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Dr. Jack Cush reviews the journal reports and news from RheumNow.com. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
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Drs. Dejaco and Matteson have published and update and review of polymyalgia rheumatica (PMR) in the NEJM. They lay out the initial approach to diagnosis, initial steroid dosing, management over time and when to use steroid sparing therapy.
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JAMA Dermatology has published a review of the pharmacologic landscape on managing adults with moderate to severe plaque psoriasis.
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Medicare coverage of targeted disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) -- both under Medicare Advantage and in separate Part D plans -- is likely to leave many patients wanting, researchers found.
Dr. John Cush
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A multi-center, retrospective chart review of 82 Still's disease pts (63% female; mean Dx age 6.4 ± 4 yrs; F/U ~2.8 yrs). When analyzing Dz course, 34% were monophasic, 46% polyphasic (higher-than-expected), 19.5% persistent Dz. non-monophasic predicted by active 3 mos from Dx https://t.co/V7OxwEI4it
Dr. John Cush
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Autoantibodies Anonymous
A new blog post from Dr. Artie Kavanaugh
https://t.co/GodltmEexc https://t.co/Mv2zIvGHyv
Dr. John Cush
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Systemic Treatments for Chronic Plaque Psoriasis
JAMA Dermatology has published a review of the pharmacologic landscape on managing adults with moderate to severe plaque psoriasis.
https://t.co/fJQDvZDdbs https://t.co/IYAsdujsMf
Dr. John Cush
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Spotty Medicare Coverage for Newer Rheumatoid Arthritis Meds
Medicare coverage of targeted disease-modifying anti-rheumatic drugs (DMARDs) for RA -- both under Medicare Advantage and in separate Part D plans -- is likely to leave many patients wanting, researchers found. https://t.co/CW6gIHtnIw
Dr. John Cush
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Disease activity defined in adult-onset Still's dz. Criteria developed using Italian cohort 187 & 41 from CONSIDER (canakinumab) trial. Active AOSD based on 5 criteria: fever, plus 1: skin rash, arthritis, pt global>2 cm, CRP > 10 mg/L; or any 3 without fever (AUC 0.93, 0.85, https://t.co/J94pkQqZFP
Dr. John Cush
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Real-world safety of tofacitinib vs biologics in 48,167 #PsA pts Rx w/ TOFA (3,166); TNFi (27K); IL-17Ai (20K); risankizumab (4,381); ustekinumab (4,499). Crude IRs/100 PY were 1.78-2.53 for serious infxn, 0.27–0.61 MI/stroke, 0.17–0.42 VTE, & 0.74–1.06 cancer. TOFA had signif https://t.co/Z5wZTGc5gB
Dr. John Cush
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Incident RA is assoc w/ considerable work loss. 3850 RA pts compared to 4422 same-sex siblings (2006-2020). Work loss began 13 mos before RA Dx & peaked the year after, less in last 10 yrs. Work loss highly skewed; small proportion contributed the most work loss days. https://t.co/splolrEDpe
Dr. John Cush
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Advanced Practice Rheum: Evaluation of Rheumatic Complaints
In this review, Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice. He emphasizes three key priorities: identifying "red flag" conditions (septic https://t.co/QX8AM9YNAf
Dr. John Cush
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JAMA survey study of 5741 physicians found mean moral distress score (0-10, >4 High) =3.29, w/ 39% having high level of moral distress; more than US workers. Burnout, intent to leave (ITL), or reduce work hours (ITR) was higher for each 1-point incr in moral distress score https://t.co/dslwMztjV7
NEJM
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Polymyalgia rheumatica is an inflammatory condition that affects persons >50 years of age and is characterized by pain in both shoulders with or without hip or neck pain (or both) and with pronounced morning stiffness. Learn more about the diagnosis and management: https://t.co/pKCl42dGVX
The Lancet Diabetes & Endocrinology
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#Glucocorticoid-induced #osteoporosis results from direct suppression of osteoblast & osteocyte function, a transient stimulation of osteoclast formation & activity, catabolic effects on #bone matrix & muscle protein, and metabolic alterations https://t.co/ZmMFAOJkmw
#OpenAccess https://t.co/6CubKRbjin
Dr. John Cush
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In this https://t.co/4UQlqwujiR 2026 podcast, Dr. Elena Myasoedova examines mortality trends in RA, exploring whether we are seeing continued decline, delayed impact, or a concerning plateau.
🎧 Listen here: https://t.co/tYS24BNsXw
#Rheumatology #RheumatoidArthritis #MedEd https://t.co/GbZV43Cnse
Dr. John Cush
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EULAR 2025 Update for Behçet’s syndrome
EULAR has updated its recommendations for the management of Behçet’s syndrome, the last being published in 2018. The current update carries no recommendations from the previous version: seven recommendations have content modifications, https://t.co/QcjVUqlyMU
Dr. John Cush
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Retrospective TriNetX Network cohort study of adult PsA (N 123,031) pts, propensity- matched to non-PsA controls. PsA had signif higher CV morbidity: MACE (HR 1.74); mortality (HR 1.95); CHF (HR 1.96), MI (HR 1.71), & CVA (HR 1.49). bDMARDs reduced MACE (HR 0.95) & mortality (HR https://t.co/bHrq9KpwBM
Dr. John Cush
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Economic analysis of ESR & CRP testing (are they same or different?). Compared to doing either ESR OR CRP, they found the ESR + CRP testing was cost-effective strategy, reducing misdiagnoses, followup costs and overall healthcare costs. https://t.co/UU15bxuPKP https://t.co/7zNkUOcQpU
Dr. John Cush
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phase 3 VALOR trial of 6-valent OspA-based Lyme dz vaccine (LB6V) vs placebo; 4 doses given @ Mos 0, 2, 5-9, & 12 mos later. LB6V reduced Lyme Dz risk by 73.2% @28d after 4th dose. But it was only 15.8% effective (falling short of prespecified 20%) because of fewer than expected https://t.co/TcX0GV05gY
