Hmmm Really? (7.11.2025)
Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?
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BMJ - UK population study of 1.5 million adults finds pts w/ autoimmune dz have twice the risk of affective disorders (depression, bipolar dz, anxiety) significantly higher (p<0.001) (28.8% vs 17.9% in gen. population. Signif regardless of age, sex, ethnicity, income, Fam Hx, https://t.co/dsJxkvD4Nu
Dr. John Cush @RheumNow( View Tweet )
Jokes Aside: The Impact of Laughter in RA
Dr. Aurelie Najm reports on POS0685, 'The Impact of Social Frailty and Physical Function on Laughter Frequency in Rheumatoid Arthritis Patients from a Multicenter Observational Study (T-FLAG)', presented at EULAR 2025 in Barcelona, https://t.co/z3tvqQmH96
Dr. John Cush @RheumNow( View Tweet )
Transcranial Stimulation is Effective in Fibromyalgia
A randomized, controlled clinical trial in fibromyalgia (FM) has shown the efficacy of transcranial direct current stimulation (A-tDCS) (along with exercise and pain neuroscience education [PNE]), in alleviating the pain. https://t.co/kJk1R8ubqk
Dr. John Cush @RheumNow( View Tweet )
Older adults with chronic MSK pain report lower physical health—but better mental health—than younger peers.
Fewer missed work days, too.
Is this resilience, adaptation, or shifting expectations with age?
POS0402 @RheumNow #EULAR2025
Jiha Lee @JihaRheum( View Tweet )
Presenteeism and absenteeism in RA aren’t just about joints. In this UK study, comorbid anxiety, depression, and OA drove lost productivity.
Treating RA is not enough —holistic management matters.
POS0403 @RheumNow #EULAR2025
Jiha Lee @JihaRheum( View Tweet )
The relation between RA, comorbidities and presenteism
NRAS survey 891 RA pts
75% had at least one comorbidity
Absenteeism more likely if
One OR = 1.68 or Two OR = 2.26 comorbid conditions
In particular
Anxiety OR = 2.39
Depression OR = 1.75
Osteoarthritis OR = 1.85
Back
Aurelie Najm @AurelieRheumo( View Tweet )
Why do Rheumatologists shift to private practice? Are there gender based differences?
A survey of 100+ European rheumatologists
Female 🚺 rheumatologists:
Leave hospital earlier
At a lower hierarchical level
Reasons for leaving:
nightshifts
unfair promotion decisions
Aurelie Najm @AurelieRheumo( View Tweet )
ICI-PMR irAEs are sometimes underestimated compared to inflamm arthritis, but why?
ICI-IA and ICI-PMR look different, but at @HSpecialSurgery, steroid needs and disease impact for both are basically the same. Let’s not devalue either
@lovetolearn27 #EULAR2025 POS1200 @RheumNow https://t.co/NVq2tpjvdu
Links:
David Liew @drdavidliew( View Tweet )
Depression and anxiety in PsA is higher and has more consequences than in general population
Swedish and Danish clinical registers 23000+ PsA pts
HR 1.4 specialised psychiatric out/ inpatient care vs. general pop
HR for psychiatric in patient care numerically higher but ns.
No https://t.co/qduMcwGK0S
Aurelie Najm @AurelieRheumo( View Tweet )
#D2M_axSpA_saga 🇬🇷
Prevalence of D2M axSpA in 395 patients: 10.1%
Associated factors:
🔹️High disease activity at diagnosis
🔹️Comorbidities (high BMI, smoking, depression)
🔹️Unemployment
Kougkas et al.
POS#0121
#EULAR2025
@rheumnow https://t.co/vcPcTATTx5
Nelly ZIADE 🍀 @Nellziade( View Tweet )
#neuromodulation in #rheumatoid #arthritis
What is it?
👇
Autonomic & immune system interaction
Who seeks this Rx?
desperate pts w pain
No Rx left
Interested in technology
#EULAR2025 @RheumNow @eular_org
#D2T #RA https://t.co/XWWFiUK6Em
Links:
Janet Pope @Janetbirdope( View Tweet )
Even after having things laid out in a great debate, rheumatologists remain unconvinced by medical cannabis #EULAR2025 @RheumNow https://t.co/xMTvngS5N1
David Liew @drdavidliew( View Tweet )
Transcranial Stimulation is Effective in Fibromyalgia
A randomized, controlled clinical trial in fibromyalgia (FM) has shown the efficacy of transcranial direct current stimulation (A-tDCS) (along with exercise and pain neuroscience education [PNE]), in alleviating the pain. https://t.co/P8SKs3JNEx
Dr. John Cush @RheumNow( View Tweet )
We should address patients anxiety at RA diagnosis:
cohort 250+ newly diagnosed RA pts
-49% reported anxiety
-41% by 3 months
Anxiety asso w/ CDAI, PROs and 3-5 fold increase in prescription of bio/tsDMARDs
Analysis reasonably adjusted
POS0163 #EULAR2025 @RheumNow https://t.co/2gejEkRQhO
Aurelie Najm @AurelieRheumo( View Tweet )
Access inequity across Europe is real.
New #RheumaFacts data show major gaps in RMD care:
🔹 Full tsDMARD access in just 4% of countries
🔹 Self-referral possible in 57%
🔹 Rheum physio reimbursed in 63%
🔹 Psych care? Only 30%.
Abstract#OP0025
@RheumNow #EULAR2025
Jiha Lee @JihaRheum( View Tweet )
In #InflammatoryArthritis, baseline depression was linked to ↑ presenteeism & ↓ QoL at baseline + 3mo, but not absenteeism. Data from 9-country study provide further evidence that mental health is key to supporting work outcomes in RA, PsA & axSpA.
@RheumNow #EULAR2025 #OP0028
Mrinalini Dey @DrMiniDey( View Tweet )
Systematic review of fibromyalgia & sleep quality - 47 RCTs, 11094 pts showed CBT for insomnia had a significant improvement in sleep quality; but CBT for pain had no impact. Only moderate improvement w/ pregabalin, sodium oxybate; but no effect w/ amitriptyline, milnacipran, https://t.co/bArizMLGR8
Dr. John Cush @RheumNow( View Tweet )
Systematic review of fibromyalgia & sleep quality - 47 RCTs, 11094 pts showed CBT for insomnia had a significant improvement in sleep quality; but CBT for pain had no impact. Only moderate improvement w/ pregabalin, sodium oxybate; but no effect w/ amitriptyline, milnacipran, https://t.co/AEqbShRh6e
Dr. John Cush @RheumNow( View Tweet )
Psychological Bulletin has published that invalidating (gaslighting) pts Sxs can have harmful consequences. Includes pts dx w/ Ehlers-Danlos, endometriosis, fibromyalgia, ME/CFS, POTS, Gulf War, IBS, long Covid, multiple chemical sensitivity, SLE, and vulvodynia.
Dr. John Cush @RheumNow( View Tweet )
Review of Emerging Treatments for Vitiligo an immune mediated dz that affects QOL & has psychosocial impact. JAKi only ruxolitinib is FDA-approved, but Tofa & Bari show promise. Emerging therapies include simvastatin, afamelanotide, and metformin https://t.co/Rp2yYx6SyZ https://t.co/pBo1IDe8pQ
Dr. John Cush @RheumNow( View Tweet )
Psychological Bulletin has published that invalidating (gaslighting) pts Sxs can have harmful consequences. Includes pts dx w/ Ehlers-Danlos, endometriosis, fibromyalgia, ME/CFS, POTS, Gulf War, IBS, long Covid, multiple chemical sensitivity, SLE, and vulvodynia.
Dr. John Cush @RheumNow( View Tweet )
How Living With Childhood-Onset Lupus Impacts Mental Health
Children, teens, and young adults with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent organ damage. Recently, the mental health burden for cSLE patients has https://t.co/JXkdYiAO9o
Dr. John Cush @RheumNow( View Tweet )
Diagnosing Neuropsychiatric SLE (5.23.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow - including views on the vagus nerve, NPSLE and CAR-T mania.
https://t.co/PadauvfWWA https://t.co/4k4nfHSPg5
Dr. John Cush @RheumNow( View Tweet )
How Living With Childhood-Onset Lupus Impacts Mental Health
Children, teens, and young adults living with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent serious organ damage. By the mid-2010’s, multiple studies were published that showed high rates of depression, anxiety, and suicidal
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