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What Worries You, Masters You (7.1.2022)

Jul 01, 2022

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.




  1. FDA approved Abbvies risakizumab-rzaa

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Podcast on Podcasting (6.24.22)

Jun 24, 2022

A tutorial on podcasting - what works and what does not, 7 keys to podcast success, who and what is it for, and more!

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Simultaneous Versus Staged Knee Arthoplasty?

Jun 23, 2022

Aside from cost, there are significant concerns regarding efficacy and safety outcomes and recovery time. These issues are compounded with the need for bilateral TKR, wherein the patient and surgeon need to decide whether to have both TKRs done simultaneously or staged (single TKR one after

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Burnout Threatens the Rheumatology Workforce Conundrum

Jun 21, 2022

There is a shortage of rheumatologists in Canada and the recent 2020 Canadian Rheumatology Association (CRA) Workforce and Wellness study shows that the shortage may be compounded by rheumatologist burnout, especially among young and female physicians. 

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Two Week Twitter (6.17.2022)

Jun 17, 2022

Dr. Jack Cush does a 2-week review of RheumNow Tweets on news and journal citations worth noting, along with some opinions on Telehealth, manpower, monkeypox and the price of drugs.




  1. Although Rheumatology currently ranks 2nd or 3rd in specialty use of telemedicine - the vast

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ACR Applauds FTC Decision to Investigate PBM's

ACR Press Release
Jun 13, 2022

The American College of Rheumatology applauds the Federal Trade Commission’s decision to investigate the business practices of pharmacy benefit managers (PBMs), which continue to increase PBM profit margins while placing the burden of skyrocketing drug costs on America’s most vulnerable

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Price of a newly launched drug increased from $2115 per year in 2008 to $180 007 per year in 2021. In 2008 only 9% of drug cost >$150k/yr; this rose to 47% by 2021. Greater increases seen w/ biologics, rare disease and nononcology drugs https://t.co/JaGzNqCxdF

Dr. John Cush @RheumNow( View Tweet )

Jun 10, 2022
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To TDM or Not in Rheumatology?

May 24, 2022

Therapeutic Drug Monitoring (TDM), especially for biologic therapies, has become a standard in gastroenterology, but shunned by most rheumatologists. Until recently there were few studies to support it's benefit in rheumatoid arthritis (RA) or psoriatic arthritis (PsA), but now EULAR has

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Biologic Persistence in Psoriatic Arthritis and Psoriasis

May 19, 2022

Two recent studies examined the durability and persistence of biologic agents in patients with psoriasis (PSO) and psoriatic arthritis (PsA) and while some differences were noted overall persistence was low 3 years later.

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Rising Incidence of Systemic Lupus Erythematosus

May 17, 2022

Data from Olmstead county, MN over the past four decades shows that the incidence and prevalence of systemic lupus erythematosus (SLE) is increasing.



SLE was diagnosed using the EULAR/ACR criteria and looked at patients seen between 1976–2018.



They identified a total

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Acute Inflammatory Responses Needed to Resolve Chronic Pain

May 16, 2022

Science Translational Medicine has published results of a Canadian study of low back pain (LBP) suggests that pain control by anti-inflammatory treatments might have negative effects on pain duration and may be counterproductive for long-term pain outcomes.

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Bimekizumab Development Delayed by FDA

May 16, 2022

UCB announced they have received a Complete Response Letter (CRL) from the U.S. Food and Drug Administration (FDA) regarding the Biologics License Application (BLA) for bimekizumab for the treatment of adults with moderate to severe plaque psoriasis (PSO).

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Methotrexate Monitoring (5.13.2022)

May 13, 2022

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Bad news for digitial ulcers in Systemic sclerosis, Readmissions in Lupus and Thrombocytopenia in APL patients.




  1. Risk factors for readmission among 132,400 #SLE hospitalizatiions included

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A Day in the Life: Consults with a Rheumatology Fellow

MedPage Today
May 13, 2022

Join medical resident Siobhan Deshauer, MD, as she visits three hospitals for inpatient rheumatology. Watch the video or read the partial transcript below.  Siobhan Deshauer, MD, is an internal medicine resident in

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Diagnostic Delays in Spondyloarthritis Still Prolonged

May 09, 2022

Previously quoted average  delay in diagnosing axial spondyloarthritis (axSpA) may be improving as a recent UK study shows the mean average time to diagnosis in two different NHS trusts was between five and six years. 



The diagnostic delay in axSpA has been attributed to a slower

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Trends in Rheumatoid Arthritis Disabililty, Despite Biologics

MedPage Today
May 03, 2022

Disability claims in the U.S. related to rheumatoid arthritis (RA) were just as common in 2015 as in 1999, a government researcher found, against expectations that the advent of biologic therapy would have led to a steady decrease.



Over that 17-year period, rates of Medicare

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Consensus Best Practices for Virtual Care in Rheumatology

Apr 13, 2022

The Canadian Rheumatology Association’s (CRA) Telehealth Working Group (TWG) has developed a series of best practice statements for the virtual care in adult and pediatric rheumatology patients.

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The Effect of Socioeconomic Status on Lupus Outcomes Socioeconomic status (SES) often associates with poorer outcomes in systemic lupus erythematosus (SLE) patients; and a current study suggests this is unrelated to healthcare access issues.https://t.co/J1BMlsakGN https://t.co/BNhCN89Pqv
Dr. John Cush @RheumNow( View Tweet )
Mar 31, 2022
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The Effect of Socioeconomic Status on Lupus Outcomes

Mar 30, 2022

Socioeconomic status (SES) often associates with poorer outcomes in systemic lupus erythematosus (SLE) patients; and a current study suggests this is unrelated to healthcare access issues.



A retrospective cohort of 617 adult SLE patients followed in tertiary medical centers were

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malar lupus

Poor Outcomes in Lupus Patients Not at Target

Mar 22, 2022

A prospective, longitudinal systemic lupus erythematosus (SLE) cohort study examined outcomes and showed that failure to control SLE was common and associated with poorer outcomes including organ damage, glucocorticoid exposure, poor quality of life, and increased mortality.

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Adalimumab Addition vs. Methotrexate Escalation in Psoriatic Arthritis

Mar 21, 2022

An interesting study in Lancet Rheumatology shows that psoriatic arthritis patients not responding to methotrexate alone can respond after adding or escalating adalimumab (ADA) on top of methotrexate (MTX) to reach minimal disease activity (MDA) response. 

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Disappointment Behind Acute Gout Hospitalizations

Mar 16, 2022

Analysis of emergency department visits from two UK hospitals shows a high rate of hospitalization, and low use of urate-lowering therapies (ULT) and treat-to-target (T2T) management. 



Between 2017 and 2020 there were 1,220 emergency attendances for gout flares -  23.5% required

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Ethnic and Behavioral Drivers of Gout Risk

Mar 07, 2022

Gout is common but disproportionately affects certain groups (e.g., the elderly, Pacific Islander, Blacks). Ethnic links to gouts were also shown to be linked to modifiable behavioral factors and such information maybe useful in managing gout patients.

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Vaccination,vaccine

Downside of Holding Methotrexate with COVID-19 Vaccination

Feb 28, 2022

A recent prospective, randomized, blinded clinical trial has shown that a 2 week hold of methotrexate (MTX) following COVID-19 (Sinovac-CoronaVac) vaccination resulted in greater anti-SARS-CoV-2 immunogenicity; but there was an increase in flare rates after the second dose of vaccine.

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Diagnostic Delay in Axial Spondyloarthritis (2.25.2022)

Feb 25, 2022

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week, rheumatologic problems incited by respiratory infections, air pollution and how you live, now where you live.




  1. Diagnostic delay in axial spondyloarthritis? Systematic review

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