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APPs in the News (12.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.
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Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it?
Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) the data supporting its use is limited.
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Changing Loan Limits for Advance Practice Providers
The "One Big Beautiful Bill" (OBBB), or H.R. 1, was signed into law in July, calls for significant changes in the funding of healthcare education. This bill that lowers cap limits on education loans applies to graduate (APRN, PA) programs.
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Legislative Issues Affecting APPs
Here's a summary of legislative issues in three key areas: APRN compact and interstate licensing hold up; scope of practice; and, reimbursement hassles.
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Long-Term APP Retention: Building Success for Practices and Providers
Advanced Practice Providers (APPs) play an increasingly vital role in rheumatology practices across the country. With rising patient volumes and a growing demand for timely, high-quality care, incorporating an APP into a rheumatology team can be transformative.
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Hiring, Onboarding and Training APPs
Watch our kickoff webinar for this month's Mission: APP — Partners in Care campaign. Our panel of rheumatologists and experienced advanced practice providers share insights into hiring, onboarding, training, compensation, and more. https://t.co/stgTQM9soW
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RheumNow Live 2026
Where the data meets the dialogue.
Join leading rheumatologists, researchers, and innovators at RheumNow Live 2026 — the meeting redefining rheumatology education.
➡️https://t.co/zYYC2350tE https://t.co/4Vz7swwqFJ
Links:
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Consensus Definitions on Difficult to Treat PsA
A substantial number of patients with PsA, have difficult, persistent and hard-to-treat disease. A GRAPPA task force has developed a consensus terminology for two distinct states:
Complex-to-manage PsA (C2M-PsA) https://t.co/po1psn9GNm
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Turkey Tryptophan (11.28.2025)
Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
https://t.co/cnxxwqwyTE https://t.co/82zugQnp2Y
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WHO recommendations on GLP-1 agonists: 1) conditional recommendation - GLP-1 drugs can be used for for long-term obesity treatment by adults, except pregnant women; 2) GLP-1a use should be paired with a healthy diet and physical activity. Access to these drugs is a problem. https://t.co/jMa7rbJPby
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U Colorado compared 10K Traditional Rheum consults (TC) to 670 eConsults. 75% eConsults completed without F2F eval & 73% w/in 3 days. eConsults referred to F2F had better 180d completion rates (36% vs 19% TC, p< 0.001). Dx & Rx rates were similar. Most eConsults came from PCPs. https://t.co/fE6yLMcm25
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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. This review presents the epidemiology, https://t.co/u4w3b915my
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10 yr European retrospective study of haemophagocytic lymphohistiocytosis found 3345 deaths due HLH from 29 countries. Crude mortality rate = 5.3 per 10million PYs (range: 1.1-11.3). From 2011 to 2021, increasing from 3.9 to 6.6/10millPYs, varying by country, sex, age. https://t.co/58gCQ72saF
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PROSPERO metanalysis of 22 studies & 2208 JIA associated uveitis (JIAU) showed severe visual impairment in 16.6% at ~18 yrs. Most frequent: Cataract (44.3%), followed by glaucoma, synechiae, band keratopathy and hypotony. Biologics were protective https://t.co/6OoupX64NE https://t.co/4GFnugdvod
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A&R USA adult rheum workforce study showed in 2019, there were 5,667 rheumatologists & 379 APPs. Betw 2009 - 2020, rheumatologist #s increased 23%, while #APP #s increased 141%. There was a signif increase in female rheumatologists & APPs over time https://t.co/Y5ZSwPLsNe https://t.co/RzDxbN7irL
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Congratulations to Professor Stuart Ralston (Versus Arthritis Professor of Rheumatology) from the University of Edinburgh. He has been honored with the RSE Sir James Black Medal by The Royal Society of Edinburgh for his research research & dedication to medical education https://t.co/vCm4Mkp6u7
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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. It classified these refractory disease patients as those with either (1) persistent https://t.co/uDeIkIek1d
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"When you learn, teach. When you get, give." – Maya Angelou
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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/M0tI8wjzh4
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A New Disease Activity Score for Antiphospholipid Syndrome?
APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and https://t.co/G2xGtOPmwb
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