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Turkey Tryptophan (11.28.2025)
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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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.
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Treating Refractory Still's Disease
A full read systematic review article examined treatment options for difficult to manage systemic juvenile idiopathic arthritis, or Still’s disease.
Chronic pain may dramatically raise your blood pressure
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Science Daily
Widespread chronic pain may stealthily drive up blood pressure, partly through its ties to depression and inflammation.
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Managing Perioperative DMARDs with Arthroplasty
Postoperative complications with arthroplasty may be related to chronic inflammation and immunosuppressive therapy. Yet a recent retrospective study total ankle arthroplasty in end-stage RA patients shows that early postoperative wound complications are unaffected by the continued use of their preoperative medications including DMARDs.
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RheumNow Live 2026 is coming February 7th and 8th to Dallas, Texas - and registration is now open!
This year’s program covers vasculitis, autoimmune disease, PsA, RA outcomes, spondyloarthritis, and much more.
Reserve your spot today at https://t.co/o78Pc8LPsQ https://t.co/GOUW5Od9Hy
Links:
Dr. John Cush RheumNow ( View Tweet)
Study of 452 #PsA pts who failed 1st line TNFi Rx (LOE) - 275 Cycled to another TNFi vs 177 Swapped to an IL-17i. Higher Retention in Swap (78%) vs cycled (68%) PsA pts (p < 0.001) @12 mos (60 v 40%@3yrs). Tx failure predicted by cycling, Dz Activity, Rx year, axial & mixed https://t.co/VQLBlBEw4W
Dr. John Cush RheumNow ( View Tweet)
Subclinical Cardiac Dysfunction in Gout. ECHO study of 202 hyperuricemic (100 gout vs 102 asympt [asymSUA]) pts. VS. asymSUA, Gout pts had signific more LV Diastolic Dysfunc (31% vs 11%), lower LV ejection Fx (60 vs 65); questioning need for tailored CV monitoring in ^SUA pts https://t.co/gCOKKk7H05
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
Study of 2280 dermatomyositis (DM) & polymyositis (PM) pts looked at short term (ST: <3 mos) vs long term (LT) steroid (GC) use. Vs ST, LT GC use assoc w/ higher risks of heart failure (adj OR 1.8), osteoporosis (1.9), all-cause & PM/DM-related admission (3.8) & higher costs https://t.co/Q9xt06yzew
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
2023 National Health Interview Survey studied arthritis-attributable work limitations (AAWL) in US adults (18-64 yrs) - it was 38.8% (unchanged from 2019). AAWL was higher in Hispanics (50%), American Indian/Alaska Natives (56%), & disabled (62%), & veterans (52%) https://t.co/sE3En74zfq
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
CorEvitas observational registry of 3,696 w/ psoriatic arthritis (no hx of CV eents), followed for mean 3.7 yrs, showed that Dactylitis and enthesitis did not predict future CV events. But Dactylitis and enthesitis and Synovitis were all significantly interrelated. Cureus 17(11): https://t.co/kPgGKliUUs
Dr. John Cush RheumNow ( View Tweet)
Betw 1990 to 2021 the global psoriasis burden had a slight increase w/ little difference betw men & women, roughly 57-61 100 000 (10% increase). Risk highest in N.America & W.Europe. PSO risk highest with higher incomes. https://t.co/raruHn5Txx https://t.co/bp1rWyWS7y
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Dr. John Cush RheumNow ( View Tweet)
Partial vs Total Knee Replacement: Is One Superior?
Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little https://t.co/abER7mS3QR
Dr. John Cush RheumNow ( View Tweet)
Zantac is Back! Ranitidine has been off the market for 5yrs, withdrawn over concerns about N-nitrosodimethylamine (NDMA) impurity affecting shelf-life. The FDA has approved reformulated ranitidine tablets - the drug has the same prior efficacy and safety label. https://t.co/j655eiCvgf
Dr. John Cush RheumNow ( View Tweet)
RNL 25 Replay: Psoriatic Arthritis
Enjoy these excerpts from the RNL 2025 meeting, and join us for RNL 2026 in Dallas, TX - registration is now open! Visit https://t.co/o78Pc8LPsQ for complete details.
https://t.co/ri0E9Z7GWG https://t.co/RPdwjE9eNB
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 39 pts w/ MDA5 + DM-ILD Rx w baricitinib. 31 (79.5%) had improvement in Gottron’s, heliotrope, dyspnea, HRCT score, ferritin, LDH, steroid dose & 6 mo survival (87% vs. 70%, p = 0.047). https://t.co/RCTbBsCkeV https://t.co/K49cEmeRk3
Dr. John Cush RheumNow ( View Tweet)
