Prescribing Lessons (4.17.2026) Save

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.

1. Modest Benefits with AI Scribes on EHR Documentation Documenting patient visits in the EHR is essential to care, but a major contributor to clinician burnout. AI-enabled ambient documentation (“AI scribes”) can auto-generate draft clinical notes for clinician review. They may reduce burnout, but large-scale studies on their impact on clinician workflows are lacking https://t.co/6HaUwpFYLC
2. NHIS 10yr survey of 195,600 Americans shows Chronic pain assoc w/ double rates of smoking & vaping. Smoking decr over time, but always higher in chronic pain pts (17.7% 2014, 13.1% in 2023) than w/o pain (12.5% 2014, 7.5% 2023). E-cigs incr over time, more w/ chronic pain https://t.co/iW7IDwHyJa
3. Gabapentinoid use 2008-2018: worldwide there was an annual incr of +17.2% (from 4.2/d to 18.3/d per 10K pop. Highest GABA use in high income countries, 6X higher than lower income (40/d vs 6.1/d) https://www.nature.com/articles/s41467-023-40637-8
4. Cross-sectional study from UK Clinical Practice Research Datalink Aurum looked at > 40K w/ #PMR Rx w/ steroids - 67% were coprescribed bisphosphonates (BP) & 79% Rx PPIs/H2RAs (less in males & pts deprived areas) resulting more Fx w/in 12 mos (2.32% vs 1.4%). https://buff.ly/3usBFB0
5. Potential new mechanism of MTX Effx - MTX polyglutamates accumulates in monocytes by D5, modulates transcriptional signature “non-classical monocyte”-assoc genes by Wk4, & predicts MTX responses https://t.co/g14GONKgvq
6. Leeds study of 63 pts w/ palindromic rheumatism (PR) progressed to Persistent IA (PIA) @ median 13.4 mos, hands predominating across flares. PIA developed in joints involved in PR flares in 71% of pts. @RA Dx, PR onset pts had signif higher swollen joints (4.1 vs 3.2) https://t.co/PnrQvWkUm4
7. 152 pts w/ immune thrombocytopenia (ITP) Rx in DBRPCT of Ianalumab (9mg or 3 mg/kg) or PBO q mo x 4 mos (all on Eltrombopag ). Time to Rx failure signif longer w/ ianalumab. Stable 6 month response better w/ 9-mg group vs PBO (62% vs 39%; P=0.045) https://t.co/J04trYAwLu
8. A LESSON FOR GC OVERUSE: Inappropriate PPI use was Twice as successful w/ reduced w/ GP & Pt-facing intervention (15 vs 7%) vs usual care or GP-only intervention. Study of 1498 GPs, 34K pts https://t.co/4cxoeanAK8 https://t.co/FdfUdST40o
9. Global Study of #gout - incidence increased by 158% (from 1990 to 2023), during which mean onset age rose from 58 to 62 years; but % young-onset gout dropped 15.8% to 9.8%. #s due to aging, not younger onset. https://t.co/5pqMwPEnuj
10. TRACE study in 90 active axSpA, biologic-naïve, Rx w/ secukinumab 150 mg; @wk16 ASDAS remission in 30 (35%) & 55 incr SEC to 300 mg. By wk 24, 22% of 300 mg achieved ASDAS remission; but without signif change in MRI inflamm (SPARCC). Most MRI changes in 1st 4wks https://t.co/1ct22RdFZq
11. Systematic review of plasma exchange (PE) in myositis (IIM) - 35 studies (mostly observational), 473 IIM pts (361 Rx w/ PE). Many reported improvements (publication bias). 7 comparative RCTs show no mortality benefit (severe ILD) (RR 0.41, 95% CI 0.16–1.06, I2 = 70%) https://t.co/ox0pdUL3Ek
12. Litifilimab in Cutaneous Lupus Erythematosus
13. Physician Use of Augmented Intelligence has Doubled