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Outcomes

U Colorado compared 10K Traditional Rheum consults (TC) to 670 eConsults. 75% eConsults completed without F2F eval & 73% w/in 3 days. eConsults referred to F2F had better 180d completion rates (36% vs 19% TC, p< 0.001). Dx & Rx rates were similar. Most eConsults came from PCPs. https://t.co/fE6yLMcm25
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Fast Facts About Rheumatologist Compensation 2025: - Rheum among lowest paid (~$284k) - 2024 salaries rose 2% - 53% say theyre underpaid - 41% supplement their income - 6/10 recv incentive bonuses https://t.co/TrPRJ96hY0 https://t.co/2sP8DJTSeB
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TriNetX retrospective cohort study of 1402 propensity matched Systemic Sclerosis pts on vs off SGLT2 inhib (2013-2025) & found SGLT2i significantly lowered all-cause mortality (HR 0.54), stroke (HR 0.64), & hospitalizations (HR 0.76), moreso in SSc without Hx of CHF (HR 0.62) https://t.co/t6GVrN6zoQ
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High Cost of Cancelling Knee Replacement Surgery

Thousands of NHS knee replacement operations are cancelled at short notice every year, many for avoidable reasons, according to a new study published December 1st. This costs the NHS millions of pounds and increases waiting times for patients, many of whom are in severe pain.

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Consensus Definitions on Difficult to Treat Psoriatic Arthritis

A substantial number of patients with psoriatic arthritis (PsA), have difficult, persistent and hard-to-treat disease. A GRAPPA task force has developed a consensus terminology for two distinct states: complex-to-manage PsA and treatment-refractory PsA.

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Hematologic Malignancies Increased in Systemic Sclerosis

Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.

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BASDAI scores elevated in Fibromyalgia - 58 FM pts were surveyed wtih FIQ, SSS, BASDAI. BASDAI was ≥ 4 points in 91.4% of FM (vs 13% controls (p < 0.001). BASDAI correlated w/ the FIQ (pain, fatigue, stiffness) & SSS scores (r = 0.88, p < 0.00). Could BASDAI be used in FM? https://t.co/M0tI8wjzh4
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Partial vs Total Knee Replacement: Is One Superior? Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little https://t.co/KOZwedtnxo
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Turkey Tryptophan (11.28.2025)

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

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Obesity-inflammation axis in PsO & PsA: obesity is assoc w/ less remission& poorer drug responses; possibly from adipokines, biomechanical stress, gut dysbiosis, etc. Notably, weight loss can improve both psoriatic disease course and response to therapy. https://t.co/cZbeu0zfmR https://t.co/EoCTNKk265
Dr. John Cush @RheumNow( View Tweet )
BASDAI scores elevated in Fibromyalgia - 58 FM pts were surveyed wtih FIQ, SSS, BASDAI. BASDAI was ≥ 4 points in 91.4% of FM (vs 13% controls (p < 0.001). BASDAI correlated w/ the FIQ (pain, fatigue, stiffness) & SSS scores (r = 0.88, p < 0.00). Could BASDAI be used in FM? https://t.co/VF94ru0o3Q
Dr. John Cush @RheumNow( View Tweet )
2023 National Health Interview Survey studied arthritis-attributable work limitations (AAWL) in US adults (18-64 yrs) - it was 38.8% (unchanged from 2019). AAWL was higher in Hispanics (50%), American Indian/Alaska Natives (56%), & disabled (62%), & veterans (52%) https://t.co/sE3En74zfq
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Treating Refractory Still's Disease

A full read systematic review article examined treatment options for difficult to manage systemic juvenile idiopathic arthritis, or Still’s disease. It classified these refractory disease patients as those with either (1) persistent arthritis, (2) recurrent or difficult-to-treat

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Chronic pain may dramatically raise your blood pressure

Science Daily

Widespread chronic pain may stealthily drive up blood pressure, partly through its ties to depression and inflammation.

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CorEvitas observational registry of 3,696 w/ psoriatic arthritis (no hx of CV eents), followed for mean 3.7 yrs, showed that Dactylitis and enthesitis did not predict future CV events. But Dactylitis and enthesitis and Synovitis were all significantly interrelated. Cureus 17(11): https://t.co/kPgGKliUUs
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Betw 1990 to 2021 the global psoriasis burden had a slight increase w/ little difference betw men & women, roughly 57-61 100 000 (10% increase). Risk highest in N.America & W.Europe. PSO risk highest with higher incomes. https://t.co/raruHn5Txx https://t.co/bp1rWyWS7y
Dr. John Cush @RheumNow( View Tweet )
Partial vs Total Knee Replacement: Is One Superior? Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little https://t.co/abER7mS3QR
Dr. John Cush @RheumNow( View Tweet )

Managing Perioperative DMARDs with Arthroplasty

Postoperative complications with arthroplasty may be related to chronic inflammation and immunosuppressive therapy. Yet a recent retrospective study total ankle arthroplasty in end-stage RA patients shows that early postoperative wound complications are unaffected by the continued use of their

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Retrospective analysis of 2614 FM pts in the Italian Fibromyalgia Registry underscores the seasonal changes in FM pain, w/ signif. differences in FM assessment tools WPI p=0.042 & FASmod p=0.037); these changes were only seen in female patients, not males https://t.co/LqXnTgGIMB https://t.co/ihw1yJqKLC
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Vitamin D and Lupus Outcomes (11.21.2025) Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow. https://t.co/M2e4kMi5H7 https://t.co/wEcAjWJSk7
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Partial vs Total Knee Replacement: Is One Superior?

Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little bit better. Final results of the landmark TOPKAT study indicated that

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Colchicine prevents total joint arthroplasty (TJA). Study of 31,478 colchicine initiators, followed 4.5 yrs. W/ an overall 12% lower risk of TJA (HR 0.88 95% CI 0.81 to 0.96), and a 23% lower risk of TJA in those with knee/hip OA (HR 0.77) https://t.co/1JsZd8K0sI

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Retrospective study of 39 pts w/ MDA5 + DM-ILD Rx w baricitinib. 31 (79.5%) had improvement in Gottron’s, heliotrope, dyspnea, HRCT score, ferritin, LDH, steroid dose & 6 mo survival (87% vs. 70%, p = 0.047). https://t.co/8whN2I1hXh https://t.co/voSVzPQWUI
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A New Disease Activity Score for Antiphospholipid Syndrome? APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and https://t.co/eouynDPLUX
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Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual

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