Telling You Where to Go (12.19.2025)

Jack Cush, MD

Dec 19, 2025 7:00 am

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Who would've thunk - a PsA FMF connection? Labs to diagnose SSc-ILD? IgA-RF may be important or RZV may not work in JAK inhibitor treated patients?

Top 10 States to Practice Rheumatology 1 North Dakota 2 Wisconsin 3 Alaska 4 Montana 5 South Dakota 6 Nebraska 7 Minnesota 8 Washington 9 Utah 10 Maine https://t.co/x2tKflV2S7
Lilly announced phase 3 RCT TRIUMPH-4, where Retatrutide, a new GIP, GLP-1 & glucagon recpt agonist, was given to obese (BMI >35), knee osteoarthritis pts *without diabetes*. Wt loss at 68 wks was 28.7% with reduced WOMAC pain scores of -4.5 points (75.8%) https://buff.ly/uxLpnmD
IN RA: IgA-RF seen in 50%, IgA-ACPA in 20-40% (& are very specific). IgA-RF or -ACPA found in serum, saliva & syn.fluid.& may underlie "mucosal hypothesis" of RA. IgA-RF assoc w/ more severe RA, worse outcomes, Xtra-articular manifestations, & blunted TNF inhibitor responses https://t.co/SVUJmrIy2F
Lancet review of skin cancer risk w/ inflammatory arthritis - both melanoma and Non-melanoma skin cancers are increased in RA & inflammation. Also Package inserts for TNFi say all TNFi Rx pts should have complete skin exams "periodically". Skin cancer screening advised. https://t.co/MNuQO6Dw5b
Austrian 1K Paracelsus cohort study; from 9,665, 296 (3.1%) had RA. CKD prevalence was higher in RA vs controls (11.8% vs. 6.7%, p<0.001). Albuminuria was dominant renal dz in RA (6.8% vs 4.2%, p=0.027), but missed signif after adjustments (OR 1.43; 0.96–2.13) https://t.co/qf0IpZC50Q
Japanese retrospective study-194 #RA pts Rx w/ JAK inhib (74 vaccinated w/ recombinant zoster (RZV) & 120 Not-Vax). H.zoster lower w/ RZV (4.8/100PY) vs UnVax (7.8/100PY) w/ overall efficacy of 59.1%. RSV Vax pts who got HZ had signif lower lymphocyte #s, higher SDAI & CDAI. https://t.co/4VMWPhzXeL
Study of 177 #SSc pts (116 w/ SSc-ILD vs 61 without ILD). SSc-ILD had more dcSSc, Raynaud’s & GI Dz. SSc-ILD predicted by triad of elevated NLR, PT, anti-SCL-70 (AUC of 0.879; sensitivity 82.6%; specificity 85.0%). NLR: neutrophil to lymphocyte ratio; PT: prolonged prothrombin https://t.co/iI6ZnZgJE7
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
MEDISPO study of 38 mild-mod psoriasis pts, 16-wk Mediterranean diet vs low-fat diet. Mediterranean diet did much better w/ PASI change −3.4 vs 0, more pts achieving a PASI 75 reduction (47.4% vs none) https://t.co/ZJU58VanGr
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
Wolters Kluwer surveyed 203 PAs: - 62% wish for more clinical experience prior to - Most adopted AI, majority need more AI training - 45% prefer title of “physician associate” https://t.co/96Hkh21wSr
Survey of physician assistants finds 56% use AI daily (19% AI extensively). 87% PAs say they need to learn more about AI, 83% desire formal, employer-led AI training. 89% believe AI will dramatically changes PA practice, but only 32% have clear workplace guidelines on AI usage https://t.co/yGqZRC3mNt
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RheumNow Live 2026 is coming February 7th and 8th to Dallas, Texas - and registration is now open! This year’s program covers vasculitis, autoimmune disease, PsA, RA outcomes, spondyloarthritis, and much more. Reserve your spot today at https://t.co/o78Pc8LPsQ