EMR Messaging Woes (4.11.2025)
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com
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Delays in RA diagnosis can lead to irreversible joint damage. 14-3-3eta complements traditional biomarkers to improve early detection and monitoring. Dr. @WalterMaks outlines its clinical value. Sponosred by Augurex. Learn more: https://t.co/1ICzyRgzMe https://t.co/JKITbo1NKT
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Dr. John Cush @RheumNow( View Tweet )
43 days to the Lupus Congress 2025 in Toronto 🦋...see you soon!
Abstract Sessions, Poster Tour Presentations, Plenary Sessions, Scientific Sessions, Debate Sessions, Patient Sessions, Fishbowl Discussion, and GALA DINNER on May 23!!!
@LupusCongress https://t.co/MaWjyofnIz
Zahi Touma, MD, PhD @ZahiTouma( View Tweet )
EPIC EHR data assessed pre- & post-COVID. Pt messaging increased w/ pandemic & remained elevated, w/ no change in pt phone calls. MD EHR time/wk increased for all MDs, post COVID-19: (PCP +6.5%), subspecialists (+9.9%), surgeons (+5.2%). https://t.co/nJZw0Ftjqi https://t.co/ty942TGblu
Dr. John Cush @RheumNow( View Tweet )
Systemic sclerosis pts in the PRESS & STRIKE cohorts - High type I interferon (IFN) scores in diffuse SSc pts correlated w/ high disease activity & worse 12-month prognosis and overall survival. https://t.co/pdPjoVfQNH https://t.co/RB7li2ZIxX
Dr. John Cush @RheumNow( View Tweet )
Should Lupus Nephritis Receive PJP Prophylaxis?
A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and risk factors.
There are no clear guidelines
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185 children with SLE (cSLE) were analyze for long-term outcomes. 38 (20.54%) had serositis. Pts w/ serositis were younger, had more Dz activity, acomorbidities, & mortality. Having both serositis and ESRD increased risk of poor 20 Yr survival. https://t.co/fw8wcuS48E https://t.co/LgS3Sxy7gd
Dr. John Cush @RheumNow( View Tweet )
EPIC EHR data assessed pre- & post-COVID. Pt messaging increased w/ pandemic & remained elevated, w/ no change in pt phone calls. MD EHR time/wk increased for all MDs, post COVID-19: (PCP +6.5%), subspecialists (+9.9%), surgeons (+5.2%). https://t.co/j8zwPkdmp9 https://t.co/SyYpZwnMfN
Dr. John Cush @RheumNow( View Tweet )
Pregnancy-Related Deaths in the US
A CDC cross-sectional national study showed an increase in pregnancy-related deaths in the US from 2018 to 2022, with highest rates among American Indian, Alaska Native women, and non-Hispanic Black women.
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Mindfulness and CBT improve chronic low back pain
Behavioral interventions were associated with reduced pain and daily opioid use and improved function and quality of life for up to 12 months among adults with opioid-treated chronic low back pain, according to a new randomized https://t.co/e4jLNwNBy3
Dr. John Cush @RheumNow( View Tweet )
185 children with SLE (cSLE) were analyze for long-term outcomes. 38 (20.54%) had serositis. Pts w/ serositis were younger, had more Dz activity, acomorbidities, & mortality. Having both serositis and ESRD increased risk of poor 20 Yr survival. https://t.co/tnYgg6MNXp https://t.co/zJor1oTFfD
Dr. John Cush @RheumNow( View Tweet )
RA Prevention through Deep Immunophenotyping
Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for rheumatoid arthritis (RA). They have found the expansion of specific T cell subtypes, in the at-risk group, and postulate this could lead to future immunospecific prevention
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Uveitis Risk with Slow Adalimumab Weaning
MedPage Today
Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.
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JAMA Staphylococcus aureus Review
- s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%)
- bacteremia (≥48 hs) has 39% 90-day mortality risk
https://t.co/atao3mF32L https://t.co/oMSJVNKvJN
Dr. John Cush @RheumNow( View Tweet )
Matched cohort study of 83,811 #RA pts showed RA had a 12% increased risk of avoidable hospitalizations (CHF, pulmonary edema; (IRR 1.12). Predictors of ACSC hosp. were age, Steroids, ambulatory comorbid Dxs. ambulatory care access & ^ primary care may reduce this risk. https://t.co/Tx7LO59RbP
Dr. John Cush @RheumNow( View Tweet )
12-month community trial 770 adults w/ opioid-treated chronic low back pain (CLBP). Found that opioid dosage decreased with both mindfulness-based therapy & cognitive behavioral therapy (CBT) at 6 & 12 mos.(noninferior) - Why dont we use these? https://t.co/9VhqJEHlhc https://t.co/GWnL66nbvY
Dr. John Cush @RheumNow( View Tweet )
NORD-STAR RCT: Rx -naïve pts w/ early #RA found triple (MSH) Rx w/ prn IA steroid injx was superior to MTX + Pred (w/ taper) - w/ better clinical outcomes, fewer withdrawals, fewer AEs, & less steroid use BUT slightly worse Xray outcomes https://t.co/YN6Om2xdIP https://t.co/a7G8WFZSK7
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Dr. John Cush @RheumNow( View Tweet )
ACP: Best Practice Advice on Cannabis or Cannabinoids Use for Chronic Noncancer Pain
The American College of Physicians published a best practice advisory on cannabis or cannabinoids in the Annals of Internal Medicine.
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Mindfulness and CBT improve chronic low back pain
EurekAlert!
Behavioral interventions were associated with reduced pain and daily opioid use and improved function and quality of life for up to 12 months among adults with opioid-treated chronic low back pain, according to a new randomized clinical trial.
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Diagnostic delays and Undertreatment of Psoriatic Arthritis
New research from the University of Bath in the UK reveals delayed diagnosis and undertreatment of psoriatic arthritis often results in irreversible damage to joints.
https://t.co/AyaxUXJs8n https://t.co/9x9GhnTR1Y
Dr. John Cush @RheumNow( View Tweet )
Matched cohort study of 83,811 #RA pts showed RA had a 12% increased risk of avoidable hospitalizations (CHF, pulmonary edema; (IRR 1.12). Predictors of ACSC hosp. were age, Steroids, ambulatory comorbid Dxs. ambulatory care access & ^ primary care may reduce this risk. https://t.co/AxQVoXoxxx
Dr. John Cush @RheumNow( View Tweet )
Vamorolone: a New Steroid on the Horizon?
Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases. It is a dissociated steroidal compound with reduced side effects, and in an animal model of inflammation has shown effective antiinflammatory properties and reduced systemic
Steroids, Prophylaxis and Pneumocystis Pneumonia
A case-control study has shown that glucocorticoids and tapering glucocorticoids are risk factors for the development of Pneumocystis jirovecii pneumonia (PJP). The authors provide guidance on the optimal timing for prophylaxis use and withdrawal.
1st Line Biologics vs. csDMARDs in Adult Still's Disease
A German multicentre, retrospective study assessed the first-line efficacy of biologics and conventional synthetic DMARD therapy in patients with adult-onset Still's disease (AOSD) and found biologic agents were https://t.co/EeSuBiYx5Q
Dr. John Cush @RheumNow( View Tweet )
Upadacitinib for Giant-Cell Arteritis - A Phase 3 Trial
The NEJM has published a randomized controlled trial in giant-cell arteritis (GCA) patients, demonstrating significant efficacy and safety of upadacitinib (UPA), given as 15 mg daily, as compared to placebo.
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