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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.

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nurse,appointment,vitals

Nurse-Led Treat-to-Target Clinics

EurekAlert!

New studies shared at the 2025 annual EULAR congress in Barcelona highlight the benefits that nurse-led care can bring for both patients and healthcare systems.

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ERA, APPs, & Alpha GAL (3.21.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  Listen in for 2 new case questions - Ask Cush Anything.

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NP and PA Growth in the USA

Jack Cush, MD

Forbes has published a thoughtful perspective on the declining number of US physicians and the growth in the number of advanced practice providers or APPs (nurse practitioners and physician assistants) in the US clinical workforce. Gastroenterologist Dr. Spencer Dorn writes that in the US, there are fewer physicians per capita (2.6 per 1,000) than most developed nations (average 3.6 per 1,000), with a physician shortfall of 125,000, that is projected to be ~200,000 by 2037.

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Alive in 2025 (1.10.2025)

Jack Cush, MD

Dr. Jack Cush brings in the new year with a review of the latest from RheumNow.com

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ild.jpg

Best of 2024: 13 Risk Factors for RA-associated Interstitial Lung Disease

Jack Cush, MD

Interstitial lung disease (ILD) is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). A recent metanalysis shows the pooled prevalence of RA-ILD was approximately 18.7%.

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ACR’s Run at Goliath (PCPs) (5.31.2024)

Jack Cush, MD

Dr. Jack Cush reviews the journal reports and articles from this past week on RheumNow.com. The ACR (and Cush) address their new website designed to educate PCPs and APPs - what do you think?

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ild.jpg

13 Risk Factors for RA-associated Interstitial Lung Disease

Jack Cush, MD

Interstitial lung disease (ILD) is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). A recent metanalysis shows the pooled prevalence of RA-ILD was approximately 18.7%. 

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Methotrexate + pegloticase increases response rates in gout

Bella Mehta, MBBS, MS

In abstract 0001 presented at ACR22 Convergence, researchers presented 12-month data from a randomized double-blind placebo-controlled trial of pegloticase with or without MTX.

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AMN Healthcare report on MD salaries -- high demand for specialist MDs w/ RHEUM the 7th Most In-Demand. 2024/205 Rheum were low of $214K, a high of $450K, median of $341,000. Avg salary for NPs is $180K up from $164,000 last year, a 9.6% increase. https://t.co/NcmwrMxpKr https://t.co/a86NvQhZry

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Dr. John Cush RheumNow ( View Tweet)
CMS to Test Prior Authorization Model in Traditional Medicare The Centers for Medicare & Medicaid Services (CMS) announced a new experimental model late last week to streamline some prior authorizations under the traditional Medicare program, but some politicians and experts https://t.co/o8iV9Bb6Ir
Dr. John Cush RheumNow ( View Tweet)
ACR & Arthritis Foundation Denounce the Dismantling of Vital Health Programs As organizations representing nearly 60 million adults and children living with arthritis in the United States and the rheumatologists and health care professionals who treat them, we are deeply https://t.co/VH3hPz115f
Dr. John Cush RheumNow ( View Tweet)
#JIA #biologics and #tsDMARDs: Are all patients getting the same access? MDTs, share your insights on on-label and off-label prescribing and help improve future care. 💬 Take the survey by 15 April: https://t.co/vC2Pv5vmH4 https://t.co/rRM5rH0QQl

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BSR RheumatologyUK ( View Tweet)
Peripheral Nerve Blocks for Hip Fractures JAMA reviews the use of peripheral nerve block with hip fractures as an effective pain management strategy that can be performed by credentialed clinicians outside of the operating room. https://t.co/baeLWVxeUo https://t.co/ZBTVDT0jGR

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Dr. John Cush RheumNow ( View Tweet)
State Update @ACRheumDC No executive level changes, some state legislative flips Political changes will likely lead to more state legislative healthcare legislation - In the works for PBM reform, copay accum, prior auth/Step, reprod healthcare @RheumNow #ACR24 https://t.co/94KyHU0Blr

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Eric Dein ericdeinmd ( View Tweet)
@LennMcD @ACRheumDC Current congress (118th) - very tight margins, paralyzed by the ‘24 elections. Now in lame duck Many ACR policies made into bills - PA, step rx, copay accumulator, workforce, loan repayment, incr Rx transparency Needs to be passed into law @RheumNow #ACR24 https://t.co/1elEUiUAmh

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Eric Dein ericdeinmd ( View Tweet)
Early RA Journey - Patient Perspectives and Uncertainties Canadian early RA (ERA) patients were interviewd to depict their perspectives from onset and diagnosis to referral and care. This report highlights the importance of patient pain and primary care physician (PCP) intake… https://t.co/gwNL7iZIT5 https://t.co/SL0Jw0H8f6
Dr. John Cush RheumNow ( View Tweet)
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