYUKZ https://t.co/nsTf370bu9
Dr. John Cush
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Lilly announced phase 3 RCT TRIUMPH-4, where Retatrutide, a new GIP, GLP-1 & glucagon recpt agonist, was given to obese (BMI >35), knee osteoarthritis pts *without diabetes*. Wt loss at 68 wks was 28.7% with reduced WOMAC pain scores of -4.5 points (75.8%) https://t.co/73yIyvwRtL
Dr. John Cush
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Lyme disease is endemic in Massachusetts. EHR study shows Lyme dz incidence declined from 211 per 100 000 patients in 2012 to 86 per 100 000 in 2024 (P< .001), but this decr. was driven by 1 large practice group implemented a new initiative to reduce Lyme Dx & Rx in pts w/ https://t.co/lMCUA9o4Uc
Ravi Kumar
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🦴 Genant-Modified Sharp Scoring System
🧮 A radiographic scoring system used to quantify joint damage in Rheumatoid Arthritis (RA), especially in clinical trials and long-term follow-up.
🔍 What does it assess?
X-rays of hands and feet for:
•Erosions
•Joint Space Narrowing https://t.co/r5bvzFliBP
