Article
The term nociplastic pain refers to pain arising from altered central nervous system processing, without evidence of tissue or nerve damage.
Dr. John Cush
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New Treatment for Fibromyalgia? Will It Help or Harm?
For years, the pharmacologic treatment landscape for fibromyalgia has remained relatively unchanged, with limited therapeutic options despite a substantial disease burden. This condition is characterized by chronic https://t.co/nn9wu7xibY
Dr. John Cush
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Beyond Joint Inflammation: Does Early RA Control Prevent Chronic Pain and Fatigue?
Could the therapeutic window of opportunity in rheumatoid arthritis extend beyond preventing structural damage to preventing chronic pain, fatigue, and neuroimmune complications?
This is the https://t.co/WVSjwIHOAM
David Liew
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Might stem cells actually work in knee OA??
Possibly, only the right combo 🇰🇷
OSCA: OS (allo mesenchymal stem cells) + CAM (cartilage acellular matrix)
anti-inflamm, structural, pain
ph2a
impressive signal over placebo
& maybe tissue repair, benefit out to 5y?
#ACR26 @RheumNow https://t.co/PU3MUqxH7Q
Antoni Chan MD (Prof)
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ACR26 summary, pain in axSpA: nociplastic features in 32.5%, fibromyalgia in 9.3%, and early back pain improvement associated with better outcomes at 52 weeks. @rheumnow #ACR26 Abstract#1337 Abstract#1354 Abstract#0347
Daric Mueller, PA-C
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Points to consider to D2M AxSpA
Mimics + Interfering Factors:
Nociplastic Pain
Degenerative Joint/Spine/SI/Hip disease
Fracture
Infection
Malignancy
Mental/psychosocial factors
Poor sleep
Other (crystalline arthritis, metabolic bone disease)
Abst2944 #ACR26 @RheumNow
Dr. John Cush
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Is Obesity Inflating Your Disease Activity Scores?
Dr. Michael George, MD, MSCE, will take on that question in the session "Size Matters: Optimizing Therapy and Outcomes for Patients with Obesity and Rheumatic Disease"
https://t.co/ZS5dQSZVUj https://t.co/D5ekNiRxQu
sheila
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Spanish retrospective study by Funcia et al on DEN discontinuation & fracture incidence
7% developed fractures after DEN dc
Incr fall risk was the only significant factor identified
Causes of discontinuation: Poor adherence, other causes & AEs
@RheumNow #ACR26 Abs2956 https://t.co/lSSJMrxVuk
Dr. John Cush
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Can We Predict Work Disability in Lupus?
When it comes to managing patients with
SLE there are many aspects of the disease to consider – disease activity, organs involved, and the potential for long term damage. Given that SLE affects many working-age adults, there is another https://t.co/9Fp4MxKpw9
Audrey Gibson
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Merola et al. (TOGETHER-PsA): Could the next PsA treatment algorithm include an obesity-treatment pathway? TOGETHER-PsA suggests combined inflammatory and metabolic management can improve clinical response. @rheumnow #ACR2026 Abstract#2942 https://t.co/PMu7XZ9SA0
Bella Mehta
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Not every osteophyte means clinically important OA. Abst#1923 at #ACR26 - isolated grade 1 patellofemoral osteophytes were not linked to meaningful pain or progression, while grade ≥2 lesions were more clinically relevant. Important nuance for early OA definitions. @rheumnow
Article
A 34 year old female has axSpA. Her CRP is 3, her MRI is quiet, and her BASDAI is 7. She has tried two biologics and is asking about a third. Before we write that prescription, #ACR26 challenges us to ask a different question: is it still inflammation?
Jiha Lee
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We see the patient for their disease. They are also living personal and professional lives in parallel.
Listen, explain, and support psychosocial needs to deliver whole-person care
Session: Patient Perspectives #ACR26 @RheumNow
Antoni Chan MD (Prof)
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In the ASAS GRAPPA definition of axial PsA, the clinical and laboratory domain covers chronic back pain, inflammatory back pain, good response of back pain to NSAIDs and HLA B27 positivity. The imaging domain covers radiographic sacroiliitis, MRI of the sacroiliac joints, https://t.co/mIIKvbISJT
Eric Dein
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Ab#2547 #ACR26 @RheumNow
Sublingual cylcobenzaprine - now approved for Fibro
RELIEF, RESILIENT trials:
NNT (# needed for >30% pain reduction) = 7
NNH (# needed for one Rx d/c due AEs) = 26
LHH (NNH/NNL) = 3.7, suggests nearly 4x likelihood of benefit to harm
Eric Dein
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Ab#2545 #ACR26 @RheumNow
Post-exertional malaise (PEM) in Fibro study:
PEM present in 3/4 of Long COVID pts, 1/4 SARD pts
Fibro in 44% L-COVID, 21% SARD pts
PEM more severe in L-COVID than SARD
PEM severity signific assoc w/ worse phys fxn in both groups https://t.co/EaB9JRMC7I
Eric Dein
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Ab#2543 #ACR26 @RheumNow
Survey of US Academic Rheums on Opioid Rx
IMG trained - lower odds of opioid Rx
<5 yrs since training less likely to prescribe, 10-20 yrs OR 5.2, 20-30 yrs OR 6.7
60% felt opioids have role in rheum pain mgmt
70% feel pressured by pts
Dx: OA 41%, RA 28% https://t.co/Octn02lo3E
Bella Mehta
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Pain outcomes require more than analgesics. #ACR26 Abs#1555: 196 pts with FM followed for 12 mos, catastrophizing and insomnia independently tracked with greater pain and symptom burden regardless of rehab pathway. Assess without stigmatizing. @RheumNow
Bella Mehta
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SLE can permanently alter employment. In a cohort 1800pts followed a median 18 years, 84.3% of pts initially receiving disability benefits remained in that state. Renal, neuropsychiatric, endocrine and musculoskeletal damage predicted disability. @rheumnow #ACR26 Abstract #1266 https://t.co/9tzmAlJcx1
Bella Mehta
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Why do pain conditions cluster? #ACR26 Abs# 1551 used Framingham family data to examine heritability of pressure pain threshold and conditioned pain modulation, plus genetic overlap with joint and non-joint pain. Pain sensitization may reflect shared biology. @RheumNow https://t.co/ESVWExCS5Y
Mrinalini Dey
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CDAI remission does not describe every symptom. In a 787-patient RA study, those in remission still had meaningful pain interference (19%), fatigue (20%) and impaired function (23%). PROMIS scores show symptoms that composite score missed. #2874 @Rheumnow #ACR26
Bella Mehta
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In 8,090 RApts 18.3% had unacceptable pain and 14.6% had patient-physician discordance ≥3 cm. #ACR26 Abstract 0617: discordance was the strongest correlate of unacceptable pain, followed by joint distribution and disability. Ask why pain and inflammation disagree. @RheumNow https://t.co/8zVt1fo30J
Audrey Gibson
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Jamshaid & Gomaa (Tirzepatide vs semaglutide cohort): tirzepatide was associated with lower 1-year and 3-year risks of treatment-defined flare proxies compared with semaglutide. @rheumnow #ACR2026 Abstract#2641
Audrey Gibson
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Is an acidic joint environment accelerating OA?
New translational research links joint acidosis to chondrocyte senescence, while GPR68 activation appears to attenuate senescence responses.A potential therapeutic target beyond pain relief! Yung et al. | #LB03 @RheumNow #ACR26
Bella Mehta
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Pain in myositis is heterogeneous.#ACR26 abs#2597: latent class analysis 426 pts used pain distribution, persistence, flare-related change and disease duration to id distinct pain phenotypes. One label may not fit all; consider inflammatory + nociplastic mechanisms. @RheumNow
Podcasts
ACR 2026 Daily Podcasts - Day4a
ACR 2026 RheumNow Day 3 Recap-
ACR 2026 Daily Podcasts - Day2a