Fibromyalgia/Pain

Why Do Gout Flares Start at Night? The striking propensity for gout flares to initiate at night has been recognized for centuries. More recent epidemiological research supports this observation, indicating that the risk of a gout flare is more than twice as high in the early https://t.co/FbCUmXEl2y
Dr. John Cush @RheumNow( View Tweet )
EULAR meeting room

Psoriatic Arthritis: EULAR 2026 Recap

Jack Cush, MD

Years of IL-17 vs. IL-23 debate in PsA finally got tested head-to-head: bimekizumab outperformed risankizumab on joint outcomes in the BE BOLD trial, while a GLP-1 combination study suggests weight and metabolic status are active drivers of PsA — not just comorbidities. This recap also digs into

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Genicular artery embolization for knee OA does not work in a 12-mos randomized sham-controlled trial of 58 pts. Pain scores improved equally in both groups https://t.co/7wwmzpTaNL https://t.co/8MsRXqKDo2

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Do we need Better Strategies to Prevent Osteoporotic Fractures? In a recent JAMA Viewpoints article, Dr. Susan Ott addresses several controversies in preventing osteoporosis (OP) related fractures. https://t.co/YpmyZGCsjz https://t.co/NUkJVcxBjc

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New research shows synovial lining enriched in macrophages expressing SPP1 (encoding osteopontin) in proximity to fibroblasts and fibrin deposits. SPP1+ macrophages degrade fibrin & promote fibroblast proliferation that deposit collagen & does the damage, joint remodeling. A new https://t.co/yFxwAYFPPb
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Updated Algorithm for the Management of Restless Legs Syndrome Diagnose: chronic vs intermittent RLS (no need for polysomnography) Test Iron levels (& Rx if) Consider: remove exacerbators; walking/massage/heat; carbidopa/ levodopa; pramipexole or ropinirole; low potency opioids; https://t.co/XdzIipw1X8
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QD Clinic: Cellulitis Paradoxes Dr. Richard Conway, Dublin, discusses a case of cellulitis and gout. Presented as part of RheumNow's "Gout: More than Flares" campaign during the month of July 2026. https://t.co/ZeYyISJrrE https://t.co/2Ih4QRa7FK

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QD CLINIC: Senior Year Gout Daric Mueller, PA-C, discusses a case of difficult-to-treat gout in an individual first diagnosed at age 18 who is now in his early 30s. This QD Clinic is presented as part of RheumNow's "Gout: More than Flares" campaign. https://t.co/9GNk8ZqwyS https://t.co/hAFz6zPcay

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Dr. John Cush @RheumNow( View Tweet )
Weight loss helps gout, but extreme weight loss (bariatric surgery, ketogenic diets) may trigger gouty attacks. (Not seen with GLP-1 agonist weight loss) For more gout content, follow our Gout: More than Flares campaign at https://t.co/xnBVBN5IXZ, https://t.co/LGEENexSZ6

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The Power of Self-Management with Chronic Low Back Pain Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the https://t.co/urZPsVwCV8
Dr. John Cush @RheumNow( View Tweet )
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The Power of Self-Management with Chronic Low Back Pain

EurekAlert!

Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the workforce

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RheumIQ: True or False: In the NORD-STAR trial, failure to achieve early remission in RA was associated with a significantly increased risk of fibromyalgic RA at 48 weeks. Find out if you got it right at https://t.co/z8mLbcgE5D. https://t.co/vkusOYHcQj

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RT @rheumarampa "There’s more work to do” as Dr. Floris van Gaalen summarizes the challenges in peripheral SpA -pSpA has limited lab value testing like imaging, clinical diagnosis - few clinical trials to support tx guidelines - SPARTACUS trial: GOL vs. MTX in early pSpA

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RT @aurelierheumo Failure to achieve early remission RA asso w/ non-inflammatory pain NORD-STAR 526 early RA pts) no remission at 24 wks increased risk of 48wk • unacceptable pain (OR ~6) • refractory pain (OR ~6) • fibromyalgic RA (OR ~16) Signal strongest w/ very early

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Which is NOT a key feature of inflammatory back pain: relief with activity; morning stiffness; age under 40 years; unilateral pain? Test your knowledge in this week's RheumIQ quiz at https://t.co/z8mLbcgE5D. https://t.co/tOdPfEBJa4

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Self-Directed Cognitive Behavioral Therapy for Chronic Pain Is self-directed cognitive behavioral therapy (CBT) when augmented with asynchronous, personalized feedback for chronic pain (CBT-CP) superior to clinician-delivered CBT-CP? https://t.co/P2DDvCiLNL https://t.co/hyAArEG6V1

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U Maryland study found that 5-minutes of proximal intercessory prayer (PIP) — in-person prayer offered by a trained volunteer — significantly reduced pain and anxiety in primary care patients compared to a music control group. 180 pain pts (pain >4/10) w/ > 2 pt reductions at 2 & https://t.co/k4JiQvyC31
Dr. John Cush @RheumNow( View Tweet )
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Self-Directed Cognitive Behavioral Therapy for Chronic Pain

Jack Cush, MD

Is self-directed cognitive behavioral therapy (CBT) when augmented with asynchronous, personalized feedback for chronic pain (CBT-CP) superior to clinician-delivered CBT-CP?

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Retrospective study of 116 BL KOA (Kellgren–Lawrence I–II) pts rx w/ three PRP injx (n 58) or NSAIDs +/- IAhyaluronic acid (n 58). After 5 yrs there was no signif. difference in VAS, WOMAC, and SF-36, with both groups worsening. https://t.co/KDSMTvEl59 https://t.co/lgHOsppIU3

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Dr. John Cush @RheumNow( View Tweet )
JAMA Review on Low Back Pain A comprehensive JAMA review synthesizes current evidence on the epidemiology, pathophysiology, clinical evaluation, and treatment of nonspecific low back pain (nsLBP), drawing on 108 publications identified from a PubMed search (2005–2026) and the https://t.co/liEitQ2ACf
Dr. John Cush @RheumNow( View Tweet )
back, LBP, spine, AS

JAMA Review on Low Back Pain

Jack Cush, MD

A comprehensive JAMA review synthesizes current evidence on the epidemiology, pathophysiology, clinical evaluation, and treatment of nonspecific low back pain, drawing on 108 publications identified from a PubMed search (2005–2026) and the most recent guidelines from the WHO, ACP, and NICE.

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Genicular artery embolization (GAE) in knee OA? Multiple open label studies & metanalyses suggest a clear pain benefit; BUT 3 sham-controlled RCTs have not demonstrated a statistically significant benefit over placebo. GAE is not addressed by ACR or EULAR guidelines. https://t.co/amIN6kzY74
Dr. John Cush @RheumNow( View Tweet )
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EULAR 2026: Updated Recommendations for Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases

Jack Cush, MD

This update includes new pandemic era evidence, recombinant zoster vaccine data, and new perspectives on vaccination in patients taking novel immunosuppressants. Five overarching principles and 10 vaccine recommendations follow.

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MTX: SC vs Oral? Metanalysis of 9 RCTs, 974 RA pts. Compared w/ oral, SC MTX signif. incr odds of ACR20 (RR=1.15), ACR50 (RR=1.14) & reduced GI adverse events (RR=0.58), diarrhea (RR=0.42): BUT no difference in ACR70, DAS28-ESR, bioavailability AUC, or other AE https://t.co/tQeQz7H7do
Dr. John Cush @RheumNow( View Tweet )
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EULAR 2026 Rheumatology RoundUp

Jack Cush, MD

It’s time for Rheumatology RoundUp from EULAR 2026 from London, UK. Drs. Artie Kavanaugh and Jack Cush review their choice presentations from the meeting, offering their perspectives on impact and applicability.

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Recent Blogs

Advanced Practice Rheum

Fibromyalgia

Jack Cush, MD
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Dr. Jack Cush reviews fibromyalgia.
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Advanced Practice Rheum

Evaluation of Rheumatic Complaints

Jack Cush, MD
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Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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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.
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