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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.

Article

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.

Article

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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ACR Applauds Bipartisan Support for Prior Authorization Reform Bill The ACR commended the more than 295 bipartisan, bicameral cosponsors of The Improving Seniors’ Timely Access to Care Act, which, if enacted, would reform the prior authorization process for Medicare Advantage https://t.co/n0MKkSqRwO
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JihaRheum
CDAI appropriately guided therapy escalation in RA, but not for everyone. Treatment adjustments were less likely in pts with public or no insurance. Even data-driven care can fall short when access barriers persist. @RheumNow #ACR25 Abstract#2616
Akhil Sood MD, MS Tweet
AkhilSoodMD
Paging the pharmacist Abstract 1973: Dedicated clinic pharmacist -> benefits Tasks included: 🔹 74% PA support 🔹 55% patient education 🔹 40% medication management ~50% pts had clinically meaningful improvement Providers report ↑ care quality & ↓ admin burden @RheumNow #ACR25
Jiha Lee Tweet
JihaRheum
ADA-biosimilar use surged just before CVS formulary change then dropped sharply after. In RISE data, uptake reached 25% of users overall. Formulary policies reshape prescribing, but sustaining adoption needs alignment with patient access and preferences. @RheumNow #ACR25 A#1042
Dr. John Cush Tweet
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ACR Urges Alaska and Montana to Strengthen Rheumatology Care The American College of Rheumatology (ACR) is calling on Alaska and Montana to seize the opportunity to address critical gaps in rheumatology care by accessing funding from the Rural Health Transformation Program https://t.co/exHRCORcCG
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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 Tweet
RheumNow
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
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