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: Antifibrotics - A New Class of Therapies in Rheumatology?
Rheumatologists typically manage systemic autoimmune rheumatic diseases and associated interstitial lung disease with immunosuppressants. However, evidence increasingly supports also the use of antifibrotic agents in this setting.
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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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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/XddFDe0xh8
Dr. John Cush @RheumNow( View Tweet )
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/vJJRflJ23x
Dr. John Cush @RheumNow( View Tweet )
FDA has approved nerandomilast (Jascayd) for the treatment of progressive pulmonary fibrosis (PPF) in adults, based on the results of the phase 3 FIBRONEER trial. Nerandomilast is PDE4 inhibitor,, in Oct 2026 it was approved for use in diopathic pulmonary fibrosis (IPF) https://t.co/WVrGj7q7hB
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 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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Lyme disease is endemic in Massachusetts. EHR study shows Lyme dz incidence declined from 211 per 100 000 patients in 2012 to 86 per 100 000 in 2024 (P< .001), but this decr. was driven by 1 large practice group implemented a new initiative to reduce Lyme Dx & Rx in pts w/ https://t.co/lMCUA9o4Uc
Dr. John Cush @RheumNow( View Tweet )
Tricks of the Trade – Clinic Advice from APPs
J. Cush and many APPs
December 2025 is focused on advanced practice providers, their impact, education and priorities. In seeking and soliciting the help and advice of leaders in the rheumatology APP world, I have been impressed by APP pride, dedication and passion for what they do.
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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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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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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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British Society of Rheumatology Guideline for Monitoring DMARDs
The British Society of Rheumatology has published an update to their previous 2017 BSR/BHPR guideline regarding the use and monitoring of DMARDs (disease-modifying anti-rheumatic drugs) used to treat systemic https://t.co/iANvir1EFI
Dr. John Cush @RheumNow( View Tweet )
PSS & Biomarkers: Dutch international scleroderma trial of 21 pts showed that cartilage oligomeric matrix protein (COMP), and collagen type IV alpha 1 (COL4A1) significantly correlated with modified Rodnan skin score; COMP were associated with mRSS change (r = 0.013) https://t.co/E7SgmIiYmn
Dr. John Cush @RheumNow( View Tweet )
Taiwanese retrospective study (2001-2022) of 2,383 PsA pts Rx w/ 1+ DMARDs. Comparing 1,190 bDMARDs vs 1,193 cDMARD Rx pts, bDMARDs assoc. w/ signif lower risk of MACE (HR 0.65), all-cause mortality (0.44), CV mortality (0.54), but more infx related Hosp (1.45) https://t.co/eu7fSVkjZl
Dr. John Cush @RheumNow( View Tweet )
B Cell Targeting in Idiopathic Thrombocytopenic Purpura
The New England Journal of Medicine has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune https://t.co/VN0KjE478B
Dr. John Cush @RheumNow( View Tweet )
FDA has issued its final guidance on: Promotional Labeling and Advertising Considerations for Prescription Biological Reference Products, Biosimilar Products, and Interchangeable Biosimilar Products: Questions and Answers https://t.co/69sbgoWnSW https://t.co/kpTgdPOkka
Dr. John Cush @RheumNow( View Tweet )
FDA has issued its final guidance on: Promotional Labeling and Advertising Considerations for Prescription Biological Reference Products, Biosimilar Products, and Interchangeable Biosimilar Products: Questions and Answers https://t.co/bjiV4S0Fur https://t.co/dDyJqhV5VF
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Dr. John Cush @RheumNow( View Tweet )
The countdown is on! ⏱️
Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one.
✅ Register now at https://t.co/4UQlqwujiR
🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu
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Dr. John Cush @RheumNow( View Tweet )
Medical Cannabis for Pain Management
Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients.
Chronic pain affects more than one in five American adults, yet practitioners are limited in treatment alternatives. Even if we exclude the
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B Cell Targeting in Idiopathic Thrombocytopenic Purpura
EurekAlert!
The New England Journal of Medicine has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune
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QD Clinic: CAR-T Cell Therapy for Lupus
Philip Mease, MD and Cayla Alexander, DNP, ARNP, Seattle, Washington, discuss the case of a patient with lupus who underwent CAR-T cell therapy for her disease. This QD clinic is presented as part of RheumNow's "Mission: APP Partners in https://t.co/WXWOLupWna
Dr. John Cush @RheumNow( View Tweet )
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