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Clinical Skills

Systemic Sclerosis Future Therapies and Outcome Measures

May 19, 2020

Nagaraja, Khanna and colleagues have published an overview of current and future therapies in patients with systemic sclerosis (SSc) and have reviewed the potential outcome measures for this difficult autoimmune disorder. Notably there have been several novel agents studied in recent years,

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Interview w/ Private Practice Rheums on Covid - Drs. Herb Baraf and Danny Ricciardi. DC & Brooklyn Docs wrangle technology, Telehealth, Return to normal, the future and more.

Dr. John Cush RheumNow ( View Tweet)

May 13, 2020

Secukinumab Better than Adalimumab - Maybe?

May 11, 2020

The EXCEED study was a head-to-head trial of secukinumab (SEC) versus adalimumab (ADA) as first-line monotherapy in psoriatic arthritis (PsA) patients; this 52 week trial showed that while SEC failed to achieve clinical superiority over ADA, SEC treated patients demonstrated higher

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Physical Activity Prevents Hospitalization

May 06, 2020

Modifiable lifestyle choices can impact long term health.  A recent study shows that usual and increased physical activity can results in less hospitalization amongst the the general population.

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ACR: In-Person Urgent vs. Virtual Non-Urgent Medical Care

May 05, 2020

On April 26, 2020 the American College of Rheumatology (ACR) published a guidance paper to assist rheumatologists and rheumatology health professionals in assessing the need for urgent or face-to-face medical care versus virtual or telehealth patient care.  The driving principals being the

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Biologic Dose Cuts Feasible in RA

May 04, 2020

Many patients with rheumatoid arthritis (RA) who achieved remission or low disease activity on biologic treatment were able to reduce the dose of their biologic, particularly if they were also on methotrexate, a retrospective study found.

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Rheum Views on the Upside and Downside of COVID-19

Apr 29, 2020

The world has been turned upside down in the last 6 weeks. Medicine and rheumatology have certainly changed – a frightening experience for Chicken Little, a disaster for the pessimist, a challenge for the pragmatist and an opportunity for the optimists amongst us. Last week I asked our audience

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TNR Grand Rounds - Moving Forward with Telemedicine

Apr 22, 2020

Dr. Alvin Wells gives a primer on Telerheumatology and Telemedicine in the era of COVID-19. This 1 hour Grand Rounds Presentation includes a 30 minute lecture, followed by stimulating 30 minutes of Q&A with a rheumatology attendee audience.

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Tuesday Nite Rheumatology Grand Rounds - Febrile Disorders

Apr 17, 2020

Dr. Jack Cush reviews the appproach to evaluating fever in adults suspected of having a rheumatic disease, Stills disease or autoinflammatory conditions. Presentations, fever duration, disease criteria and genetic testing are discussed.

For more information on this subject or use of

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COVID-19 Systemic Involvement

Apr 15, 2020

The presentations of the COVID-19 infection have been clearly chronicled with the worrisome onset of sore throat, dry cough, loss of smell and taste with fevers, myalgias, fatigue and the worrisome progression of pulmonary involvement in a minority.  Lab findings may include a leukocytosis,

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ACR COVID-19 Guidance for Rheumatic Disease Patients

Apr 14, 2020

On April 11th, the ACR Board of Directors approved a COVID-19 guidance document written by an ACR task force charged with updating and clarifying recommendations for rheumatologists and rheumatic disease patient management during the current COVID-19 crisis.

This ACR release, in its

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Post 9/11 Autoimmune Disease Risk

Apr 14, 2020

The 9/11/01 terrorist attach on the World Trade Center (WTC)  resulted in at least 2,977 fatalities, over 25,000 injuries, and caused at least $10 billion in infrastructure and property damage.  Arthritis & Rheumatology reports that dust cloud exposure among responders and PTSD

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TNR - Grand Rounds: Safety of Biologics & New Agents

Apr 08, 2020

On Tuesday, April 7th, RheumNow hosted its first Tuesday Nite Rheumatology webinar - kicking off a two-month series of Rheumatology Grand Rounds lectures.  The first session featured Jack Cush, MD (UT Southwestern) who lectured on "The Safety of Biologics and Newer Agents".

This 30

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NICE Guidelines on Managing Rheumatologic Conditions During COVID-19 Pandemic

Apr 07, 2020

On April 3rd, the National Institute for Health and Care Excellence (NICE) in the UK, published a rapid guideline for managing children and adults with rheumatological autoimmune, inflammatory and metabolic bone disorders during the COVID-19 pandemic, while protecting staff from infection.

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TeleRheumatology - a TED Talk by Alvin Wells, MD

Mar 30, 2020

RheumNow Live 2020 featured a series of shorter STEP (TED-like) talks. This one features Dr. Alvin Wells discussing the opportunities and new paradigms encumbent with telemedicine in rheumatology.

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Infusions in the Time of Coronavirus

Mar 20, 2020

As they say, necessity is the mother of invention. After years of bemoaning the challenges of telemedicine, our rheumatology clinic transition entirely to a remote clinic in the space of a week. One of the few good things to come out of this crisis is that we may learn that in-person visits

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In Lupus, Keep BP Below 130/80

Mar 18, 2020

Blood pressure should be maintained at a level below 130/80 mm Hg in all patients with lupus to lessen their likelihood of atherosclerotic vascular events, Canadian researchers asserted.

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A Rheumatologist’s Tips: Telemedicine in 6 Easy Steps

Mar 18, 2020

Ready for telemedicine/telerheumatology?

Once you and your patient agree on a virtual visit, the following suggestions may help facilitate the interaction. If you have the ability and the capacity, record the visit.

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The COVID-19 Global Rheumatology Registry

Mar 17, 2020

As the highly virulent SARS-CoV-2 spreads over the world, uncertainty and fear for our patients with rheumatic diseases mount.  

As of March 17, 2020 over 183,000* cases of Coronavirus disease 2019 (COVID-19) have been recorded, with the majority in China and Europe, but that may be the

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RheumNow Podcast- Corona Increases RA Risk (3.13.20)

Mar 13, 2020

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

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Primary Care Visits Decline 2008-2016

Feb 17, 2020

A national claims-based analysis has shown a consistent decline, by commercially insured adults (18-64 yrs), in primary care physician visits from 2008 to 2016; with nearly one half having no PCP visits in a given year by 2016. 

Efforts to contain costs and improve clinical outcomes

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RheumNow Podcast - RWCS Quick Hits (2.14.20)

Feb 14, 2020

Dr. Jack Cush reviews the highlights from the 2020 RWCS meeting in Maui, Hawaii.

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DMARD Inertia by Registry Rheumatologists

Feb 10, 2020

A registry study of metric use (primarily RAPID3 and CDAI) in the treatment of rheumatoid arthritis (RA) patients shows that, even in the face of moderate or high disease activity, treatment changes by rheumatologists were relatively low (35.6–54.6%).

Researchers used data from the ACR

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Bariatric Weight Loss Fails to Alter RA Risk

Feb 06, 2020

Obesity has been shown to be a risk factor for the onset of rheumatoid arthritis (RA) and also shown to affect outcomes by impairing responses to many DMARD therapies. A Swiss study of RA patients undergoing bariatric surgery failed to show that bariatric surgery and weight loss had any effect

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RheumNow Podcast- A Good First Impression (1.24.20)

Jan 24, 2020

Dr Jack Cush comments on this week's journal articles, reviews and studies.

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