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Outcomes

Best of 2025: Targeting Obesity in Rheumatic Disease Patients

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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Best of 2025: GRAPPA vs. EULAR on Complex/Difficult-to-Manage Psoriatic Arthritis

The “Difficult” framework has now reached PsA. At EULAR 2025, two independent definitions were presented: one by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis and another by EULAR. This short review explores the similarities and differences between these definitions

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Best of 2025: Contraception in SLE

Pregnancy in SLE gets a lot of press in the rheumatology literature, and deservedly so, since pregnancy risks can be markedly increased. It was not that many years ago that women with SLE were counseled to avoid pregnancy.

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Best of 2025: Hydroxychloroquine for Everyone

Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA

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Best of 2025: Glossary for Giant Cell Arteritis

Dejaco and colleagues have published a glossary of terms often used in conjunction with giant cell arteritis. The glossary of definitions for 23 signs and symptoms of GCA was developed through a consensus process involving international experts.

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Best of 2025: Distinguishing Septic and Gouty Arthritis

A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal threshold of 50,000 cells/mm3.

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Best of 2025: Dermatomyositis Reviewed

Researchers from the University of Pennsylvania have published an open-access review of dermatomyositis (DM) - its manifestations, hallmark cutaneous features, etiopathogenesis and treatment options.

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Disease Activity Criteria for Adult-Onset Still's Disease: EULAR Points to Consider EULAR has published a "points to consider" (PtCs) guidance on the development of criteria for the assessment of the disease activity in adult-onset Still’s disease (AOSD). https://t.co/3FikFiGgxM
Dr. John Cush @RheumNow( View Tweet )

Best of 2025: Methotrexate intolerance in rheumatoid arthritis

Methotrexate (MTX) is the most commonly used DMARD in rheumatoid arthritis (RA); however, there is significant intolerance to this drug among adult RA patients - especially at doses above 15 mg per week.

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Best of 2025: Overview of the VEXAS Syndrome

A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.

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“Absence of proof of efficacy does not equal proof of absence of efficacy” - Arthur Kavanaugh, MD

Dr. John Cush @RheumNow( View Tweet )

Austrian 1K Paracelsus cohort study; from 9,665, 296 (3.1%) had RA. CKD prevalence was higher in RA vs controls (11.8% vs. 6.7%, p<0.001). Albuminuria was dominant renal dz in RA (6.8% vs 4.2%, p=0.027), but missed signif after adjustments (OR 1.43; 0.96–2.13) https://t.co/9DnErwT4rX
Dr. John Cush @RheumNow( View Tweet )
2025 Adult Rheumatology Fellowship Match is Strong (Again) The ACR announced today that 2025 Medicine and Pediatric Specialties Match results show rheumatology fellowship positions continuing to fill at high rates. The Match uses a computerized process to pair applicant and https://t.co/ynP46pEKCa
Dr. John Cush @RheumNow( View Tweet )
ACR: New Data Highlights Urgent Need to Address Arthritis Burden New findings from national U.S. surveys reveal the profound impact of arthritis on millions of adults, especially those facing social and economic challenges. These data will be featured in an upcoming issue of https://t.co/3LlNQ3tx90
Dr. John Cush @RheumNow( View Tweet )
Five Fractures You Don’t Want to Miss In orthopedic practice, missing the wrong fracture can significantly alter a patient’s outcome. Certain injuries may appear subtle on initial imaging yet carry serious consequences if not promptly recognized and managed. https://t.co/zyCRdUkMua
Dr. John Cush @RheumNow( View Tweet )

Telling You Where to Go (12.19.2025)

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Who would've thunk - a PsA FMF connection? Labs to diagnose SSc-ILD? IgA-RF may be important or RZV may not work in JAK inhibitor treated patients?

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🦴 Genant-Modified Sharp Scoring System 🧮 A radiographic scoring system used to quantify joint damage in Rheumatoid Arthritis (RA), especially in clinical trials and long-term follow-up. 🔍 What does it assess? X-rays of hands and feet for: •Erosions •Joint Space Narrowing https://t.co/r5bvzFliBP

Ravi Kumar @RheumattDoc( View Tweet )

Tricks of the Trade – Clinic Advice from APPs

J. Cush and many APPs

December 2025 is focused on advanced practice providers, their impact, education and priorities.  In seeking and soliciting the help and advice of leaders in the rheumatology APP world, I have been impressed by APP pride, dedication and passion for what they do.

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MEDISPO study of 38 mild-mod psoriasis pts, 16-wk Mediterranean diet vs low-fat diet. Mediterranean diet did much better w/ PASI change −3.4 vs 0, more pts achieving a PASI 75 reduction (47.4% vs none) https://t.co/ZJU58VanGr https://t.co/x6juAT672B
Dr. John Cush @RheumNow( View Tweet )
IN RA: IgA-RF seen in 50%, IgA-ACPA in 20-40% (& are very specific). IgA-RF or -ACPA found in serum, saliva & syn.fluid.& may underlie "mucosal hypothesis" of RA. IgA-RF assoc w/ more severe RA, worse outcomes, Xtra-articular manifestations, & blunted TNF inhibitor responses https://t.co/SVUJmrIy2F
Dr. John Cush @RheumNow( View Tweet )
French ESTIVAL study - DB, sham trial of auricular vagal N stimulation in 148 Erosive hand OA (eHOA) pts w/ erosion + synovitis by US. @12wks, no signif difference in VAS pain (–16·0 vs –6 sham; p=0·22) w/ no safety issues. Was this a failed study or encouraging outcome? https://t.co/KI86H9izYS
Dr. John Cush @RheumNow( View Tweet )
76 PsA pts asked 32 questions submitted to Chat-GPT4 & 12 specialists. Answers were scored (accuracy, completeness). Both equally accurate, ChatGPT scored lower in completeness. Other pts reviewed answers; they preferred ChatGPT 49% vs clinician 34%. ChatGPT was more readable.

Dr. John Cush @RheumNow( View Tweet )

Austrian 1K Paracelsus cohort study; from 9,665, 296 (3.1%) had RA. CKD prevalence was higher in RA vs controls (11.8% vs. 6.7%, p<0.001). Albuminuria was dominant renal dz in RA (6.8% vs 4.2%, p=0.027), but missed signif after adjustments (OR 1.43; 0.96–2.13) https://t.co/qf0IpZC50Q
Dr. John Cush @RheumNow( View Tweet )

Optimizing Hydroxychloroquine Blood Levels in Lupus

A large observational cohort study suggests that monitoring hydroxychloroquine (HCQ) blood levels is effective in systemic lupus erythematosus (SLE) patients with a target therapeutic range (for HCQ level monitoring) of 750-1150 ng/ml.

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Survey of physician assistants finds 56% use AI daily (19% AI extensively). 87% PAs say they need to learn more about AI, 83% desire formal, employer-led AI training. 89% believe AI will dramatically changes PA practice, but only 32% have clear workplace guidelines on AI usage https://t.co/yGqZRC3mNt
Dr. John Cush @RheumNow( View Tweet )
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