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Self-Directed Cognitive Behavioral Therapy for Chronic Pain

Jack Cush, MD

Is self-directed cognitive behavioral therapy (CBT) when augmented with asynchronous, personalized feedback for chronic pain (CBT-CP) superior to clinician-delivered CBT-CP?

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back, LBP, spine, AS

JAMA Review on Low Back Pain

Jack Cush, MD

A comprehensive JAMA review synthesizes current evidence on the epidemiology, pathophysiology, clinical evaluation, and treatment of nonspecific low back pain, drawing on 108 publications identified from a PubMed search (2005–2026) and the most recent guidelines from the WHO, ACP, and NICE. While the primary audience is generalists, the review carries important implications for rheumatologists who regularly encounter patients with back pain in the context of inflammatory arthritis, axial spondyloarthritis, and other systemic diseases.

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EULAR 2026: Updated Recommendations for Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases

Jack Cush, MD

This update includes new pandemic era evidence, recombinant zoster vaccine data, and new perspectives on vaccination in patients taking novel immunosuppressants. Five overarching principles and 10 vaccine recommendations follow.

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EULAR 2026 Rheumatology RoundUp

Jack Cush, MD

It’s time for Rheumatology RoundUp from EULAR 2026 from London, UK. Drs. Artie Kavanaugh and Jack Cush review their choice presentations from the meeting, offering their perspectives on impact and applicability.

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EULAR flags

Day 3 EULAR Report

Jack Cush, MD

Day 3 was an interesting mix of posters, oral presentations, and review sessions on many practical subjects like osteoarthritis, large vessel vasculitis, systemic sclerosis, and pregnancy. Here are a few of my recommended abstracts from Friday at EULAR 2026.

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U Maryland study found that 5-minutes of proximal intercessory prayer (PIP) — in-person prayer offered by a trained volunteer — significantly reduced pain and anxiety in primary care patients compared to a music control group. 180 pain pts (pain >4/10) w/ > 2 pt reductions at 2 & https://t.co/k4JiQvyC31
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 116 BL KOA (Kellgren–Lawrence I–II) pts rx w/ three PRP injx (n 58) or NSAIDs +/- IAhyaluronic acid (n 58). After 5 yrs there was no signif. difference in VAS, WOMAC, and SF-36, with both groups worsening. https://t.co/KDSMTvEl59 https://t.co/lgHOsppIU3

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Dr. John Cush RheumNow ( View Tweet)
JAMA Review on Low Back Pain A comprehensive JAMA review synthesizes current evidence on the epidemiology, pathophysiology, clinical evaluation, and treatment of nonspecific low back pain (nsLBP), drawing on 108 publications identified from a PubMed search (2005–2026) and the https://t.co/liEitQ2ACf
Dr. John Cush RheumNow ( View Tweet)
Genicular artery embolization (GAE) in knee OA? Multiple open label studies & metanalyses suggest a clear pain benefit; BUT 3 sham-controlled RCTs have not demonstrated a statistically significant benefit over placebo. GAE is not addressed by ACR or EULAR guidelines. https://t.co/amIN6kzY74
Dr. John Cush RheumNow ( View Tweet)
MTX: SC vs Oral? Metanalysis of 9 RCTs, 974 RA pts. Compared w/ oral, SC MTX signif. incr odds of ACR20 (RR=1.15), ACR50 (RR=1.14) & reduced GI adverse events (RR=0.58), diarrhea (RR=0.42): BUT no difference in ACR70, DAS28-ESR, bioavailability AUC, or other AE https://t.co/tQeQz7H7do
Dr. John Cush RheumNow ( View Tweet)
Understanding Comorbidities in RMD People with rheumatic and musculoskeletal diseases (RMD) are at risk of a number of comorbidities, from cardiovascular diseases to cognitive impairment and fractures. EIULAR 2026 showcased new data and ideas around various comorbidities and https://t.co/twr0EiMp9f
Dr. John Cush RheumNow ( View Tweet)
#OP0159 #EULAR2026 Multimodal study in D2T RA identified altered brain connectivity patterns linked to pain, psychological features & peripheral transcriptomics. Supports neuroimmune component in D2T RA & need for personalised approaches beyond inflammation control. @RheumNow https://t.co/qMQbkiMCwX

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Mrinalini Dey DrMiniDey ( View Tweet)
Does #RA accelerate age-related functional decline in older adults? STAR study (n=421, age 55-85): RA with worse HAQ, grip strength, but aging's effect on function similar in RA vs controls. Geriatric syndromes like sarcopenia may matter more than RA @RheumNow #EULAR2026 POS0360

Jiha Lee JihaRheum ( View Tweet)

Do GLP-1 agonists achieve meaningful weight loss in patients with RMDs? RISE registry Retrospective N=60,206 Tirzepatide: lost 8% Semaglutide: list 6% At 12 months PsA had the highest usage OP0112 #EULAR2026 @RheumNow https://t.co/P3CTgiwqCr

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Nelly ZIADE 🍀 Nellziade ( View Tweet)
Machine learning identifies a “vulnerable” phenotype in older RA patients n=275 -51% “vulnerable” -Worse grip strength, gait speed & SARC-F -Higher disability (HAQ 1.56 vs 0.64) -More fatigue, poorer QoL -Higher DAS28 despite greater biologic exposure Suggests we should assess https://t.co/bv1FbTxGKR

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Aurelie Najm AurelieRheumo ( View Tweet)
Failure to achieve early remission RA asso w/ non-inflammatory pain NORD-STAR 526 early RA pts) no remission at 24 wks increased risk of 48wk • unacceptable pain (OR ~6) • refractory pain (OR ~6) • fibromyalgic RA (OR ~16) Signal strongest w/ very early remission wk8 https://t.co/H8iyhIrsJw

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Aurelie Najm AurelieRheumo ( View Tweet)
What does remission really mean to patients with #PsA? The RemiPPsA international qualitative study asked 123 patients across 11 countries. Pain-free + ability to resume daily life topped the list, not just composite scores. #EULAR2026 @RheumNow, POS0294 https://t.co/mEGpkewuTX

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Jiha Lee JihaRheum ( View Tweet)
What does remission look like for people living with PsA? Much more than the absence of swollen joints Absence of pain Skin management Ability to resume daily activities Sustained over time A definition not always reflected in our disease activity scores #POS0294 #EULAR2026 https://t.co/VCnMGAOVYm

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Aurelie Najm AurelieRheumo ( View Tweet)
PET-derived parameters in #PsA correlated with DAPSA, CRP and patient pain. Angiogenesis imaging may be a complementary biomarker of overall disease burden Abstr#OP068 #EULAR2026 #Imaging

Antoni Chan MD (Prof) synovialjoints ( View Tweet)

#EULAR2026 OP0220 How can we improve physical function of #SLE patients? Cross-sectional study of 2 US cohorts: poor physical function was associated with Fatigue, depression, learned helplessness and perceived stress. We should focus on improving fatigue & wellbeing @RheumNow https://t.co/vAFqYyuzgN

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
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