Doubting RS3PE (8.14.2026)
Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.
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2026 BSR Pain Guideline: What Rheumatologists Need to Know
The British Society for Rheumatology has issued its first guideline dedicated solely to pain in inflammatory arthritis (IA)—covering RA, PsA, axial SpA and JIA.
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UK Clinical Practice Research Database study RA pts 3134 on glucocorticoids (vs not 4142 matched controls). were identified. GC use assoc w/ signif risk of SSRI initiation risk - recent GC (adj OR 1.53) & past GC (aOR 1.40). GC effect or confounding dz activity? Think depression! https://t.co/WZLkQWlURC
Dr. John Cush @RheumNow( View Tweet )
True or False: Neuropsychiatric SLE (NPSLE) was associated with a higher odds ratio for cerebral atrophy compared to age.
See if you got it right in this week's RheumIQ quiz at https://t.co/yQn8cIT5Cw. https://t.co/YjHwLFclv4
Dr. John Cush @RheumNow( View Tweet )
💡 JAMA Insights: #SleepHealth and #obesity are linked, with insufficient sleep quantity and poor sleep quality associated with weight gain, less healthy diet, and incident obesity.
https://t.co/SEj9dwNHiW https://t.co/JbPah4BwDr
JAMA @JAMA_current( View Tweet )
Machine learning study of 657 multiethnic Lupus pts - 14% had organic & 30% had neuropsychiatric damage. High Glucocorticoid dose was the strongest predictor or organic Dz. NP damage predicted by MD global, fatigue, pain, & steroids https://t.co/LVK57LxKk6 https://t.co/VLisZT7ReY
Links:
Dr. John Cush @RheumNow( View Tweet )
The Power of Self-Management with Chronic Low Back Pain
EurekAlert!
Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the workforce
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Spotlight on Comorbidities from EULAR 2026
EurekAlert!
Systemic autoimmune diseases are associated with increased cardiovascular morbidity and mortality – possibly through autonomic imbalance, myocardial inflammation, or fibrotic infiltration of the conduction system. A team in Colombia have been looking into the
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Self-Directed Cognitive Behavioral Therapy for Chronic Pain
Is self-directed cognitive behavioral therapy (CBT) when augmented with asynchronous, personalized feedback for chronic pain (CBT-CP) superior to clinician-delivered CBT-CP?
https://t.co/P2DDvCiLNL https://t.co/hyAArEG6V1
Dr. John Cush @RheumNow( View Tweet )
Generic Tofacitinib (6.26.2026)
Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Updates on tofacitinib, CAR-T therapy and AI.
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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 )
Self-Directed Cognitive Behavioral Therapy for Chronic Pain
Is self-directed cognitive behavioral therapy (CBT) when augmented with asynchronous, personalized feedback for chronic pain (CBT-CP) superior to clinician-delivered CBT-CP?
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, drawing on 108 publications identified from a PubMed search (2005–2026) and the most recent guidelines from the WHO, ACP, and NICE.
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US telehealth utilization rose 10.1% in 1st quarter of 2026 (5% to 5.51% medical claims). Most use in mental health conditions (52%) w/ joint/soft tissue dz at 3% overall, higher in west & NE states. 57% for outpt visits, only 7.7% for new visits. 35% for psychotherapy services. https://t.co/L8c7p3iQPL
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
Mrinalini Dey @DrMiniDey( View Tweet )
Depression at RA diagnosis did not predict short-term CV events in a nationwide early RA cohort
-17,669 early RA pts
-7.3% BL depression
-Median follow-up 1.2 years
-No association w/ CV hospitalisation after adjustment (sHR 1.05)
Reassuring short-term data, longer follow-up https://t.co/XmMVGY1VlI
Aurelie Najm @AurelieRheumo( View Tweet )
Using AI to integrate EHR, SDOH , psychological data - can help finding psychosocial risk factors.
Complex cases can be diagnosed using solutions (iceberg health) like this. #EULAR2026 @rheumnow https://t.co/t4keRbpkrx
Links:
Bella Mehta @bella_mehta( 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
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
🔍 Do posterior element lesions progress over 10 years in axSpA?
Data from the DESIR inception cohort (n=320) says RARELY!
But baseline PE inflammation raises facet ankylosis risk ~70-fold
#POS0189 #EULAR2026 @RheumNow https://t.co/PdwlPGjKqK
Nelly ZIADE 🍀 @Nellziade( View Tweet )
D2T RA shows a linked brain–psychology–immune signature
Cohort D2T RA vs non-D2T RA vs HC
91% D2T RA
Higher catastrophizing
Higher pain sensitivity
More emotion-focused coping strategies
“Chronic pain-like” profile
Associated with higher CNS related gene expression NRG1 https://t.co/nkQco73vqI
Aurelie Najm @AurelieRheumo( View Tweet )
Sad to see this but important to be aware. Increasing risk of suicide using colchicine in Familial Mediterranean Fever. #POS0768 #EULAR2026 @rheumnow.
Average age 28! 87%female, only 7 % with psychiatric referral!
Retrospective 15 pts. https://t.co/241SE6O395
Links:
Bella Mehta @bella_mehta( View Tweet )
RA comorbidities are changing. ILD, anxiety, depression increasing. Less extraartic. manifestations, CA & CV dz. Consider screening for cervical CA, ILD, CV dz & OP (for pts on steroids) https://t.co/WVITFXNva7 https://t.co/tggdaO9RJB
Dr. John Cush @RheumNow( View Tweet )
Integrating D2T into T2T Practices in RA
Researchers at Semmelweis University analyzed how depression, smoking, obesity, sleep disorders, and other health problems are linked to difficult-to-treat rheumatoid arthritis (D2T-RA) and how this can inform treat-to-target (T2T) and https://t.co/buCXeK2jNS
Dr. John Cush @RheumNow( View Tweet )
Integrating D2T into T2T Practices in RA
EurekAlert!
Researchers at Semmelweis University analyzed how depression, smoking, obesity, sleep disorders, and other health problems are linked to difficult-to-treat rheumatoid arthritis (D2T-RA) and how this can inform treat-to-target (T2T) and individualized therapy.
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"Courage is resistance to fear, mastery of fear, not absence of fear."
- Mark Twain https://t.co/xyJqiV7biI
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”.
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The presence of comorbidities naturally complicates treatment choice, patient adherence to medication and patient outcomes, increasing also the risk of making RA ‘difficult-to-treat’.
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With the increasing development and use of new biologics and oral targeted therapies to treat RA and other immune mediated inflammatory diseases, an awareness of infection risk and prevention has become of increasing interest as well. While our patients may be susceptible to many different types of infections depending on immunosuppressive regimen, age and co-morbidities, I’ll highlight a few of the “usual suspects”.
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Podcasts
EULAR 2026 Daily Podcast Day 2a
