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2026 Resolutions (1.9.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, announcements and journal articles from this past week on RheumNow.com. More on Variable bendability, a better way to treat RA, and a novel advance for GLP1a in PsA; and 2026 Resolutions!

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Obesity and Low Back Pain

EurekAlert!

A large patient population study finds weight gain,  increases risk for low back pain - the risk increased 7% for every BMI unit or 10 pounds over ideal weight. 

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2025 Rheumatologists, In Memorium In 2025, rheumatology lost many of its most influential clinicians, mentors, and colleagues. This honor roll recognizes those who cared for countless patients, shaped generations of rheumatologists, and left a lasting legacy in our field. As Dr.
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Nordic Registry Study on NSAID use of ~750K, w/ 34-40% under 60 yrs. 48-58% started NSAIDs before Dx of OA. NSAID use incr w/ age from 18 to 55 yrs, then declined. OA pts have a substantial risk of GI complications in all age groups, including those under 60 yrs. Need to consider https://t.co/PLoUVI4Hys
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VA registry study; among 2771 RA pts (~65y), 64 (2.3%) had CPPD by ICD9/10 codes. RA+CPPD pts signif older [68 v. 64y], w/ more comorbidity/OA (94 v 80%), spine Dz, DM, but less ACPA (63 v 78%). SNRA+CPPD achieved less LDA, more use of pred & b/tsDMARDs (OR >2), death, TJR. Is https://t.co/hUPJzDseVc
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AC&R metanalysis of Generalized Joint Hypermobility (GJH) in adults - 46 studies (n=23,000 pts). GJH required 6 or more Beighton criteria, w/ prevalence of 2%, but 5% in young adults (18-25 yrs). Propose Dx thresholds should vary w/ age = ≥6/9 (18-25y), ≥5/9 (26-65y) & ≥4/9 https://t.co/fgDGKwUozh
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Adult co-twin study of 1261 pairs, 1/2 Rx w/ metformin. Although metformin Rx Twin had higher BMI, they had significantly less incident peripheral OA (adjusted HR 0.60; 0.44–0.82). @ 10 yrs, 6.7% of treated twins, vs 9.7% of non-treated twins had incident OA, with difference of https://t.co/7KpiGssFSo
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Best of 2025: 2025 BSR Guideline for Treatment of Axial Spondyloarthritis The British Society of Rheumatology's 2025 Guidelines for treating axSpa focus on both axial and extra-musculoskeletal issues like uveitis, psoriasis, and IBD. They evaluate the effectiveness and safety of https://t.co/fxFcqy13g7
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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
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APP Pearls “It’s important to explain the difference between an overreactive immune system vs. a weakened immune system” - Miguel Rodriguez, ANP

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"It's suppose to be hard, if it wasn't hard everyone would do it. Hard is what makes it great! - Tom Hanks in "League of Their Own"
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Best of 2025: Targeting Obesity in Rheumatic Disease Patients Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese. https://t.co/aPGuYFCWLo
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Best of 2025: GRAPPA vs. EULAR on Complex/Difficult-to-Manage Psoriatic Arthritis Following the establishment of formal definitions for Difficult-to-Treat Rheumatoid Arthritis (D2T RA) by EULAR and Difficult-to-Manage axial Spondyloarthritis (D2M axSpA) by ASAS, the “Difficult” https://t.co/hFejdS4sjk
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APP Pearls “Ensure a patient understands the weekly dosing instructions for methotrexate” - Ben Smith, DMSc, PA-C

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