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Dr. Jack Cush reviews the journal reports and news from RheumNow.com. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
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European nations may be winning at optimizing care for people with axial spondyloarthritis (axSpA), international survey data indicate. In data collected from physicians and patients in the U.S. and five European countries, American patients reported a greater symptom burden on average after treatment had begun, and they agreed less often with their physicians regarding satisfaction with therapy.
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EULAR has updated its recommendations for the management of Behçet’s syndrome, the last being published in 2018. The current update carries no recommendations from the previous version: seven recommendations have content modifications, four have minor wording amends, and one is entirely new.
Dr. John Cush
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Advanced Practice Rheum: Evaluation of Rheumatic Complaints
In this review, Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice. He emphasizes three key priorities: identifying "red flag" conditions (septic https://t.co/DwyO6FySxE
Dr. John Cush
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"At the end of the day, it’s not about what you have or even what you’ve accomplished. It’s about what you’ve done with those accomplishments. It’s about who you’ve lifted up, who you’ve made better. It’s about what you’ve given back."
- Denzel Washington
Dr. John Cush
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EULAR 2025 Update for Behçet’s syndrome
EULAR has updated its recommendations for the management of Behçet’s syndrome, the last being published in 2018. The current update carries no recommendations from the previous version: seven recommendations have content modifications, https://t.co/Xb6KyqsDXf
Dr. John Cush
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Rush University MDHAQ surveys done on 1,337 pts (excluding primary FM), identified 30% w/ anxiety, 24% depression, 25% fibromyalgia, & 44% w any 3 of these. In this 44%, HIGHER pain (7 vs 4) and RAPID3 (17 vs 8.2) vs those without FM, anxiety, or depression (p< 0.001). https://t.co/xbOKeZj5cm
Dr. John Cush
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A multi-center, retrospective chart review of 82 Still's disease pts (63% female; mean Dx age 6.4 ± 4 yrs; F/U ~2.8 yrs). When analyzing Dz course, 34% were monophasic, 46% polyphasic (higher-than-expected), 19.5% persistent Dz. non-monophasic predicted by active 3 mos from Dx https://t.co/V7OxwEI4it
Dr. John Cush
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Autoantibodies Anonymous
A new blog post from Dr. Artie Kavanaugh
https://t.co/GodltmEexc https://t.co/Mv2zIvGHyv
Dr. John Cush
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Disease activity defined in adult-onset Still's dz. Criteria developed using Italian cohort 187 & 41 from CONSIDER (canakinumab) trial. Active AOSD based on 5 criteria: fever, plus 1: skin rash, arthritis, pt global>2 cm, CRP > 10 mg/L; or any 3 without fever (AUC 0.93, 0.85, https://t.co/J94pkQqZFP
Dr. John Cush
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JAMA survey study of 5741 physicians found mean moral distress score (0-10, >4 High) =3.29, w/ 39% having high level of moral distress; more than US workers. Burnout, intent to leave (ITL), or reduce work hours (ITR) was higher for each 1-point incr in moral distress score https://t.co/dslwMztjV7
NEJM
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Polymyalgia rheumatica is an inflammatory condition that affects persons >50 years of age and is characterized by pain in both shoulders with or without hip or neck pain (or both) and with pronounced morning stiffness. Learn more about the diagnosis and management: https://t.co/pKCl42dGVX
Dr. John Cush
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EULAR 2025 Update for Behçet’s syndrome
EULAR has updated its recommendations for the management of Behçet’s syndrome, the last being published in 2018. The current update carries no recommendations from the previous version: seven recommendations have content modifications, https://t.co/QcjVUqlyMU
Dr. John Cush
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phase 3 VALOR trial of 6-valent OspA-based Lyme dz vaccine (LB6V) vs placebo; 4 doses given @ Mos 0, 2, 5-9, & 12 mos later. LB6V reduced Lyme Dz risk by 73.2% @28d after 4th dose. But it was only 15.8% effective (falling short of prespecified 20%) because of fewer than expected https://t.co/TcX0GV05gY
Dr. John Cush
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Prevalence of fibromyalgia in PsA = 18%. FM-PsA pts have higher scores Dz activity scores from FM, rather than inflammation. Fibromyalgia is assoc w/ worse disease outcomes, including failure to achieve low disease activity state and poorer response to therapy. https://t.co/utQRXPmpDs
Dr. John Cush
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"If you have a great 2nd act; the 3rd act writes itself". - Ron Shelton https://t.co/OFgISgu2qF
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JAMA Patient Education Page on JAMA Eosinophilic Fasciitis (EF). EF is rare, but begins with swelling and redness of the arms and/or legs. Later the skin thickens and develops the peau d' orange appearance. EF does not involve fingers or toes, & doesnt have Raynauds https://t.co/WEFFITtmQC
Dr. John Cush
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You can change what comes to your attention. We can change the external and internal focus by being mindful of the triggers and amplifiers we consume. If you’re not happy with what your attention is bringing you, you can change it. - Seth Godin https://t.co/QsUxTmjX1U
Dr. John Cush
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New Dyslipidemia (Cholesterol) Guidelines from AHA/ACC: A) Check during childhood; B) Lower Targets: if 10-year ASCVD risk =10%, aim for LDL <70; if you have ASCVD/MI/CV, aim for 55; C) chk lipoprotein(a) once; D) supplements dont lower cholesterol - statins do. https://t.co/tRwdg6GHm8
Dr. John Cush
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SOLSTICE: phase 3b RCT of IL-23i, guselkumab vs PBO in 451 active PsA pts (GUS q4wk vs q8wk vs PBO). @wk 24 GUS signif better than PBO-ACR20 (59%/62% vs 35%), ACR50 (31%/32% vs 12%), ACR70 (17%/17% vs 2%), PASI 90 (49%/45% vs 12%), MDA (19%/24% vs 5%) ction) https://t.co/QDMCnGdN6J
