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Telling You Where to Go (12.19.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Who would've thunk - a PsA FMF connection? Labs to diagnose SSc-ILD? IgA-RF may be important or RZV may not work in JAK inhibitor treated patients?

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APP.TIPS

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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EULAR.Docs.APP

Role of the Nurse in the Care and Management of Rheumatic Diseases - EULAR Review

Jack Cush, MD

In 2023, a EULAR subcommittee set out to assess the roles of nurses and Advanced Practice Nurses (APN) in the care of arthritis as outlined in published EULAR guidelines. The scope of APN practices was first proposed in 2012 and revised in 2018.

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Plaquenil.HCQ_.pills_.jpg (keep)

Optimizing Hydroxychloroquine Blood Levels in Lupus

Jack Cush, MD

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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cannabis,weed,marijuana

Medical Cannabis for Pain Management

Jack Cush, MD

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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purpura

B Cell Targeting in Idiopathic Thrombocytopenic Purpura

EurekAlert!

The New England Journal of Medicine  has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune thromboc

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Japanese retrospective study-194 #RA pts Rx w/ JAK inhib (74 vaccinated w/ recombinant zoster (RZV) & 120 Not-Vax). H.zoster lower w/ RZV (4.8/100PY) vs UnVax (7.8/100PY) w/ overall efficacy of 59.1%. RSV Vax pts who got HZ had signif lower lymphocyte #s, higher SDAI & CDAI. https://t.co/vJJRflJ23x
Dr. John Cush RheumNow ( View Tweet)
FDA has approved nerandomilast (Jascayd) for the treatment of progressive pulmonary fibrosis (PPF) in adults, based on the results of the phase 3 FIBRONEER trial. Nerandomilast is PDE4 inhibitor,, in Oct 2026 it was approved for use in diopathic pulmonary fibrosis (IPF) https://t.co/WVrGj7q7hB
Dr. John Cush RheumNow ( View Tweet)
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 https://t.co/7pggMk2pTO
Dr. John Cush RheumNow ( View Tweet)
Lyme disease is endemic in Massachusetts. EHR study shows Lyme dz incidence declined from 211 per 100 000 patients in 2012 to 86 per 100 000 in 2024 (P< .001), but this decr. was driven by 1 large practice group implemented a new initiative to reduce Lyme Dx & Rx in pts w/ https://t.co/lMCUA9o4Uc
Dr. John Cush RheumNow ( View Tweet)
Lancet review of skin cancer risk w/ inflammatory arthritis - both melanoma and Non-melanoma skin cancers are increased in RA & inflammation. Also Package inserts for TNFi say all TNFi Rx pts should have complete skin exams "periodically". Skin cancer screening advised. https://t.co/MNuQO6Dw5b
Dr. John Cush RheumNow ( View Tweet)
Japanese retrospective study-194 #RA pts Rx w/ JAK inhib (74 vaccinated w/ recombinant zoster (RZV) & 120 Not-Vax). H.zoster lower w/ RZV (4.8/100PY) vs UnVax (7.8/100PY) w/ overall efficacy of 59.1%. RSV Vax pts who got HZ had signif lower lymphocyte #s, higher SDAI & CDAI. https://t.co/4VMWPhzXeL
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)
British Society of Rheumatology Guideline for Monitoring DMARDs The British Society of Rheumatology has published an update to their previous 2017 BSR/BHPR guideline regarding the use and monitoring of DMARDs (disease-modifying anti-rheumatic drugs) used to treat systemic https://t.co/iANvir1EFI
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)
Taiwanese retrospective study (2001-2022) of 2,383 PsA pts Rx w/ 1+ DMARDs. Comparing 1,190 bDMARDs vs 1,193 cDMARD Rx pts, bDMARDs assoc. w/ signif lower risk of MACE (HR 0.65), all-cause mortality (0.44), CV mortality (0.54), but more infx related Hosp (1.45) https://t.co/eu7fSVkjZl
Dr. John Cush RheumNow ( View Tweet)
B Cell Targeting in Idiopathic Thrombocytopenic Purpura The New England Journal of Medicine has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune https://t.co/VN0KjE478B
Dr. John Cush RheumNow ( View Tweet)
FDA has issued its final guidance on: Promotional Labeling and Advertising Considerations for Prescription Biological Reference Products, Biosimilar Products, and Interchangeable Biosimilar Products: Questions and Answers https://t.co/69sbgoWnSW https://t.co/kpTgdPOkka

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Dr. John Cush RheumNow ( View Tweet)
FDA has issued its final guidance on: Promotional Labeling and Advertising Considerations for Prescription Biological Reference Products, Biosimilar Products, and Interchangeable Biosimilar Products: Questions and Answers https://t.co/bjiV4S0Fur https://t.co/dDyJqhV5VF

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Dr. John Cush RheumNow ( View Tweet)
The countdown is on! ⏱️ Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one. ✅ Register now at https://t.co/4UQlqwujiR 🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu

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Dr. John Cush RheumNow ( View Tweet)
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