All News
Tricks of the Trade – Clinic Advice from APPs
J. Cush and many APPs
December 2025 is focused on advanced practice providers, their impact, education and priorities. In seeking and soliciting the help and advice of leaders in the rheumatology APP world, I have been impressed by APP pride, dedication and passion for what they do.
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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 750-1150 ng/ml.
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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.com. B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.
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2025 Adult Rheumatology Fellowship Match is Strong (Again)
ACR
The American College of Rheumatology (ACR) announced today that 2025 Medicine and Pediatric Specialties Match results show rheumatology fellowship positions continuing to fill at high rates.
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Medical Cannabis for Pain Management
Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients.
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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
Ravi Kumar RheumattDoc ( View Tweet)
MEDISPO study of 38 mild-mod psoriasis pts, 16-wk Mediterranean diet vs low-fat diet. Mediterranean diet did much better w/ PASI change −3.4 vs 0, more pts achieving a PASI 75 reduction (47.4% vs none) https://t.co/ZJU58VanGr https://t.co/x6juAT672B
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
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.
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
Survey of physician assistants finds 56% use AI daily (19% AI extensively). 87% PAs say they need to learn more about AI, 83% desire formal, employer-led AI training. 89% believe AI will dramatically changes PA practice, but only 32% have clear workplace guidelines on AI usage https://t.co/yGqZRC3mNt
Dr. John Cush RheumNow ( View Tweet)
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/1p7o10kLPR
Dr. John Cush RheumNow ( View Tweet)
Dr, Tuhina Neogi writes its time for a new understanding of OA; its not just wear n tear. Based on preclinical and clinical evidence, OA is a systemic, whole-body disease and that this should change future research and treatment of #OA. https://t.co/gn9xt6CafP https://t.co/2iSKiyiCX4
Links:
Dr. John Cush RheumNow ( View Tweet)
GESPIC - German SpA study of 252 SpA (139 nr- axSpA, 113 r-axSpA), followed w/ serial Xrays and mSASS Scores over 2 yrs. 80% were on NSAIDs. Higher NSAID intake, particularly COX2i, on slowing radiographic progression in axSpA https://t.co/sKgCGaJFVr https://t.co/jMQTAnsCmG
Dr. John Cush RheumNow ( View Tweet)
PSS & Biomarkers: Dutch international scleroderma trial of 21 pts showed that cartilage oligomeric matrix protein (COMP), and collagen type IV alpha 1 (COL4A1) significantly correlated with modified Rodnan skin score; COMP were associated with mRSS change (r = 0.013) https://t.co/E7SgmIiYmn
Dr. John Cush RheumNow ( View Tweet)
JAMA reports that by end of 2025, half (52-56%) of USA nonfederal acute care hospitals will use generative AI and predictive AI. Teaching hospitals and EPIC EHR are early adopters, while For-profit and government hospitals were less likely to currently adopt AI. https://t.co/iJib0YjnW3
Dr. John Cush RheumNow ( View Tweet)
Phase 1 trial of IL-6 targeting immunotherapy (PPV-06) in 24 pts w/ inflammatory knee osteoarthritis (KOA) demonstrates safety, Abs that neutralize IL-6, decreasing CRP values and improved clinical outcomes, determined by changes in KOOS scores https://t.co/urZupN62Kw https://t.co/sru1SnsOig
Links:
Dr. John Cush RheumNow ( View Tweet)
Dr, Tuhina Neogi writes its time for a new understanding of OA; its not just wear n tear. Based on preclinical and clinical evidence, OA is a systemic, whole-body disease and that this should change future research and treatment of #OA. https://t.co/HQWI14WSXg https://t.co/5bIWgqaETU
Links:
Dr. John Cush RheumNow ( View Tweet)
Simple, low-cost strategy to Dx/Prognose GCA using CBC components NLR & PLR. 119 GCA vs 131 non-GCA pts - All CBC biomarkers signif assoc w/ ESR & CRP, but ESR/CRP did not predict mortality over time; YET mortality signif predicted by PLR, NLR, MLR (P value < 0.044) https://t.co/96Q7jDAiWt
Dr. John Cush RheumNow ( View Tweet)
