All News

Article

Best of 2025: Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients

Jack Cush, MD

More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the perioperative management of DMARDs and found inconsistencies and low quality evidence, with great reliance on conditional (expert opinion) recommendations.

Dr. John Cush Tweet
RheumNow

DPC - direct primary care offices run by nurse practitioners - states that allow independent NP practices have NPs opening DPC offices, that operate under a membership model, with pts paying for access to the office services, tests, and imaging. Over 2,300 DPC offices currently

Dr. John Cush Tweet
RheumNow

APP Pearls “Steroids: Set a stop date upfront, educate on side effects, and teach "every milligram matters." Prevents dependence and eases tapering” - Barbara A. Slusher, MSW, PA-C, DFAAPA, DipACLM

Dr. John Cush Tweet
RheumNow
APP Pearls “It’s okay not to “fix” the complaint right away. Validate the patient, then watch and wait when appropriate. The urge to intervene quickly without confidence can be dangerous. See the patient back, keep listening, & continue good history-taking” - Jeannette Hart PA-C
Dr. John Cush Tweet
RheumNow

APP Pearls “It’s important to explain the difference between an overreactive immune system vs. a weakened immune system” - Miguel Rodriguez, ANP

Dr. John Cush Tweet
RheumNow

APP Pearls “Ensure a patient understands the weekly dosing instructions for methotrexate” - Ben Smith, DMSc, PA-C

Dr. John Cush Tweet
RheumNow

APP Pearls “When I’m explaining treatment options, I say “hey you are the captain of this ship, I’m your co-captain. I help to guide you along this journey… (I can help you) avoid that Hurricane.” - April Woodrow, APRN, ANP-BC

Dr. John Cush Tweet
RheumNow
APP Pearls “Steroids are not a long-term plan; AND One visit cannot fix everything” - Claudia Rivera-Salas, NP
Dr. John Cush Tweet
RheumNow
APP Pearls “Get to know your patients and any barriers they have that may impact their healthcare” - Natalie Lane, FNP-C
Dr. John Cush Tweet
RheumNow
APP Pearls “When seeing a new patient, never assume that their preconceived or prior diagnosis is the only rheumatology condition that they have” - Lindsay Tom, PA-C
Dr. John Cush Tweet
RheumNow
APP Pearls “Point out to every patient with gout that poorly controlled gout will increase their risk of CV events and mortality” - Emma Bavage, NP
Dr. John Cush Tweet
RheumNow

APP Pearls “Do not order a test if you do not know how to interpret the results whether normal or abnormal” - Madison Chastain, CRNP

Dr. John Cush Tweet
RheumNow
APP Pearls “Never stop learning—rheumatology is full of surprises” - Kayla Carlucci, FNP-BC
Dr. John Cush Tweet
RheumNow
Three Things to Know About Hiring, Onboarding, and Training APPs As the utilization of APPs (nurse practitioners and physician assistants) in rheumatology becomes more prevalent, here are three things to consider if you are thinking about adding an APP to your practice: Read https://t.co/24RVd09vcK
Dr. John Cush Tweet
RheumNow
APP Controversies and Misconceptions In this Tuesday Night Rheumatology, panelists discuss a range of topics, including APP roles and impact; models of care; independence; seeing new patients and complex cases; and more. Panelists: Daric A. Mueller, PA-C; Lisa Carnago, PhD, https://t.co/t2PssfUNoV
Dr. John Cush Tweet
RheumNow
APP Pearls “You must assess sleep and mood- without this, even if you control all inflammation, you will not control pain and fatigue!” - Christine Stamatos, NP, DNP, RN
How well do you know this week's rheumatology news?
Take the rheumIQ quiz
Take the RheumIQ Quiz

×