Fibromyalgia/Pain

GLP-1.injx

GLP-1 drugs cost-effective for knee osteoarthritis and obesity

EurekAlert!

A new study led by investigators at Mass General Brigham finds that adding novel weight loss GLP-1 drugs semaglutide and tirzepatide to usual care represents a cost-effective treatment strategy for people with knee osteoarthritis and obesity, with tirzepatide providing greater health benefits at

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Nitazenes — a class of highly potent synthetic opioids — are rapidly emerging as a major contributor to the overdose crisis; they are over 20 times more potent than fentanyl. Nitazenes are an illegal Schedule I drug that are rapidly spreading in the illicit drug market

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Hospital for Special Surgery (HSS) reports that ear acupuncture applied during hip replacement surgery reduces pain and lessens opioid use over the weeks to follow. https://t.co/lOrwb1DzW5 https://t.co/6rkHNTwaAl

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Dr. John Cush @RheumNow( View Tweet )
RCT of 800 adults w/ Chronic LBP, acupuncture (AP) was compared usual care or AP +/- added maintenance found that acupuncture improved pain-related disability at 6 months and 12 months, with no statistically discernible benefit of additional maintenance sessions. https://t.co/suy09fGxxI
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An important message from Prof. @XBaraliakos on D2M-axSpA: Re-evaluate your diagnosis & check for comorbids before labelling pts as tx-refractory or difficult-to-manage. consider other causes: FM, other causes of pain @RheumNow #APLAR25 @rheumarhyme @marklagacmd https://t.co/Lo0yShOK0P

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RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are there benefits to diet or vegan diets? What's the effect of menopause on CTD?  Ro52 makes a big entrance with all our ILD coverage this month.

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Metanalysis of 7 studies (1979-2023) shows RA pts on vegetarian or vegan diets achieved no improvement in disease activity or physical function, but did have a small significant improvement in pain. Insufficient Data on Fatigue. Overall, low certainty https://t.co/jeh6gN5Byg
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Addressing Disparities and Unequal Burdens in ILD

Deji Adegunsoye, MD, PhD, FACP, FCCP

Interstitial lung diseases (ILDs) represent a complex spectrum of conditions that share one  unifying truth: they are almost always serious, progressive, and life-altering. But for many patients,  the burden of disease does not fall evenly. We are increasingly learning that where you

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Crepitus Does Not Predict Earlier/Worse OA

EurekAlert!

Young adults who experience grinding or clicking sounds in their knees post-surgery may be alarmed, but new research from La Trobe University suggests these sounds may not signal early-onset osteoarthritis. 

Knee crepitus, the sound of cracking or grinding in the knee joint is very

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JAMA: Cognitive functional therapy (CFT) is effective in control of chronic low back pain. Study of 500 LBP pts Rx w/ usual care, CFT, or CFT with biofeedback over 3 mos. F/U of ~ 300 pts found that the benefits extended up to 3 years after the intervention. https://t.co/dLv53M7Xkp
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tylenol,acetaminophen,pills,tablets

Prenatal acetaminophen linked to increased autism and ADHD

EurekAlert!

Researchers at the Icahn School of Medicine at Mount Sinai have found that prenatal exposure to acetaminophen may increase the risk of neurodevelopmental disorders, including autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD), in children. The study, published today

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Sjögren's Graduates (8.22.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports, FDA approvals, drug safety, and more from this week.

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RCT of 2331 chronic MSK pain pts showed that telehealth Cognitive behavioral therapy (CBT) (health coach) superior to self-care (Pain trainer) or usual care at achieving a >30% reduction in pain (32% vs 26.6% vs 20.8% respectively) & benefits were sustained at 12 months. https://t.co/a69zPsJslH
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FDA Approves 1st new Fibromyalgia drug in 15 yrs - Tonmya (cyclobenzaprine HCl sublingual) as treatment of fibromyalgia in adults. Based on 2 phase 3 trials and 1400+ pts. Dose 2.8 mg tabs 1-2 SL qhs (peak concentration 4.3 hours; t1/2 life = 36 hrs, longer w/ elderly, liver dz) https://t.co/8DVRet5sjU
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Pain Flares in RA are just pain, not inflammation. Study of 195 RA pts (11+ yrs dz dur), 49-89% experienced at least 1 flare (median 2-4 flares/mo), IQR 2.1-5), lasting median of 2 days. Flares preceded by worsening mood, anxiety, sleepiness - but no change in Accelerometer https://t.co/csbHtiEglp
Dr. John Cush @RheumNow( View Tweet )
Pain Flares in RA are just pain, not inflammation. Study of 195 RA pts (11+ yrs dz dur), 49-89% experienced at least 1 flare (median 2-4 flares/mo), IQR 2.1-5), lasting median of 2 days. Flares preceded by worsening mood, anxiety, sleepiness - but no change in Accelerometer https://t.co/twI6wcxKf7
Dr. John Cush @RheumNow( View Tweet )
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Teaching You How to Think… (8.15.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and  aphorisms to live by.

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PT in RA - Metanalysis of 17 RCTs, 1362 pts Rx w/ aerobic/resistance exercise, hydrotherapy, manual Rx, electrotherapy, multimodal Rx. 5 RCTs (n 307) signif reduced pain (SMD −0.347; interpreted as a small to medium effect favoring PT. https://t.co/UJGSGrgMV0 https://t.co/n4DzMSm9iJ

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Dr. John Cush @RheumNow( View Tweet )
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Repurposing & Pipeline (8.8.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.

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Survey of 39 Spanish rheumatologists (mean age 50 yrs, 9.6 yrs in practice) finds that while 79% agreed on the importance of using Patient-Reported Outcome Measures (PROMs), only 28% use them routinely (mostly pain, VAS, HAQ) - reason? Time! https://t.co/YnZBXlK24M https://t.co/a8W52XO8jh

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Mild cognitive impairment (MCI), (a reversible precursor to dementia) is increased in elderly RA (n=378) and is signif. assoc w/ course of disease(OR 1.07), DAS28 (OR 1.31), high CRP (OR 1.01) & osteoporosis (OR 1.88) as independent risk factors. https://t.co/45DY03sD23 https://t.co/kdX9TnykVK

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Plant extracts, C. longa & B. serrata extracts (CBTIL) studied in hand OA in 3 mos, DBRPCT of 162 HOA pts given CBTIL (n83) or PBO (n 79). Also signif were decreased Pt global, acceptable symptom status (PASS), SF-36 pain, SF36 health change (no AE diff) https://t.co/vqhqnEZIsz https://t.co/XuCX0zc4qD

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Dr. John Cush @RheumNow( View Tweet )
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NHANES, Numbers, & Risk (7.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".

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Americans choose short term relief for neck and back pain

EurekAlert!

New survey data from the Orlando Health Spine Center reveals a significant difference among Americans on how to manage neck and back pain. Respondents were split between relying on rest and reduced activity (44%), turning to over-the-counter pain

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Genicular nerve block (GNB) is effective intervention for Knee OA. Metanalysis of 6 RCTs & 420 KOA pts. GNB significantly reduced pain & improved function (p<0.003), w/ significant relief as early as 2wks and function by 12 weeks. https://t.co/wC2dPvVR7x https://t.co/HCFSXBfVGM

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

From DNA to PGA

David Pisetsky, MD, PhD
dna
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. Read Post

From the Archives: Rheumatology Dead Word Cemetery

Jack Cush, MD
CTD.jpg
I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine. How did we decide which words should perish? And by what criteria? Who has the final say? Read Post
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