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Moral Distress (3.27.2026)

Jack Cush, MD

Dr. Jack Cush reviews the journal reports and news from RheumNow.com.  This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.

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Spotty Medicare Coverage for Newer Rheumatoid Arthritis Meds

MedPage Today

Medicare coverage of targeted disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) -- both under Medicare Advantage and in separate Part D plans -- is likely to leave many patients wanting, researchers found.

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Rheumatology Pitfalls (3.20.2026)

Jack Cush, MD

Dr. Jack Cush reviews the regulatory actions, news and journal reports from this past week on RheumNow.com.

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2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management

Jack Cush, MD

The European Alliance of Associations for Rheumatology (EULAR) has updated their rheumatoid arthritis (RA) management recommendations, notably with fewer recommendations (total of 9, down from 11 in 2022 version), by merging and removing previous recommendations.

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Pitfalls of autoimmune serologic testing

Jack Cush, MD

Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of  serological autoimmune markers. 

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Rheumatic Immune-related Adverse Effects with Checkpoint Inhibitor Therapy

Jack Cush, MD

A retrospective study of patients who developed rheumatic immune-related adverse events (R-irAEs) after receiving immune checkpoint inhibitors (ICIs) at two oncology centers in Spain suggests that early recognition can lead to effective management that allows continuation of cancer therapy. 

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RA erosions bone ACR

b/ts-DMARDs Do Not Arrest Bone Loss in RA

Jack Cush, MD

In RA, the goal is to control or arrest inflammation such that articular and bony damage is halted. While we have many effective therapies, it is not clear that biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) can prevent or improve osteoporosis outcomes in RA. A current real-world study showed that 1 year of b/tsDMARDs use did not arrest osteoporosis progression.

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Incident RA is assoc w/ considerable work loss. 3850 RA pts compared to 4422 same-sex siblings (2006-2020). Work loss began 13 mos before RA Dx & peaked the year after, less in last 10 yrs. Work loss highly skewed; small proportion contributed the most work loss days. https://t.co/splolrEDpe
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In this https://t.co/4UQlqwujiR 2026 podcast, Dr. Elena Myasoedova examines mortality trends in RA, exploring whether we are seeing continued decline, delayed impact, or a concerning plateau. 🎧 Listen here: https://t.co/tYS24BNsXw #Rheumatology #RheumatoidArthritis #MedEd https://t.co/GbZV43Cnse

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Mortality in Rheumatoid Arthritis: A Story of Decline, Delay, or Plateau? Dr. Elena Myasoedova https://t.co/YoQmrXHZif https://t.co/7v82hHvvZv

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Dr. John Cush RheumNow ( View Tweet)

Prednisone use in Alberta primary care 546 #RA pts - 40% of PCP RA Rx w/ 1 or more prednisone Rx. 41% Rx w/ both Pred + DMARD, w/ 44% on Pred median 124 day before DMARD. 66% continued Pred >1 yr after DMARD initiation. https://t.co/wrxQRP2TWN https://t.co/XxWpjafBsk

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Dr. John Cush RheumNow ( View Tweet)
RA pt on 7.5 mg/d Prednisone need hip replacement. What do you advise re: pred dose before TKR?

Dr. John Cush RheumNow ( View Tweet)

2025 Update: EULAR Recommendations on Rheumatoid Arthritis Management EULAR has updated its RA management recommendations, notably with fewer recommendations (a total of 9, down from 11 in the 2022 version), by merging and removing previous recommendations. https://t.co/7SCIL2Prjw
Dr. John Cush RheumNow ( View Tweet)
https://t.co/4UQlqwujiR 2026 — On Demand Catch the sessions everyone in rheumatology is talking about: • RA advances • Psoriatic arthritis decisions • Spondyloarthritis updates • Autoimmune disease highlights • Vasculitis insights Full recordings + slides available now. https://t.co/QT6NOXakVv

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Dr. John Cush RheumNow ( View Tweet)
Annual fibromyalgia survey (FIRST) in axSpA pts in the DESIR cohort. FM was found in 22% (& assoc w/ less HLA-B27+ & XRay sacroiliitis, equal MRI SI a& ^ CRP. FM/AxSpA had less self-reported Dz activity, QOL, more disability & more likely to Rx w/ TNFi (64% vs 41%), but resp https://t.co/9rkZFUSB2M
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of calcineurin inhib. in RA - 11 RCTs, 1793 RA pts. Cyclosporin (CSA( (RR 1.6 & Tacrolimus (TAC (RR 2.1) signif improved ACR20 responses. CSA was dose dependent, less so w/ TAC. Both require serum Creat. monitoring consistent increase in s-Cr https://t.co/OxNGYbupnt https://t.co/F08vDCMYtr

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Dr. John Cush RheumNow ( View Tweet)
https://t.co/4UQlqwujiR 2026 — On Demand Catch the sessions everyone in rheumatology is talking about: • RA advances • Psoriatic arthritis decisions • Spondyloarthritis updates • Autoimmune disease highlights • Vasculitis insights Full recordings + slides available now. https://t.co/wGrptPBYNu

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Dr. John Cush RheumNow ( View Tweet)
Poor sleep increases risk of #RA. English Longitudinal Study of Ageing. RA risk was signif. higher in those with moderate sleep quality (SQ) (HR 1.23) or poor SQ (HR 1.50), cmpared to good SQ. Partly mediated by depression https://t.co/kTbCUHeIGi https://t.co/6CD5tsKDdA

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Dr. John Cush RheumNow ( View Tweet)
Hydroxychloroquine Lowers SLE and RA Hospitalizations A population-based study from British Columbia, Canada, shows that antimalarial adherence was associated with a lower risk of hospital admission in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus https://t.co/vsJDOh09ji
Dr. John Cush RheumNow ( View Tweet)
US Epidemiologic survey data from NHANES gout prevalence is incr. in RA pts vs controls (10.3% vs. 4.8%, P < 0.001), increasing trend over time. RA is as an independent risk factor for gout (OR: 2.67), strongest in SNRA. Evidence for the converse may not be as strong. https://t.co/hhRT9NCzVG
Dr. John Cush RheumNow ( View Tweet)
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