Dr. John Cush
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"No person has the right to rain on your dreams."
- Martin Luther King, Jr.
Dr. John Cush
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Systematic review of 21 papers (23K RA pts) finds 12% w/ difficult-to-treat RA. Risk factors -- smoking (OR 1·16), obesity (1·38), FM (2·20) & depression (1·74). No assoc w/ current smoking or anxiety. https://t.co/BHxyEbSg8Y
Dr. John Cush
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Southern Israel study (2009-24) shows fibromyalgia prevalence Incr from 1.04% to 3.88%, esp 30-59 yrs; more males, w/ more Psych comorbidities; fewer hospitalizations & specialist visits but increased imaging. More use of pregabalin, duloxetine, & gabapentin. https://t.co/kgmvdZF9HQ
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The Endocrine Society has published a scientific statement reframing obesity as a heterogeneous, chronically dysregulated fat-mass disorder, the biology of which is being tested effectively by GLP-1/GIP receptor agonists. Is this precision-medicine? We await long-term safety data, while
Dr. John Cush
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Observational study of 63,215 neuropsychiatric (NP) pts showed semaglutide signif lowered NP events over 2yrs (vs metformin, SGLT2 inhibitors, DPP-4 inhib);unrelaed to wt loss. Less substance, mood anxiety, CNS atrophies, neuromuscular, eating/sleep & personality/impulse-control https://t.co/tbuvLRK3QE
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Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz
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If laughter is the best medicine, then music has to be second best. A new scoping review in Pain Reports by Bradt et al., examines the effect of music-based interventions (MBIs) on pain management. While its efficacy is well established, how or why music relieves pain has never been fully
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Postural orthostatic tachycardia syndrome (POTS) is a chronic autonomic disorder affecting an estimated 0.1%–1% of the US population, with peak incidence at ages 13–29 and a striking 90% female predominance.
Dr. John Cush
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Multiple chronic conditions (MCCs; AKA multimorbidity) is highly prevalent in AIRDs; complicates Rx & increases adverse outcomes & all-cause mortality. MMCs 86% in RA, 81.5% in SLE, w/ a notable patterns of cardiopulmonary and mental health disorders https://t.co/AOWCsEodXR https://t.co/NyAR0TUQkE
Dr. John Cush
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2026 Medscape report on Nurse practitioners shows nearly half of NPs are burned out, and for 1 in 6, that exhaustion has curdled into something heavier: both burnout and depression. Worse, 63% of NPs don't believe relief is in sight https://t.co/G8N5YgOKyA
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Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.
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The British Society for Rheumatology has issued its first guideline dedicated solely to pain in inflammatory arthritis (IA)—covering RA, PsA, axial SpA and JIA.
Dr. John Cush
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UK Clinical Practice Research Database study RA pts 3134 on glucocorticoids (vs not 4142 matched controls). were identified. GC use assoc w/ signif risk of SSRI initiation risk - recent GC (adj OR 1.53) & past GC (aOR 1.40). GC effect or confounding dz activity? Think depression! https://t.co/WZLkQWlURC
Dr. John Cush
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True or False: Neuropsychiatric SLE (NPSLE) was associated with a higher odds ratio for cerebral atrophy compared to age.
See if you got it right in this week's RheumIQ quiz at https://t.co/yQn8cIT5Cw. https://t.co/YjHwLFclv4
JAMA
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💡 JAMA Insights: #SleepHealth and #obesity are linked, with insufficient sleep quantity and poor sleep quality associated with weight gain, less healthy diet, and incident obesity.
https://t.co/SEj9dwNHiW https://t.co/JbPah4BwDr
Dr. John Cush
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Machine learning study of 657 multiethnic Lupus pts - 14% had organic & 30% had neuropsychiatric damage. High Glucocorticoid dose was the strongest predictor or organic Dz. NP damage predicted by MD global, fatigue, pain, & steroids https://t.co/LVK57LxKk6 https://t.co/VLisZT7ReY
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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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Systemic autoimmune diseases are associated with increased cardiovascular morbidity and mortality – possibly through autonomic imbalance, myocardial inflammation, or fibrotic infiltration of the conduction system. A team in Colombia have been looking into the
Dr. John Cush
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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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Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Updates on tofacitinib, CAR-T therapy and AI.
Dr. John Cush
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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
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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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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.
Dr. John Cush
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US telehealth utilization rose 10.1% in 1st quarter of 2026 (5% to 5.51% medical claims). Most use in mental health conditions (52%) w/ joint/soft tissue dz at 3% overall, higher in west & NE states. 57% for outpt visits, only 7.7% for new visits. 35% for psychotherapy services. https://t.co/L8c7p3iQPL
Mrinalini Dey
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#OP0159 #EULAR2026
Multimodal study in D2T RA identified altered brain connectivity patterns linked to pain, psychological features & peripheral transcriptomics. Supports neuroimmune component in D2T RA & need for personalised approaches beyond inflammation control. @RheumNow https://t.co/qMQbkiMCwX
Recent Blogs
I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”.
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The presence of comorbidities naturally complicates treatment choice, patient adherence to medication and patient outcomes, increasing also the risk of making RA ‘difficult-to-treat’.
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With the increasing development and use of new biologics and oral targeted therapies to treat RA and other immune mediated inflammatory diseases, an awareness of infection risk and prevention has become of increasing interest as well. While our patients may be susceptible to many different types of infections depending on immunosuppressive regimen, age and co-morbidities, I’ll highlight a few of the “usual suspects”.
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Podcasts
EULAR 2026 Daily Podcast Day 2a