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Advanced Practitioner Biologic Prescriptions for Psoriasis

d Jack Cush, MD

Advanced practice clinicians (APCs; nurse practitioners and physician assistants) deliver a large share of US dermatologic care, accounting for 37% of clinicians and 27% of dermatology visits by 2020. A current JAMA Dermatology reports APC drug spending trends in dermatology, with a focus on specialty medications (eg, biologics).

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Spread of Psoriatic Disease from Skin to Joints

d Jack Cush, MD

Approximately 20 to 30 percent of all people who suffer from psoriasis also develop painful inflammation in their joints over time. If left untreated, psoriatic arthritis can lead to permanent damage to bones and joints.

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pregnant, pregnancy, mother, fertility

Antirheumatic drug use with rheumatoid arthritis pregnancies

d Jack Cush, MD

A nationwide Norwegian registry study of rheumatoid arthritis (RA) pregnancies showed that while medication use increased during pregnancy, many discontinued treatment during pregnancy, only to resumed it after childbirth.

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Diffuse Alveolar Hemorrhage in Rheumatic Disease A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/vpzF8Dnspr
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Subcutaneous Anifrolumab in SLE Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/3DWNEXaO2x
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We're less than 30 days out from RheumNow Live and we want to see you there...in-person! Why Attend In Person? ✔ Engage directly with faculty during live Q&A ✔ Network with peers who influence and lead in rheumatology ✔ Experience the energy, pace, and collaboration that https://t.co/tqSHYAEoOQ
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Systematic review of cardiovascular death in systemic immune-mediated Dz (SIDs): 39 studies, 171,748 pts - SIDs assoc w/ signif. higher CV mortality (HR 1.26; 1.09-1.47; p = 0.002), especially for RA, SLE, GPA & females. 92% of CV deaths from acute coronary syndrome (ACS) https://t.co/ogLhqKMwON
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Metanalysis of Tramadol included 19 PBO-RCTs, 6506 pts, showing a very modest benefit on chronic pain (low certainty of evidence), but a doubling of risk for serious adverse events (OR 2.13); including nausea (NNH 7), dizziness (NNH 8), constipation (NNH 9), somnolence (NNH 13) https://t.co/0ZEIoy1gqC
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Join us for STEP Talks at RheumNow Live! Big Ideas. Real Impact. No Filler! https://t.co/vvLKFWatWe Don’t miss these engaging discussions: - Placebos in Rheumatology - Dr. Andreas Kerschbaumer - Disease Modification in Osteoarthritis - Dr. Tuhina Neogi - Helicobacter pylori https://t.co/lQRCLdMSh6

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US Overdose Deaths have dropped in 2024 & 2025!. Overdose (opioids, heroin, fentanyl) deaths peaked at ~110,000 in 2022, fell a little in 2023, but plummeted (27%) to 80,000 in 2024. Reported deaths highes in the N. East & Atlantic states. https://t.co/P3mgrOzGhr https://t.co/eGOBhIx7ZB

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Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Hf7HaGOLXd
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101 Meditteranean pregnant RA compared to 236 non-RA controls. HCQ & SSZ (45-73%) most used; biologics less (25%). RA had signif more adverse preg outcomes - LBW (OR 3), C-section (OR 2.55), fewer neonatal deaths (OR 0.38). RA had more miscarriages (20 v 1%) & fewer live births https://t.co/3nTdXEbBHI
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In Dec 2025, the FDA qualified total hip bone mineral density (BMD) assessed by DXA as a validated surrogate endpoint for osteoporosis clinical trials. Previously OP trials required fracture endpoints as primary efficacy measures, necessitating large 2-5 yr studies https://t.co/q8a7QmoIXs
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Subcutaneous Anifrolumab in SLE Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/yrAirr2R2Y
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Retrospective single center --103 EGPA pts finds 36 (35%) w/ cardiac involvement, having cardiac Sxs & biomarkers. Most common: pericarditis (77%), cardiomyopathy w/ CHF (55%), myocarditis (36%), cardiogenic shock (14%), cardiac arrest (6%), coronary v.asospasm (8%) https://t.co/JNdVNlVWvA
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Kick off with a powerhouse RA session! ⚡️ Drs. Elena Myasoedova, Kristen Demoruelle, & Jeffrey Sparks dive deep into: 📉 Mortality Trends 🧬 The Mucosal Hypothesis 🫁 Recent ILD Advances Ends with a live faculty Q&A. A can’t-miss for RA clinicians in 2026! 🩺 Registration https://t.co/Z9oOkAyWPK
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PNAS/Yale researchers report on a mice model of RA, MIF-dependent, CD74+ memory T cells (normally very few) expand & incr in number in the inflammed joint. When MIF genes were deleted in a CIA model, arthritis was prevented. MIF-dependent, CD74+ T cells promote chronic synovitis. https://t.co/pdPIqtSCwG
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2026 Resolutions (1.9.2026) Dr. Cush reviews the news, announcements and journal articles from this past week on RheumNow. More on Variable bendability, a better way to treat RA, and a novel advance for GLP1a in PsA; and 2026 Resolutions! https://t.co/DgY2trZGKA https://t.co/3ka4SDRnJO

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US News & World Report - Top 10 jobs in the USA (growth, pay, security); the only HCP listings: #5: Physician Assistant: Median salary: $133,260; Unemployment 1.6%; 33,100 new jobs by 2034 #1: Nurse Practitioner: Median salary: $129,210; Unemployment 0.6%; 128,400 new jobs by https://t.co/5c2hVc4ooi

Dr. John Cush RheumNow ( View Tweet)

Geisinger. Medical Center (PA) has medical staff of nearly 1,800 and another 1,200 advanced practice providers (NPs, PAs, CRNAs, midwives). They offer specialized training (eg Advanced Practitioner Fellowship in Critical Care Medicine ) and have an Advanced Practice Nursing https://t.co/pCaPWe6niB

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