Fatigue in SLE
An NIH lupus cohort study looked at fatigue in SLE and found associations with organ damage, obesity, but does not correlate with disease activity in systemic lupus erythematosus (SLE) patients.
Goofy study of the month! (pub in JAMA!) RCT 170 adults w/ chronic LBP + MRI disc herniation found that amoxicillin-clavulanate, 500 mg/125 mg bid x 3 mos did not improve pain at 3 or 12 mos (vs PBO). Whatha... https://t.co/njrw6itAP8 https://t.co/CW2ssNPxf1
Dr. John Cush @RheumNow( View Tweet )
APR: Fibromyalgia
Dr. Jack Cush reviews Fibromyalgia as part of the Advanced Practice Rheum video series.
https://t.co/jq6dSXy6SU https://t.co/bDGRhhY2D9
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Dr. John Cush @RheumNow( View Tweet )
Depression screening (PHQ-8) equally accurate in pts w/ & w/o chronic pain. Depression screening is not biased by overlapping symptoms in depression and chronic pain. https://t.co/UWf97NDPAK https://t.co/7dvt35RT9E
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Dr. John Cush @RheumNow( View Tweet )
Meet the RheumNow #EULAR2026 Reporting Team
Delivering real-time insights from the forefront of rheumatology:
🩺 Dr. Antoni Chan (@synovialjoints)
🩺 Dr. Mrinalini Dey (@DrMiniDey)
🩺 Dr. Jiha Lee (@JihaRheum)
🩺 Dr. Aurelie Najm (@AurelieRheumo)
🩺 Dr. Janet Pope https://t.co/zpIeGWpL6P
Dr. John Cush @RheumNow( View Tweet )
Advanced Practice Rheum: Fibromyalgia
https://t.co/Wx09nPMA5n https://t.co/UAysDMGuFC
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Dr. John Cush @RheumNow( View Tweet )
JAMA Insights on Chikungunya (affects 35 million worldwide) - mosquito-borne alphavirus seen in tropics, also travelers. Dz char by fever, disabling polyarthritis; less rash, HA, myalgia, N/V, conjunctivitis; rarely myocarditis. https://t.co/Fa3cHygc4W https://t.co/jmh2WjOcI5
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Dr. John Cush @RheumNow( View Tweet )
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Chronic Low Back Pain Disappointments in a Randomized Trial
Annals of Internal Medicine reports that patients with chronic low back pain (cLBP) may benefit from physical therapy (PT); but when that fails, other secondary measures (cognitive behavioral therapy (CBT) or https://t.co/17JObbXz5U
Dr. John Cush @RheumNow( View Tweet )
Chronic Low Back Pain Disappointments in a Randomized Trial
Annals of Internal Medicine reports that patients with chronic low back pain (cLBP) may benefit from physical therapy (PT); but when that fails, other secondary measures (cognitive behavioral therapy (CBT) or mindfulness) may not be effective.
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More Comorbidity in Difficult-to-Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
https://t.co/guMm6mqJGr https://t.co/xiykw5tBlJ
Dr. John Cush @RheumNow( View Tweet )
More Comorbidity in Difficult to Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
Knee pain: JAMA review
- 5% PCP visits knee pain
- Knee OA ~654 million worldwide
- Patellofemoral pain: <40 yrs & physically active; pain on squat
- Meniscal tears in 12% adults (McMurray 61% sensitive; 84% specific; Joint line tender 83% sensitive; 83% specific) https://t.co/2fdpl464mb
Dr. John Cush @RheumNow( View Tweet )
Great Lectures; Great Presentations
Dr. Jack Cush lectures on giving a great presentation; based on 40 years of lecturing in Rheumatology.
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Weight-loss drugs may affect joints directly
A new study from Aarhus University shows that the hormone GLP-1, which is mimicked in medication for diabetes and weight loss, is present in joint fluid. In the long term, this may open up new treatments for arthritis. https://t.co/HkcPUQp05H
Dr. John Cush @RheumNow( View Tweet )
NSAIDs in Inflammatory Bowel Disease?
MedPage Today
At least some patients with inflammatory bowel disease (IBD) can safely use common drugs for musculoskeletal aches and pains, a large study of insurance claims data suggested, contradicting a widespread concern that these products can trigger IBD flares.
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Do patients with chronic pain have double the rates of smoking compared to those without pain? Take this week's RheumIQ quiz to find out.
https://t.co/rmB55KC7Zh https://t.co/ms3G9uBMd5
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Dr. John Cush @RheumNow( View Tweet )
Gabapentinoid use 2008-2018: worldwide there was an annual incr of +17.2% (from 4.2/d to 18.3/d per 10K pop. Highest gaba use in high income countries, 6X higher than lower income (40/d vs 6.1/d) https://t.co/jXjxNj1Uyz https://t.co/GmQJ3UGGw9
Dr. John Cush @RheumNow( View Tweet )
Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Opioids Down, Gabapentins Up
The number of U.S. patients prescribed long-term opioid therapy declined from 2015 to 2023, but co-prescribing of opioids with gabapentinoids increased, prescription data showed.
https://t.co/iXEUfR18Is https://t.co/6DCUvGAW6N
Dr. John Cush @RheumNow( View Tweet )
NHIS 10yr survey of 195,600 Americans shows Chronic pain assoc w/ double rates of smoking & vaping. Smoking decr over time, but always higher in chronic pain pts (17.7% 2014, 13.1% in 2023) than w/o pain (12.5% 2014, 7.5% 2023). E-cigs incr over time, more w/ chronic pain https://t.co/iW7IDwHyJa
Dr. John Cush @RheumNow( View Tweet )
Couldn’t attend https://t.co/4UQlqwujiR 2026?
You can now watch the entire meeting On Demand.
This high-impact program features leading experts discussing:
• RA outcomes and pathogenesis
• Obesity, inflammation, and rheumatic disease
• Treatment decisions in Psoriatic https://t.co/A3wb3pzbl3
Links:
Dr. John Cush @RheumNow( View Tweet )
Itch is common in Scleroderma (SSc) and not related to Dz duration. Study of 2173 Pts (~20K itch assessments), 87 F; mean age 55 yrs; 40% w/ diffuse SSc. Itch (moderate 4/10) seen in ~35% at all times https://t.co/QnT8d0xA5Z https://t.co/yEgB6ImDTi
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Dr. John Cush @RheumNow( View Tweet )
Opioids Down, Gabapentins Up
The number of U.S. patients prescribed long-term opioid therapy declined from 2015 to 2023, but co-prescribing of opioids with gabapentinoids increased, prescription data showed.
In 2023, 4.2 million people had an active long-term opioid therapy episode, defined as a period of opioid
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From 2015 to 2023, long-term opioid therapy declined in the USA. Approximately 4 million to 5 million patients were prescribed long-term opioid therapy in 2023. Long term opioid use remains a challenge https://t.co/N5s7mYvXSw https://t.co/YHdTbHLB4q
Dr. John Cush @RheumNow( View Tweet )
COMMON - Incidental Rotator Cuff Abnormalities on MRI
In this cross-sectional study of 602 Finnish adults undergoing bilateral shoulder magnetic resonance imaging (MRI) and clinical assessment, found abnormalities in nearly everyone over age 40yrs, regardless if asymptomatic or symptomatic.
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Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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I have been investigating the mechanisms of antinuclear antibody (ANA) expression in SLE since 1978. In this pursuit, I have followed the advice of my first division chief, Dr. Ralph Snyderman, a great academician. Ralph told me to identify a research focus and make it mine. I think I have done reasonably well in my mission so you can imagine my surprise (and excitement) when, for the Lupus 2025 meeting in Toronto, I was asked to conduct a Meet the Professor session on the Type 1 & 2 model for SLE.
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Podcasts
ACR 2025 Daily Podcasts Day3c-
ACR 2025 Daily Podcasts Day3a
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ACR 2025 Daily Podcasts Day2c
