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Anti-Rheumatic Rx

SMART study - Single vs. Split Dose Methotrexate in RA Split dose weekly, oral methotrexate (MTX) was shown to be superior to single dose MTX in treating active rheumatoid arthritis (RA) patients. https://t.co/JN5wPGNjao https://t.co/hI8dxWmZe8
Dr. John Cush @RheumNow( View Tweet )

Best of 2025: 2025 BSR Guideline for Treatment of Axial Spondyloarthritis

Editor's note: This article was originally published April 22, 2025, and is being shared again as part of RheumNow's 'Best of 2025' series as we close out the year. Enjoy!

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2025 update of EULAR recommendations on lupus nephritis At the 2025 EULAR congress in Barcelona, Prof Dimitrios Boumpas presented updated EULAR recommendations on managing lupus nephritis (LN). The key change is that the historic standard of care (mycophenolate with https://t.co/78J1L80Zxe
Dr. John Cush @RheumNow( View Tweet )

Best of 2025: Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients

More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the

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Best of 2025: ERS/EULAR guidelines for CTD-related interstitial lung disease

The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in

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Hydroxychloroquine for Everyone Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, https://t.co/rlnogTqk49
Dr. John Cush @RheumNow( View Tweet )
Rapid rituximab infusions are safe & efficient. Metanalysis of 7 RCTs, 538 pts w/ autoimmune/rheumatic dz, showed infusions(RTX 1000 mg) of 90-120 min (w/ premedication) had low risk (3-15%) of mild (Grades 1, 2) infusion Rxns; only 6 Grade 3 Rxns https://t.co/uVKuhhc80F https://t.co/9EhyBpSaAE
Dr. John Cush @RheumNow( View Tweet )

Best of 2025: Targeting Obesity in Rheumatic Disease Patients

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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JAMA -- Full read review "Uveitis in Adults:" - affects adults 20 to 50 years - noninfectious anterior uveitis: corticosteroids 1st line Rx - posterior noninfectious uveitis: DMARDs 1st line Rx; Biologics 2nd line https://t.co/BJQkPtK2z2 https://t.co/0puqX5iieE
Dr. John Cush @RheumNow( View Tweet )
Best of 2025: Antifibrotics - A New Class of Therapies in Rheumatology? Recent large-scale clinical trials have broadened therapeutic options for SARD-ILD beyond immunosuppressants, offering new hope for patients with these serious conditions. https://t.co/RLlOdEWTOa https://t.co/UI9cdJ5Ovd
Dr. John Cush @RheumNow( View Tweet )

Best of 2025: Hydroxychloroquine for Everyone

Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA

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2025 ACR Guideline for the Treatment of SLE The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE. https://t.co/2NFwTllLZa https://t.co/S7Cwzbgnde
Dr. John Cush @RheumNow( View Tweet )
Best of 2025: Methotrexate intolerance in rheumatoid arthritis Methotrexate (MTX) is the most commonly used DMARD in rheumatoid arthritis (RA); however, there is significant intolerance to this drug among adult RA patients - especially at doses above 15 mg per week. https://t.co/hzfF7UVKVI
Dr. John Cush @RheumNow( View Tweet )

Best of 2025: Distinguishing Septic and Gouty Arthritis

A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal threshold of 50,000 cells/mm3.

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Best of 2025: Dermatomyositis Reviewed

Researchers from the University of Pennsylvania have published an open-access review of dermatomyositis (DM) - its manifestations, hallmark cutaneous features, etiopathogenesis and treatment options.

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Best of 2025: Vitamin D for Prevention of Disease

JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults.

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Best of 2025: Methotrexate intolerance in rheumatoid arthritis

Methotrexate (MTX) is the most commonly used DMARD in rheumatoid arthritis (RA); however, there is significant intolerance to this drug among adult RA patients - especially at doses above 15 mg per week.

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Best of 2025: Overview of the VEXAS Syndrome

A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.

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Optimizing Hydroxychloroquine Blood Levels in Lupus A large observational cohort study suggests that monitoring hydroxychloroquine (HCQ) blood levels is effective in systemic lupus erythematosus (SLE) patients with a target therapeutic range (for HCQ level monitoring) of https://t.co/7pggMk2pTO
Dr. John Cush @RheumNow( View Tweet )

Telling You Where to Go (12.19.2025)

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?

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Disease Activity Criteria for Adult-Onset Still's Disease: EULAR Points to Consider

EULAR has published a "points to consider" (PtCs) guidance on the development of criteria for the assessment of the disease activity in adult-onset Still’s disease (AOSD).

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ACR: New Data Highlights Urgent Need to Address Arthritis Burden

New findings from national U.S. surveys reveal the profound impact of arthritis on millions of adults, especially those facing social and economic challenges. These data will be featured in an upcoming issue of Arthritis Care & Research, an official journal of the American College of

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Role of the Nurse in the Care and Management of Rheumatic Diseases - EULAR Review

In 2023, a EULAR subcommittee set out to assess the roles of nurses and Advanced Practice Nurses (APN) in the care of arthritis as outlined in published EULAR guidelines. The scope of APN practices was first proposed in 2012 and revised in 2018. EULAR updated its recommendations for the role

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In US, Tofacitinib loses patent exclusivity & goes generic in 2026. Worldwide Tofa sales in 2024 were $3.08 billion (55% use in RA; N. America 1st w/ ~38% of market). Tofa sales projected to rise to $5.7 bill in 2029 https://t.co/nKPaQdglYw https://t.co/DdMymmk8go
Dr. John Cush @RheumNow( View Tweet )

Optimizing Hydroxychloroquine Blood Levels in Lupus

A large observational cohort study suggests that monitoring hydroxychloroquine (HCQ) blood levels is effective in systemic lupus erythematosus (SLE) patients with a target therapeutic range (for HCQ level monitoring) of 750-1150 ng/ml.

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