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Reefer Madness (12.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com.  B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.

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Betsy Kirchner

Metabolic Bone Pearls

Elizabeth Kirchner, DNP

Betsy Kirchner, DNP, shares practical tips for managing metabolic bone disease, including the importance of VFA imaging to catch asymptomatic vertebral fractures and utilizing fracture liaison services to close care gaps. She highlights key pearls like the doubled fracture risk in RA patients, ACR's risk stratification for glucocorticoid-induced osteoporosis, and a simple FRAX adjustment calculation that can improve treatment decisions.

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I Can't Believe it's Not Seronegative Rheumatoid Arthritis?!

Daric A. Mueller, PA-C

In rheumatology, we're no stranger to uncertainty. In any diagnosis of seronegative rheumatoid arthritis, it's always our invitation to reconsider the diagnosis. 

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Eval of Rheum Complaints Cover Image

Evaluation of Rheumatic Complaints

Jack Cush, MD

Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.

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British Society of Rheumatology Guideline for Monitoring DMARDs

Jack Cush, MD

The British Society of Rheumatology has published an update to their previous 2017 BSR/BHPR guideline regarding the use and monitoring of DMARDs (disease-modifying anti-rheumatic drugs) used to treat systemic autoimmune rheumatic diseases (SARDs). 

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AANP survey of US 2338 Nurse Practitioners (mostly primary care) re: shared pts w/ rheumatologists. NPs managing RA want improved communication w/ rheums, & education on RA management. PC NP confidence w/ RA was 47% Somewhat confident, 6% very confident, 19% not confident. https://t.co/YVEpJua9hj
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Tarsal Tunnel Syndrome - review and quiz. A compressive neuropathy of the posterior tibial nerve within the tarsal tunnel. 80% caused by lipoma, ganglion, varicosity, trauma, tenosynovitis, rheumatoid arthritis, diabetes, etc https://t.co/zCyeVIJEuy https://t.co/f4jA13FDvN

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In US, Tofacitinib loses patent exclusivity & goes generic in 2026. Worldwide Tofa sales in 2024 were $3.08 billion (55% use in RA; N. America 1st w/ ~38% of market). Tofa sales projected to rise to $5.7 bill in 2029 https://t.co/nKPaQdglYw https://t.co/DdMymmk8go

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Israeli retrospective study of 9736 colchicine Rx FMF pts matched w/ 97 360 controls. On F/U Psoriatic arthritis developed in more FMF pts (43 vs 119) - HR 3.52 (CI: 2.48, 5.0). ^Risk w/ older age, smoking, SES https://t.co/blDIsmHWPC

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I Can't Believe it's Not Seronegative Rheumatoid Arthritis?! In rheumatology, we're no stranger to uncertainty. In any diagnosis of seronegative rheumatoid arthritis, it's always our invitation to reconsider the diagnosis. https://t.co/JaLfRha6dq https://t.co/WwT5Q8B5Ad

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Dr. John Cush RheumNow ( View Tweet)
Retrospective EHR study of 38,327 COVID-19 infx pts & 1,143 whodeveloped post Covid Syndrome (PCC). PCC risk was signif higher in women & obese. Pre-COVID, psoriasis (OR 1.41) & RA (OR 1.64) had incr risk of PCC. Post COVID, more Sjögren’s (OR 4.05) among PCC. https://t.co/0Z48Hy43XY
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Cases & Guidelines: Tuesday Night Rheumatology Panelists discuss their approaches to a range of difficult cases in multiple areas, including RA, PsA and PMR. Panelists: Audrey Gibson, PA-C; Benjamin A. Smith, PA-C; Emma Bavage, ANP; Jack Cush, MD https://t.co/1HPBdPdIVx https://t.co/30Q6azQU3r

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Dr. John Cush RheumNow ( View Tweet)
RHEUM Survey> In RA, seropositivity correlates best with what?

Dr. John Cush RheumNow ( View Tweet)

I Can't Believe it's Not Seronegative Rheumatoid Arthritis?! In rheumatology, we're no stranger to uncertainty. In any diagnosis of seronegative rheumatoid arthritis, it's always our invitation to reconsider the diagnosis. https://t.co/JGPTXkvF3E https://t.co/ds1aRzAPF7

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Dr. John Cush RheumNow ( View Tweet)
The countdown is on! ⏱️ Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one. ✅ Register now at https://t.co/4UQlqwujiR 🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu

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Dr. John Cush RheumNow ( View Tweet)
2018 NHANES population survey of 28,040 individuals, 4168 (14.32%) identified with sleep disorders, and 1589 (4.28%) had #RA. Thus, sleep disorders were significantly associated with increased odds of RA (OR = 1.76, 95% CI: 1.46–2.13, P < 0.001). https://t.co/9O2MsLvwVe https://t.co/cBsm8Jt8Ks

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DMARD Treatment Lags for Minority Groups with Rheumatoid Arthritis Use of disease-modifying anti-rheumatic drugs (DMARDs) for RA was markedly lower among all major racial-ethnic minority groups in the U.S. compared with white patients, analysis of federal survey data indicated, https://t.co/eZOLAN4KVr
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Cochrane review of nurse-led care (NLC) in RA, included 14 articles & 3369 RA pts. NLC proves highly effective in managing RA patients, surpassing usual care and equating to rheumatologist-led care in dz activity and some secondary (self efficacy, pain, QOL) outcomes https://t.co/gd9vbcOR8P
Dr. John Cush RheumNow ( View Tweet)
JAMA Case Challenge - Painful Hand Swelling With Finger Contractures 56-yoF w/ BL hand contractures, 15 mos BL hand pain/swelling/stiffness. No or partial relief w/ ibuprofen, 30 mg prednisone, MTX 10-20 mg/wk. All labs were normal. Whats the Dx? https://t.co/lZ0NHX5Y56 https://t.co/JC04E3JUxB

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Dr. John Cush RheumNow ( View Tweet)
Korean claims study of 60 315 adult #RA pts (matched 1:5 controls), found risk for nontuberculous mycobacteria pulmonary disease was 3 fold higher in RA (0.23% vs 0.06%; 0.54 vs 0.14/1000PYs). Mostly in seropositive RA (OR 3.77), also males, obese, EtOH use. https://t.co/xPPHvtwxIB
Dr. John Cush RheumNow ( View Tweet)
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