Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) the data supporting its use is limited.
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Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
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Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders.
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Chronic pain may dramatically raise your blood pressure
Science Daily
Widespread chronic pain may stealthily drive up blood pressure, partly through its ties to depression and inflammation.
Turkey Tryptophan (11.28.2025)
Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
https://t.co/cnxxwqwyTE https://t.co/82zugQnp2Y
Coccyx and Sacrococcygeal Joint Disorders
Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, https://t.co/u4w3b915my
BASDAI scores elevated in Fibromyalgia - 58 FM pts were surveyed wtih FIQ, SSS, BASDAI. BASDAI was ≥ 4 points in 91.4% of FM (vs 13% controls (p < 0.001). BASDAI correlated w/ the FIQ (pain, fatigue, stiffness) & SSS scores (r = 0.88, p < 0.00). Could BASDAI be used in FM? https://t.co/M0tI8wjzh4
Obesity-inflammation axis in PsO & PsA: obesity is assoc w/ less remission& poorer drug responses; possibly from adipokines, biomechanical stress, gut dysbiosis, etc. Notably, weight loss can improve both psoriatic disease course and response to therapy. https://t.co/cZbeu0zfmR https://t.co/EoCTNKk265
BASDAI scores elevated in Fibromyalgia - 58 FM pts were surveyed wtih FIQ, SSS, BASDAI. BASDAI was ≥ 4 points in 91.4% of FM (vs 13% controls (p < 0.001). BASDAI correlated w/ the FIQ (pain, fatigue, stiffness) & SSS scores (r = 0.88, p < 0.00). Could BASDAI be used in FM? https://t.co/VF94ru0o3Q
JAMA review of Peripheral Neuropathy - affects ~ 1% of adults worldwide and may cause sensory, motor, and autonomic Sxs. Diabetes is the most common cause. 1st line Rxs include gabapentin, pregabalin, duloxetine, amitriptyline. (FOR AMA MEMBERS) https://t.co/sof15I1GpU https://t.co/PN0KMeUsGA
Retrospective analysis of 2614 FM pts in the Italian Fibromyalgia Registry underscores the seasonal changes in FM pain, w/ signif. differences in FM assessment tools WPI p=0.042 & FASmod p=0.037); these changes were only seen in female patients, not males https://t.co/LqXnTgGIMB https://t.co/ihw1yJqKLC
RETREAT study was a 12 wk RCT of Tai Chi in 178 knee OA pts Rx w/ online OA info vs same plus free web based tai chi video program. Tai Chi group had signif improved knee pain (−2.7 v -1.2); (−12 v −6.9) & achieved a minimal pain & function (73% v 47%); and Its free! https://t.co/WLzQ9YHrcu
Weight Loss as a Therapeutic Goal in PsA
PsA is a complex inflammatory disease often complicated by obesity, which not only worsens disease activity but also impairs treatment response. At #ACR25, 3 compelling studies spanning pharmacologic, lifestyle, and longitudinal https://t.co/Q6IFGn5zCI
Janet Pope
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What happens if you have #axSpA & concomitant #FM?
Pts with both have less TNFi retention,
-residual pain may lead to d/c Rx.
Need to determine if axSpA pt has #fibromyalgia as there may not be objective findings if no peripheral arthritis in axSpA.
#ACR25 @RheumNow abst#534
Antoni Chan MD (Prof)
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In a PsA cohort (n=1291), higher BMI was independently linked to lower odds of achieving MDA—especially in TNFi-treated patients. Impact was strongest in pain, skin, enthesitis, and PRO domains, not swollen joints. Each unit increase in BMI reduced MDA odds by 4–7%. Highlights https://t.co/TxO3HP51uk
Akhil Sood MD, MS
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Abstract 2687: GLP-1 RA in PsA
In combined Toronto + NYU cohort, GLP-1 RA significantly associated with reduced:
- Weight, CRP, and pain scores
- Each 1% reduction in body weight associated w/ TJC, DAPSA, EQ-5D (QoL), LDL, Systolic BP
@RheumNow #ACR25 https://t.co/30lPDkALKs
#ACR25 Clinical Preview by Prof Coates for use now:
GLP-1 agonist & Diet
Abstr#813 GIP/GLP-1 improved MSK pain
Abstr#849 GLP-1 reduced risk of #MACE in PsA
Abstr#2690 RCT = the degree of weight loss regardless specific dietary strategy determined benefit in PsA @RheumNow https://t.co/4jB0fFHosC
Bella Mehta
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Disease activity associated with symtomatic knee OA and increased with increased KL grades
Abst#2625 #ACR25 @RheumNow https://t.co/uCrdnVXk0J
David Liew
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Perhaps it was my ignorance, but a FDA-approved therapy for fibromyalgia was not on my 2025 bingo card.
We’re not exactly overwhelmed with proven options for FM, the unmet need is so great, so the more, the better.
#ACR25 FDA session @RheumNow https://t.co/wwWijl3IyW
Richard Conway
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Hindosh et al. Semaglutide associated with reduced synovitis, joint pain and swelling, in RA. @RheumNow #ACR25 Abstr#2286 https://t.co/6Xs4um5l32


