Mental Health

#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

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Mrinalini Dey @DrMiniDey( View Tweet )
Depression at RA diagnosis did not predict short-term CV events in a nationwide early RA cohort -17,669 early RA pts -7.3% BL depression -Median follow-up 1.2 years -No association w/ CV hospitalisation after adjustment (sHR 1.05) Reassuring short-term data, longer follow-up https://t.co/XmMVGY1VlI

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Aurelie Najm @AurelieRheumo( View Tweet )
Using AI to integrate EHR, SDOH , psychological data - can help finding psychosocial risk factors. Complex cases can be diagnosed using solutions (iceberg health) like this. #EULAR2026 @rheumnow https://t.co/t4keRbpkrx

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Bella Mehta @bella_mehta( View Tweet )
#EULAR2026 OP0220 How can we improve physical function of #SLE patients? Cross-sectional study of 2 US cohorts: poor physical function was associated with Fatigue, depression, learned helplessness and perceived stress. We should focus on improving fatigue & wellbeing @RheumNow https://t.co/vAFqYyuzgN

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
🔍 Do posterior element lesions progress over 10 years in axSpA? Data from the DESIR inception cohort (n=320) says RARELY! But baseline PE inflammation raises facet ankylosis risk ~70-fold #POS0189 #EULAR2026 @RheumNow https://t.co/PdwlPGjKqK

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
D2T RA shows a linked brain–psychology–immune signature Cohort D2T RA vs non-D2T RA vs HC 91% D2T RA Higher catastrophizing Higher pain sensitivity More emotion-focused coping strategies “Chronic pain-like” profile Associated with higher CNS related gene expression NRG1 https://t.co/nkQco73vqI

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Aurelie Najm @AurelieRheumo( View Tweet )
Sad to see this but important to be aware. Increasing risk of suicide using colchicine in Familial Mediterranean Fever. #POS0768 #EULAR2026 @rheumnow. Average age 28! 87%female, only 7 % with psychiatric referral! Retrospective 15 pts. https://t.co/241SE6O395

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Bella Mehta @bella_mehta( View Tweet )
RA comorbidities are changing. ILD, anxiety, depression increasing. Less extraartic. manifestations, CA & CV dz. Consider screening for cervical CA, ILD, CV dz & OP (for pts on steroids) https://t.co/WVITFXNva7 https://t.co/tggdaO9RJB

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Dr. John Cush @RheumNow( View Tweet )
Integrating D2T into T2T Practices in RA Researchers at Semmelweis University analyzed how depression, smoking, obesity, sleep disorders, and other health problems are linked to difficult-to-treat rheumatoid arthritis (D2T-RA) and how this can inform treat-to-target (T2T) and https://t.co/buCXeK2jNS
Dr. John Cush @RheumNow( View Tweet )
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Integrating D2T into T2T Practices in RA

EurekAlert!

Researchers at Semmelweis University analyzed how depression, smoking, obesity, sleep disorders, and other health problems are linked to difficult-to-treat rheumatoid arthritis (D2T-RA) and how this can inform treat-to-target (T2T) and individualized therapy.

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"Courage is resistance to fear, mastery of fear, not absence of fear." - Mark Twain https://t.co/xyJqiV7biI
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 )
"Everything will be alright in the end; and if its not alright, then its not yet the end" – Suni Kapoor Best exotic Marigold Hotel https://t.co/Yua7t4yoZe
Dr. John Cush @RheumNow( View Tweet )
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Influential Rheumatoid Factors (5.8.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com

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Nurses - the calm through chaos Nurses are a unique breed. When they appear, it’s always a blessing. But who goes into nursing? What kind of person choose nursing over doctoring? https://t.co/smUWg06nVh https://t.co/swQYJ3NfZF

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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). https://t.co/guMm6mqJGr https://t.co/xiykw5tBlJ

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Dr. John Cush @RheumNow( View Tweet )
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 )
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 )
UK Our Future Health study of 1,563,155 finds affective Dz (depression, bipolar, anxiety) signific higher (p<0.001)in autoimmune pts vs gen. pop. (29% vs 18%) - dx by PHQ-9, GAD-7. (OR 1.86), even after adjustments income and pain, etc. https://t.co/HoKBeAZxbS https://t.co/NtJhaf7WCo

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Dr. John Cush @RheumNow( View Tweet )
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Top Four and More (4.10.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.

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UK Our Future Health study of 1,563,155 finds affective Dz (depression, bipolar, anxiety) signific higher (p<0.001)in autoimmune pts vs gen. pop. (29% vs 18%) - dx by PHQ-9, GAD-7. (OR 1.86), even after adjustments income and pain, etc. https://t.co/HoKBeAZxbS https://t.co/LnC4lqqgq7

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Dr. John Cush @RheumNow( View Tweet )
1/3 of American adults have poor sleep. New survey from Amer. Academy Sleep Medicine shows 45% of pts never discuss sleep issues with their doctors; only 15% discussed it with a sleep specialist. https://t.co/uvlHjpuVs8 https://t.co/fDOtp9rxOn

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Dr. John Cush @RheumNow( View Tweet )
What's it like to have RA? MARY: "I can manage the pain, the exhaustion, and side effects of the meds. The hard part is grief. I grieve for me, the adventurer that decided what she wanted and boldly went after it, no matter what. I trusted myself to handle whatever came. Now https://t.co/GakWIy2XCt
Dr. John Cush @RheumNow( View Tweet )
What's it like to have #RA? RICHARD: "There were days that I couldn’t mask the pain or hide the limp..So I tried to deny and hide the disease. I would always go up and down stairs when no one was looking. I got up extra early so no one could see me walk like an old man to the https://t.co/krHn4yoRYd
Dr. John Cush @RheumNow( View Tweet )
What's it like to have #RA? PATTY "To find patients or doctors who can talk intelligently about RA is a welcomed relief. However, I prefer that those around me not know about me and my RA. I hope they don’t notice the changes in my hands or shoes or that I cannot wear my usual https://t.co/OQbXJrcyPp
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Choice Overload (and the Way Out)

Jack Cush, MD
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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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Comorbidities in RA: Focus on Difficult-to-Treat Disease

Elena Nikiphorou, MD, PhD
Puzzle pieces
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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Infections Rheums Should Worry About

Cassandra Calabrese, DO
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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
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