Sjögren's Graduates (8.22.2025)
Dr. Jack Cush reviews the news, journal reports, FDA approvals, drug safety, and more from this week.
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RCT of 2331 chronic MSK pain pts showed that telehealth Cognitive behavioral therapy (CBT) (health coach) superior to self-care (Pain trainer) or usual care at achieving a >30% reduction in pain (32% vs 26.6% vs 20.8% respectively) & benefits were sustained at 12 months. https://t.co/a69zPsJslH
Dr. John Cush @RheumNow( View Tweet )
Pain Flares in RA are just pain, not inflammation. Study of 195 RA pts (11+ yrs dz dur), 49-89% experienced at least 1 flare (median 2-4 flares/mo), IQR 2.1-5), lasting median of 2 days. Flares preceded by worsening mood, anxiety, sleepiness - but no change in Accelerometer https://t.co/csbHtiEglp
Dr. John Cush @RheumNow( View Tweet )
Pain Flares in RA are just pain, not inflammation. Study of 195 RA pts (11+ yrs dz dur), 49-89% experienced at least 1 flare (median 2-4 flares/mo), IQR 2.1-5), lasting median of 2 days. Flares preceded by worsening mood, anxiety, sleepiness - but no change in Accelerometer https://t.co/twI6wcxKf7
Dr. John Cush @RheumNow( View Tweet )
The Patient Journey with Rheumatic Disease
Oton and colleagues have reviewed the "patient journey" - from symptoms to specialty referral in those diagnosed with rheumatic and musculoskeletal diseases (RMDs).
Metanalysis of 35 studies, 887 participants, shows 3 consecutive nights of sleep deprivation (~4.3hr/hs) assoc w/ signif. increase in IL-6 (p < 0.01) and C-reactive protein (p = 0.03) in blood. This was not seen w/ a single night of total or partial sleep deprivation https://t.co/M60wPUbsch
Dr. John Cush @RheumNow( View Tweet )
Repurposing & Pipeline (8.8.2025)
Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.
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A New RA Approval (8.1.2025)
Dr. Jack Cush reviews the news, journal reports and a new treatment for RA from the FDA.
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CKD & Osteoporosis Rx Revisited (7.25.2025)
Dr. Jack Cush reviews the news, journal and FDA updates from this past week on RheumNow.com.
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La Paz study of 903 RA pts; 136 (14.5%) were D2T-RA, 96 for inefficacy. They define early vs Late D2T-RA=44.5 mos, & differed>> Early D2T-RA (1/3) pts more likely to have anxiety or depression (76% v 0), higher CRP @6mos, & time to develop D2TRA (35 vs 70 mos) https://t.co/KFG68y9Uq5
Dr. John Cush @RheumNow( View Tweet )
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 )
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