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The Cartel is Coming for Rheumatology
"What Do Blockbuster Drugs & The Black Market All Have in Common?" asked Dr. Madelaine Feldman at RheumNow Live 2025. They thrive, she explained, on market exclusivity "... until they don't." At first glance, the pharmaceutical marketplace may not appear like a crime drug ring, but Dr. Feldman of Tulane University described how sinister forces of market manipulation have negatively impacted patient care for years.
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Valentine RNL 2025 Review (2.14.2025)
Dr. Jack Cush reviews highlights from RheumNow Live 2025 held in Dallas, TX on Feb. 8-9, 2025.
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That's not my problem - or is it? Multimorbidity in RA
Traditionally, rheumatologists have often been deferential to the non-articular concerns in RA to other providers, though these issues are often left unaddressed. What role do rheumatologists have in the management of multimorbidity in our patients?
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Will AI put me out of a job?
The development of AI and other technologies brings new possibilities for optimizing diagnosis, management and has potential for improving outcomes in RA. At RheumNow Live 2025, Dr. Jeff Curtis, University of Alabama at Birmingham, presented a talk on, "AI applied to Rheumatoid Arthritis Care: Practically (Not) Perfect".
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8 fold risk of incident ILD in #RA pts. Data from Korean National Health Insurance, 52,325 RA pts & 261,625 controls & 4.4 yrs F/U - ILD in 3.7% of RA vs 0.5% controls (adjHR 7.84); higher in seropositive RA (aHR= 9) vs seronegative RA (aHR=4.8) https://t.co/iIoZOwFYEN https://t.co/HBzSg9KrpZ
Dr. John Cush RheumNow ( View Tweet)
Full read, comprehensive review of Hidradenitis Supprativa in Lancet Feb 1, 2025
Common assn; DM, IBD, Smoking, Obesity, metabolic syndr, NASH, SpA, RA
FDA approved Rx: Adalimumab, Secukinumab, Bimekizumab https://t.co/5Tb8on21E0 https://t.co/BLu6Zaejj5
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Dr. John Cush RheumNow ( View Tweet)
That's not my problem - or is it? Multimorbidity in RA
RA can look so easy on the television commercials where patients appear young, healthy, and vibrant on the advertised treatment.
https://t.co/B7WUiysNSE https://t.co/nczmoIBfOb
Dr. John Cush RheumNow ( View Tweet)
Eric Dein @ericdeinmd
B England
75% of RA pts have multi-morbidity
Pts develop multi-morbidity BEFORE the onset of RA
Should we have different goals: Prioritize LDA over remission in pts w multimorbidity
Collaborate w PCP: one size doesn't fit all, do something better than… https://t.co/RIe7BhSgvJ https://t.co/4dVdR088XF
Dr. John Cush RheumNow ( View Tweet)
Adela Castro @AdelaCastro222
Multimorbidity in Rheumatoid Arthritis:
-Affects >75% of pts
-Reduces quality of life and increases mortality
-Highly associated w/ D2T RA
-Requires multidisciplinary care teams (PCP, specialists, case management, PT)
-Management should start early… https://t.co/Sshm8CUWOA https://t.co/W9dojZT99T
Dr. John Cush RheumNow ( View Tweet)
Jeffrey Curtis @RADoctor
Great talk at #RNL2025 by Dr Una Makris on managing geriatric rheumatology patients. How often do we under-treat #Rheumatoid arthritis patients with advanced therapies because we fall into the trap of ageism? https://t.co/kWLxt15n4X https://t.co/cmLjqigNol
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Dr. John Cush RheumNow ( View Tweet)
Janet Pope @Janetbirdope
Dispel the #myth #rheumatoid #arthritis is NOT Just a disease of Young and middle aged Elderly PREVALENT #RA Pts and 👇 INCIDENT Pts in >65yrs is skyrocketing 🚀 Need #Rx goals and equitable #Rx Uma Makris #RNL2025
https://t.co/3IsVKTSEyy
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Dr. John Cush RheumNow ( View Tweet)
Adela Castro @AdelaCastro222
Are your patients aging with RA, or are they diagnosed with Late Onset RA (LORA)? -LORA pts tend to present acutely -High inflammatory markers~PMR Like -Seronegative/Decreased titers of RF/CCP @UnaMakris #RNL2025 https://t.co/tLrGBV6P1i https://t.co/53HVvUmrG4
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Dr. John Cush RheumNow ( View Tweet)
TheDaoIndex @KDAO2011
Late onset RA (LORA) aka RA diagnosed at an older age — pts have higher inflammatory markers, presents like PMR; they also have polypharmacy, comorbidities, frailty, etc that can complicate management @UnaMakris #RNL2025 @RheumNow #GeriRheum… https://t.co/E2WFwfCsWD https://t.co/tKF0OnUFQH
Dr. John Cush RheumNow ( View Tweet)
“Preventing” Arthritis in Psoriasis
Prevention of the development of our systemic rheumatic diseases in individuals deemed at risk, or with some form of precursor disease process, has been a hot topic in recent years.
https://t.co/nGKGUkKVUl https://t.co/PruJZLAq9n
Dr. John Cush RheumNow ( View Tweet)
Eric Dein @ericdeinmd
AI models require good Positive Predictive Value (PPV) But: PPV decreases as prevalence decreases - In choosing a successful biologic: Harder to predict more challenging patients (multiple failures, co-morbidities, etc) - ACR50 non-response is higher J… https://t.co/eAOR0jFmO3 https://t.co/TB6Ecd8nZh
Dr. John Cush RheumNow ( View Tweet)
Adela Castro @AdelaCastro222
How can AI be useful for RA pts and rheumatologists? -AI models have the potential for improving diagnosis, management and outcomes in RA pts. -Can also improve efficiency and clinic workflow. -Not so perfect as it sounds (hallucinations, limited… https://t.co/YA4A990p2v https://t.co/YnHtbP83Nm
Dr. John Cush RheumNow ( View Tweet)
Eric Dein @ericdeinmd
🏈Kick-off of @RheumNow w Jeff Curtis #RNL2025 🏈 AI in RA? Can help with Rheum Boards Questions, though AI is not confident in answers May not be better than paper charts for triage Other roles: pt chatbot, AI scribe, research populations, generate DDx,… https://t.co/3vJ2gON6tR https://t.co/3ArtaRkhJp
Dr. John Cush RheumNow ( View Tweet)
TheDaoIndex @KDAO2011
Potential uses of #AI for #RA -office workflow (scribe, triage) -research (match eligible pts for trials) -help with diagnosis (and likelihood of risk) -consume guidelines for disease mgmt @RADoctor #RNL2025 https://t.co/k2nOytpKBH https://t.co/7Y2OvBv9pP
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Dr. John Cush RheumNow ( View Tweet)
-HS ttx👇
1. Lifestyle changes: smoking cessation, obesity.
2. Management of comorbidities.
3. 🔍HS- related autoimmune disorders.
4. FDA approved biologics:
-Adalimumab (PIONEER 1&2)
-Secukinumab (SUNRISE, SUNSHINE)
-Bimekizumab (BE HEARD 1&2)
"Theres no such… https://t.co/G5Voxrm3Kt https://t.co/dLGtoFZMd1
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Adela Castro AdelaCastro222 ( View Tweet)
Importance of not over-relying on lab tests. We can test for what we can test for, but this is not comprehensive. For me in clinical practice - Postive antibodies can confirm diagnosis of DM but negative cannot exclude it. @RheumNow #RNL2025 https://t.co/Kyfzne4BSD
Richard Conway RichardPAConway ( View Tweet)
