ANA Pollution (2.06.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory news from this past week on RheumNow.com
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FDA vs. Amgen: At Odds Over Avacopan
MedPage Today
The FDA has requested that Amgen voluntarily withdraw avacopan (Tavneos), a treatment for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, but the company said it has no plans to pull the drug from the market.
Originally developed by ChemoCentryx, the oral
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ACR Applauds Recent Government Funding
ACR
The American College of Rheumatology (ACR) today applauded the recent passage of the Congressional CY 26 funding package that includes several important provisions, including extending Medicare telehealth payment flexibilities, improving transparency in pharmacy benefit management (PBM)
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Which Fibromyalgia Drugs are Cost-Effective?
A cost-effectiveness analysis compared FDA approved fibromyalgia (FM) drugs (pregabalin, duloxetine, milnacipran) with amitriptyline and found duloxetine was the preferred strategy across perspectives.
https://t.co/5NZeYquGxs https://t.co/rhcwH2yLEm
Dr. John Cush @RheumNow( View Tweet )
Which Fibromyalgia Drugs are Cost-Effective?
A cost-effectiveness analysis compared FDA approved fibromyalgia drugs (pregabalin, duloxetine, milnacipran) with amitriptyline and found duloxetine was the preferred strategy across perspectives.
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Methotrexate intolerance in rheumatoid arthritis
A current large rheumatoid arthritis (RA) cohort study from Cairo assessed methotrexate (MTX) use and found over half were MTX intolerant and a third of patients were noncompliant with MTX.
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PA Assn President position on DES/gov Proposed Rule on Federal Student Loans "... loan rule is deeply flawed, outside the Dept’s authority...inconsistent w/.. Trumps rural healthcare workforce priorities.. excluding PAs will decimate US healthcare workforce pipeline" https://t.co/p5owv3Ui2B
Dr. John Cush @RheumNow( View Tweet )
TOPKAT Trial: Partial vs Total Knee Replacement
MedPage Today
Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little bit better.
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Lupus Foundation announced today that US House of Representatives have approved $27 Million in Funding for Lupus Programs in 2026 w/ fund available from (CDC), OMH, & DoD. Funding increased 40% @ CDC, 33% @OMH, & $415 million @ National Institutes of Health https://t.co/ENcykcW7yA
Dr. John Cush @RheumNow( View Tweet )
Consensus on Managing Vertebral Fractures in Advanced CKD
EurekAlert!
A coalition of leading international experts have released the first comprehensive Consensus Statement on the Management of Vertebral Fractures in Chronic Kidney Disease (CKD) Stages G4–G5D. The statement highlights a neglected yet devastating complication of advanced
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Treat-to-Target in Gout and Cardiovascular Outcomes
A 5 year JAMA study shows that a treat-to-target (serum urate < 6 mg/dL) study finds that effective urate-lowering treatment (ULT) results in a significantly reduced cardiovascular risk in patients with gout.
These findinds are significant knowing that
Trends in Rheumatoid Arthritis Mortality
A recent study examines trends in rheumatoid arthritis (RA)-related mortality among U.S. postmenopausal women (aged 55 and older). They found RA mortality rates have declined, yet disparities in who is most affected persist, especially for white women, and those over 85 yrs of age.
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Reduced Healthy Working Life Expectancy with Arthritis
MedPage Today
Using the long-running, U.S.-based Health and Retirement Study (HRS), which enrolls people age 50 and older, as the data source, Ross Wilkie, PhD, of Keele University in Staffordshire, England, and colleagues estimated that those reporting an arthritis diagnosis could expect just 6.18 more years
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APPIPRA Study - Benefits of Early Treatment
EurekAlert!
Treating people who are at high risk of rheumatoid arthritis (RA) can delay the onset of the disease for several years, with benefits also continuing well after treatment has stopped.
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Medicare Primary Care Shortage - betw 2013 -2021, PCPs decr 25%, while APPs rose 91%. 2021 AVAILABILITY per 10,000 Medicare beneficiaries; - Total clinicians: 23.4 to 22.2 (–5%) - Total new visits: 1162 to 1102 (–5%) - Total PCPs: 20.0 to 15.5 (–22%) - APPs: 3.4 to 6.7 (+97%) https://t.co/ALQI3O3Ian
Dr. John Cush @RheumNow( View Tweet )
2024 Cardiology Income Survey - CV APP salary has incr 15% from 2019 -23, median=$123K - 50% of APP programs lead by an APP >90% work in outpt. clinics - 2/3 of prgs deploy APPs lipid & prevention management - 2 APPs for every 3 cardiologists https://t.co/gtdm5qN1qD https://t.co/cx2JUcw4U3
Links:
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Emergency Department Visits by Rheumatoid Patients
A Canadian population study shows that rheumatoid arthritis (RA) patients have 30% higher emergency department (ED) visit rates for Ambulatory Care Sensitive Conditions (ACSCs) compared to age- and sex-matched population controls.
Smartphones and Rheumatoid Flares
FORWARD Databank of Rheumatoid arthritis (RA) patients reveals that smartphone data can predict flares using PROs.
RA flares are seen in 30-60% of patients, are hard
Nurse Practitioner Independence
A JAMA Viewpoint article reports on a March 2025 Nurse Practitioner (NP) Entrepreneurship Summit in Boston in March 2025 identifying barriers and opportunities to NP-owned medical practices.
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Nursing Shortage Could Worsen Due to Limited Student Loans
On 11/6, a DOE rule-making committee released a new proposed framework excluding nursing from the so-called "professional degree" category -- a plan which, if finalized, would limit nurses' access to certain student https://t.co/0zpznqgdb7
Dr. John Cush @RheumNow( View Tweet )
The 2025 Rheumatology Year in Review
The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.
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Antirheumatic drug use with rheumatoid arthritis pregnancies
A nationwide Norwegian registry study of rheumatoid arthritis (RA) pregnancies showed that while medication use increased during pregnancy, many discontinued treatment during pregnancy, only to resumed it after childbirth.
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Nursing Shortage Could Worsen Due to Limited Student Loans
MedPage Today
In November, we reported on nursing groups that pushed back against a Trump administration proposal to de-list nursing as a professional degree for purposes of student borrowing. In this report, we look ahead to see what might happen as a result of the policy change.
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GLP-1 Agonist plus IL-17 Inhibition in Obese Psoriatic Arthritis
Lilly announced the topline results from its phase 3b "TOGETHER PsA" trial, showing that the combination use of ixekizumab (Taltz) and tirzepatide (Zepbound) was superior to IXE alone, yielding both significant weight loss and ACR50 disease control in adults with active psoriatic arthritis (PsA
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2025 Rheumatologists, In Memorium
In 2025, Rheumatology lost many of our greatest clinicians, compatriots, and mentors. This is an honor roll for those who cared, taught, advised and supported many patients, and many of us.
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The advantage to patient care without the crutch of an EHR. What do you do?
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Therapeutic Updates
The Impact of Obesity on Psoriatic Arthritis
Sponsored by Lilly Medical Affairs
Obesity is common in PsA and may worsen disease activity and reduce treatment effectiveness through shared inflammatory pathways. Weight intervention may improve outcomes and support achievement of targets of disease control.
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