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APPs in the News (12.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.
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Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it?
Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) the data supporting its use is limited.
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DMARD Treatment Lags for Minority Groups with Rheumatoid Arthritis
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MedPage Today
Use of disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (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, even after adjusting for income, education, and other factors.
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Changing Loan Limits for Advance Practice Providers
The "One Big Beautiful Bill" (OBBB), or H.R. 1, was signed into law in July, calls for significant changes in the funding of healthcare education. This bill that lowers cap limits on education loans applies to graduate (APRN, PA) programs.
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High Cost of Cancelling Knee Replacement Surgery
Thousands of NHS knee replacement operations are cancelled at short notice every year, many for avoidable reasons, according to a new study published December 1st. This costs the NHS millions of pounds and increases waiting times for patients, many of whom are in severe pain.
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Hiring, Onboarding and Training APPs
Watch our kickoff webinar for this month's Mission: APP — Partners in Care campaign. Our panel of rheumatologists and experienced advanced practice providers share insights into hiring, onboarding, training, compensation, and more. https://t.co/stgTQM9soW
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QD Clinic: Flare or Beware
Lindsay Tom, PA-C and Phong Nguyen, MD, Reston, VA discuss today's case called "Flare or Beware", involving a patient who has psoriatic arthritis mutilans, presented as part of RheumNow's "Mission: APP Partners in Care" campaign during the month of https://t.co/JbyHBCQ4ct
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Survey of 500 Rheum Patients, 37% reported having APPs (NP or PA) as primary rheum providers. APP patients had greater ease scheduling& more prefer to see APPs over rheumatologists (P < 0.01) & recommend APPs . No difference between MD vs APP experience https://t.co/VShREnhsMG https://t.co/glaIUPZ5qh
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RheumNow Live 2026
Where the data meets the dialogue.
Join leading rheumatologists, researchers, and innovators at RheumNow Live 2026 — the meeting redefining rheumatology education.
➡️https://t.co/zYYC2350tE https://t.co/4Vz7swwqFJ
Links:
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Retrospective cohort study of 546 DM or clinically amyopathic DM pts. 5 factors were signif assoc w/ cancers (1 point ea): 1) TIFF-1-γ Ab (OR 3.8), poikiloderma (OR 3.1), DM subtype (2.8), anemia (2.4), but ILD was protective (OR 0.39). Markedly elevated DM cancer risk seen w/ https://t.co/r564RbZys2
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Consensus Definitions on Difficult to Treat PsA
A substantial number of patients with PsA, have difficult, persistent and hard-to-treat disease. A GRAPPA task force has developed a consensus terminology for two distinct states:
Complex-to-manage PsA (C2M-PsA) https://t.co/po1psn9GNm
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Hematologic Malignancies Increased in Systemic Sclerosis
Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.
https://t.co/BypsCRUthe https://t.co/lfLJhSqn9e
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Long-Term APP Retention: Building Success for Practices and Providers
Advanced Practice Providers (APPs) are vital in rheumatology due to rising patient numbers and the need for prompt care. Their integration enhances practice efficiency, improves patient access, and balances https://t.co/bZBkbWyWfI
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Turkey Tryptophan (11.28.2025)
Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
https://t.co/cnxxwqwyTE https://t.co/82zugQnp2Y
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WHO recommendations on GLP-1 agonists: 1) conditional recommendation - GLP-1 drugs can be used for for long-term obesity treatment by adults, except pregnant women; 2) GLP-1a use should be paired with a healthy diet and physical activity. Access to these drugs is a problem. https://t.co/jMa7rbJPby
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U Colorado compared 10K Traditional Rheum consults (TC) to 670 eConsults. 75% eConsults completed without F2F eval & 73% w/in 3 days. eConsults referred to F2F had better 180d completion rates (36% vs 19% TC, p< 0.001). Dx & Rx rates were similar. Most eConsults came from PCPs. https://t.co/fE6yLMcm25
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Fast Facts About Rheumatologist Compensation 2025:
- Rheum among lowest paid (~$284k)
- 2024 salaries rose 2%
- 53% say theyre underpaid
- 41% supplement their income
- 6/10 recv incentive bonuses https://t.co/TrPRJ96hY0 https://t.co/2sP8DJTSeB
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TriNetX retrospective cohort study of 1402 propensity matched Systemic Sclerosis pts on vs off SGLT2 inhib (2013-2025) & found SGLT2i significantly lowered all-cause mortality (HR 0.54), stroke (HR 0.64), & hospitalizations (HR 0.76), moreso in SSc without Hx of CHF (HR 0.62) https://t.co/t6GVrN6zoQ
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Coccyx and Sacrococcygeal Joint Disorders
Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, https://t.co/u4w3b915my
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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/hJgoD8mnhv
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