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Methotrexate intolerance in rheumatoid arthritis
Methotrexate (MTX) is the most commonly used DMARD in rheumatoid arthritis (RA); however, there is significant intolerance to this drug among adult RA patients - especially at doses above 15 mg per week.
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Physical Therapy Underprescribed
MedPage Today
Just one patient in six was referred for physical therapy (PT) within 15 days of being treated for knee pain at one major U.S. health system, researchers found, despite nearly universal consensus that PT should be recommended in most cases.
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It's now called Sjögren Disease!
Sjögren syndrome is now Sjögren disease, according to recommendations stemming from the 2023 International Rome consensus for the nomenclature of Sjögren disease.
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Rheums Speak: Future of Rheumatoid Arthritis
The third survey in this series addressed clinician views on future trends (AI), future therapies and lessons learned.
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Teaching You How to Think… (8.15.2025)
Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and aphorisms to live by.
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The Patient Journey with Rheumatic Disease
Oton and colleagues have reviewed the "patient journey" - from symptoms to specialty referral in those diagnosed with rheumatic and musculoskeletal diseases (RMDs).
RHEUM Survey: How important is "Seropositivity" in RA?
Dr. John Cush RheumNow ( View Tweet)
Celltrions tocilizumab biosimilar, tocilizumab-anoh (Avtozma, CT-P47), had similar efficacy when switching from reference tocilizumab (Actemra; Genentech) in a study of 444 RA patients x 52 wks. https://t.co/7aAyuUkZJ9 https://t.co/kJUrRkhstb
Dr. John Cush RheumNow ( View Tweet)
Single-center Retrospective study of 4,736 RA, propensity matched 509 w/ RA-ILD vs 509 without ILD. In multivariate analysis RF positivity was an independent risk factor for RA-ILD (adj OR = 1.5) w/ signif nonlinear relationship observed, risk threshold @60 IU/mL Paradoxical https://t.co/0XtWnIsbmK
Dr. John Cush RheumNow ( View Tweet)
Clinical Rheumatology Thread for Busy GPs:
Post 1
Early inflammatory arthritis(IA): the 3–3–3 rule
•Onset ≤3 months
•Morning stiffness ≥30–60 minutes
•≥3 swollen joints (MCP/MTP common)
If present, manage as IA: urgent rheum referral; NSAIDs if no contraindications. https://t.co/hcoumX1ZVY
Aravind Palraj Rheumat_Aravind ( View Tweet)
Rheumatic Dz & HIV
- Arthralgia: self limiting
- HIV-assoc arthritis: mimics RA
- Occurs w/ HIV: SpA, ReA, PsA
- Less : IIM, vasculitis, opportunistic infxn https://t.co/Yf7jZ0icZw https://t.co/6FuJgvDYRF
Links:
Dr. John Cush RheumNow ( View Tweet)
Cohort study of 1,553 Biologic or JAKi Rx IBD (Crohns; UC) pts (SpA excluded) found 106 (6.8%) w/ MSK Sxs & 30 (1.9%) later Dx w/ SpA (20: axial, 10: peripheral) after median F/U 5.2 yrs. SpA risk factors: partial Mayo UC (HR 1.57) & HLA-B27 positivity (HR 3.70) https://t.co/WgLLUjlLMk
Dr. John Cush RheumNow ( View Tweet)
The world of rheumatoid arthritis treatment has changed dramatically. What do the experts say about the evolution of biologics and DMARDs over the last 20 years?
Join us for a live webinar, moderated by Dr. Jack Cush, where we'll unpack the results of a nationwide survey.
Tues, https://t.co/pKhuHPwcs0
Dr. John Cush RheumNow ( View Tweet)
The Patient Journey with Rheumatic Disease
Oton and colleagues have reviewed the "patient journey" - from symptoms to specialty referral in those diagnosed with rheumatic and musculoskeletal diseases (RMDs). They identify the eight stages along the way and where improvements https://t.co/VY3kB3Ohmp
Dr. John Cush RheumNow ( View Tweet)
Pain Flares in RA are just pain, not inflammation. Study of 195 RA pts (11+ yrs dz dur), 49-89% experienced at least 1 flare (median 2-4 flares/mo), IQR 2.1-5), lasting median of 2 days. Flares preceded by worsening mood, anxiety, sleepiness - but no change in Accelerometer https://t.co/csbHtiEglp
Dr. John Cush RheumNow ( View Tweet)
Wondering what rheumatoid arthritis experts think about the future of treatment?
Dr. Jack Cush moderates a special Tuesday Nite Rheumatology session, live at 7 PM ET on August 26th, where experts will dive into a nationwide survey on the evolution of biologics and DMARDs.
Hear https://t.co/afYRarqjvj
Dr. John Cush RheumNow ( View Tweet)
Pain Flares in RA are just pain, not inflammation. Study of 195 RA pts (11+ yrs dz dur), 49-89% experienced at least 1 flare (median 2-4 flares/mo), IQR 2.1-5), lasting median of 2 days. Flares preceded by worsening mood, anxiety, sleepiness - but no change in Accelerometer https://t.co/twI6wcxKf7
Dr. John Cush RheumNow ( View Tweet)
The world of rheumatoid arthritis treatment has changed dramatically. What do the experts say about the evolution of biologics and DMARDs over the last 20 years?
Join us for a live webinar, moderated by Dr. Jack Cush, where we'll unpack the results of a nationwide survey.
Tues, https://t.co/o2WqAaQ2mN
Dr. John Cush RheumNow ( View Tweet)
PT in RA - Metanalysis of 17 RCTs, 1362 pts Rx w/ aerobic/resistance exercise, hydrotherapy, manual Rx, electrotherapy, multimodal Rx. 5 RCTs (n 307) signif reduced pain (SMD −0.347; interpreted as a small to medium effect favoring PT. https://t.co/UJGSGrgMV0 https://t.co/n4DzMSm9iJ
Dr. John Cush RheumNow ( View Tweet)
Venous thromboembolism (VTE) risk goes up w/ age, obesity, estrogens; BUT a UK primary care database shows VTE risk signif higher in RA (n 23K) vs matched controls (n 94K): adj HR 1.46. Absolute VTE risk higher w/ age & BMI, but VTE higher in younger v older; normal vs. Hi BMI: https://t.co/htI2YqiF0c
Dr. John Cush RheumNow ( View Tweet)
