APPs in the News (12.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.
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High Cost of Cancelling Knee Replacement Surgery
Thousands of NHS knee replacement operations are cancelled at short notice every year, many for avoidable reasons, according to a new study published December 1st. This costs the NHS millions of pounds and increases waiting times https://t.co/USWAPC0k6N
Dr. John Cush @RheumNow( View Tweet )
DMARD Treatment Lags for Minority Groups with Rheumatoid Arthritis
MedPage Today
Use of disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) was markedly lower among all major racial-ethnic minority groups in the U.S. compared with white patients, analysis of federal survey data indicated, even after adjusting for income, education, and other factors
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Changing Loan Limits for Advance Practice Providers
The "One Big Beautiful Bill" (OBBB), or H.R. 1, was signed into law in July, calls for significant changes in the funding of healthcare education. This bill that lowers cap limits on education loans applies to graduate (APRN, PA) programs. It was driven by the need to lower the US
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High Cost of Cancelling Knee Replacement Surgery
Thousands of NHS knee replacement operations are cancelled at short notice every year, many for avoidable reasons, according to a new study published December 1st. This costs the NHS millions of pounds and increases waiting times for patients, many of whom are in severe pain.
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Consensus Definitions on Difficult to Treat Psoriatic Arthritis
A substantial number of patients with psoriatic arthritis (PsA), have difficult, persistent and hard-to-treat disease. A GRAPPA task force has developed a consensus terminology for two distinct states: complex-to-manage PsA and treatment-refractory PsA.
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Turkey Tryptophan (11.28.2025)
Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
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Chronic pain may dramatically raise your blood pressure
Science Daily
Widespread chronic pain may stealthily drive up blood pressure, partly through its ties to depression and inflammation.
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Betw 1990 to 2021 the global psoriasis burden had a slight increase w/ little difference betw men & women, roughly 57-61 100 000 (10% increase). Risk highest in N.America & W.Europe. PSO risk highest with higher incomes. https://t.co/raruHn5Txx https://t.co/bp1rWyWS7y
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Dr. John Cush @RheumNow( View Tweet )
Managing Perioperative DMARDs with Arthroplasty
Postoperative complications with arthroplasty may be related to chronic inflammation and immunosuppressive therapy. Yet a recent retrospective study total ankle arthroplasty in end-stage RA patients shows that early postoperative wound complications are unaffected by the continued use of their
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Vitamin D and Lupus Outcomes (11.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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A New Disease Activity Score for Antiphospholipid Syndrome?
EurekAlert!
APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and non-thrombotic (TMN) symptoms. These can range in severity, and people may have
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Seeking Musculoskeletal Care
A report entitled The Burden of Musculoskeletal Diseases in the United States (BMUS) report was published by the US Bone and Joint Decade (USBJD) with input from rheumatology, orthopedic surgery, physical medicine and rehabilitation regarding musculoskeletal care.
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Rheumatology Supply and Demand (2009 - 2024)
A retrospective review of US rheumatology manpower and training between 2009 and 2024 shows that US rheumatology training has become competitive with an increasing surplus of applicants compared to available training positions, which have also increased over time.
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ACR Applauds Bipartisan Support for Prior Authorization Reform Bill
ACR
The American College of Rheumatology (ACR) today commended the more than 295 bipartisan, bicameral cosponsors of The Improving Seniors’ Timely Access to Care Act, which, if enacted, would reform the prior authorization process for Medicare Advantage plans.
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There is a growing burden of #OA among middle-aged adults, rising by 123.7%, from 11.8 million in 1990 to 26.4 million in 2021. 56.5% of incident cases & 38% of prevalent cases occur in middle-aged group (70% higher than the elderly (>60 years) population). Highest in hi-income. https://t.co/JVpZ96qe0E
Dr. John Cush @RheumNow( View Tweet )
Beyond the Breakthrough: Equity and Access in CAR-T Cell Therapy for RA
At #ACR25, abstract 1039, "Global Cost-Effectiveness and Equity in CAR-T Cell Therapy for Rheumatoid Arthritis," highlights the critical economic and ethical dimensions of CAR-T cell therapy in autoimmune https://t.co/Rci0dL7THj
Dr. John Cush @RheumNow( View Tweet )
The Interview (11.7.2025)
I've done thousands of interviews; mostly for medical school admissions or medical and research employment. They’re all the same. I'm looking for the “right one” and the interviewee is somewhere between apprehension, uncertainty and hope. From all this experience I’ve developed
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FDA is going to "fast-track" biosimilars to curtail the costs of expensive biologics https://t.co/h5NBsUaM97
Dr. John Cush @RheumNow( View Tweet )
@Janetbirdope’s #ACR25 pearls remind us:
Order ANA only when clinical suspicion exists
Never repeat a positive ANA
ENA only if ANA+
❌ Ignore dsDNA if ANA– (except anti-Ro52)
Stop serial dsDNA/C3/C4 if stable
Smart lab use saves patients anxiety and systems money.
#SLE https://t.co/Mu3EefcIx0
Romatolog @Nurullah_Akkoc( View Tweet )
Beyond the Breakthrough: Equity and Access in CAR-T Cell Therapy for RA
At ACR Convergence 2025, abstract 1039 entitled, “Global Cost-Effectiveness and Equity in CAR-T Cell Therapy for Rheumatoid Arthritis” adds a critical dimension to the growing enthusiasm around cellular therapies in autoimmune disease.
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CDAI appropriately guided therapy escalation in RA, but not for everyone. Treatment adjustments were less likely in pts with public or no insurance. Even data-driven care can fall short when access barriers persist.
@RheumNow #ACR25 Abstract#2616
Jiha Lee @JihaRheum( View Tweet )
Reaadmissions in sle pregnancies from 66k patients
Insurance and economics seem to be very important in predictions using machine learning.
Abst#2629 #ACR25 @RheumNow https://t.co/x2oo9TOxoh
Bella Mehta @bella_mehta( View Tweet )
Starting biologic early could save more than joints. In 329 RA pts, first-line anti-TNF reduced testing and hospitalization costs vs csDMARDs across Europe. Earlier targeted therapy pay off in outcomes and economics.
@RheumNow #ACR25 Abstract#2271 https://t.co/zZ32CpT36d
Jiha Lee @JihaRheum( View Tweet )
Bremer et al. Earlier initiation of biosimilar adalimumab (vs csDMARDs) may result in cost-savings. Reduced cost of tests, consultations, and hospitalisations. @RheumNow #ACR25 Abstr#2271 https://t.co/lHaSiX3WLd
Richard Conway @RichardPAConway( View Tweet )
Recent Blogs
The advantage to patient care without the crutch of an EHR. What do you do?
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