Reefer Madness (12.12.2025)
Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com. B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.
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Dr, Tuhina Neogi writes its time for a new understanding of OA; its not just wear n tear. Based on preclinical and clinical evidence, OA is a systemic, whole-body disease and that this should change future research and treatment of #OA. https://t.co/gn9xt6CafP https://t.co/2iSKiyiCX4
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Dr. John Cush @RheumNow( View Tweet )
GESPIC - German SpA study of 252 SpA (139 nr- axSpA, 113 r-axSpA), followed w/ serial Xrays and mSASS Scores over 2 yrs. 80% were on NSAIDs. Higher NSAID intake, particularly COX2i, on slowing radiographic progression in axSpA https://t.co/sKgCGaJFVr https://t.co/jMQTAnsCmG
Dr. John Cush @RheumNow( View Tweet )
PSS & Biomarkers: Dutch international scleroderma trial of 21 pts showed that cartilage oligomeric matrix protein (COMP), and collagen type IV alpha 1 (COL4A1) significantly correlated with modified Rodnan skin score; COMP were associated with mRSS change (r = 0.013) https://t.co/E7SgmIiYmn
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JAMA reports that by end of 2025, half (52-56%) of USA nonfederal acute care hospitals will use generative AI and predictive AI. Teaching hospitals and EPIC EHR are early adopters, while For-profit and government hospitals were less likely to currently adopt AI. https://t.co/iJib0YjnW3
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2025 Adult Rheumatology Fellowship Match is Strong (Again)
ACR
The American College of Rheumatology (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 program preferences, determining where
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Medical Cannabis for Pain Management
Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients.
Chronic pain affects more than one in five American adults, yet practitioners are limited in treatment alternatives. Even if we exclude the
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Phase 1 trial of IL-6 targeting immunotherapy (PPV-06) in 24 pts w/ inflammatory knee osteoarthritis (KOA) demonstrates safety, Abs that neutralize IL-6, decreasing CRP values and improved clinical outcomes, determined by changes in KOOS scores https://t.co/urZupN62Kw https://t.co/sru1SnsOig
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Dr. John Cush @RheumNow( View Tweet )
Dr, Tuhina Neogi writes its time for a new understanding of OA; its not just wear n tear. Based on preclinical and clinical evidence, OA is a systemic, whole-body disease and that this should change future research and treatment of #OA. https://t.co/HQWI14WSXg https://t.co/5bIWgqaETU
Links:
Dr. John Cush @RheumNow( View Tweet )
Simple, low-cost strategy to Dx/Prognose GCA using CBC components NLR & PLR. 119 GCA vs 131 non-GCA pts - All CBC biomarkers signif assoc w/ ESR & CRP, but ESR/CRP did not predict mortality over time; YET mortality signif predicted by PLR, NLR, MLR (P value < 0.044) https://t.co/96Q7jDAiWt
Dr. John Cush @RheumNow( View Tweet )
2018 NHANES population survey of 28,040 individuals, 4168 (14.32%) identified with sleep disorders, and 1589 (4.28%) had #RA. Thus, sleep disorders were significantly associated with increased odds of RA (OR = 1.76, 95% CI: 1.46–2.13, P < 0.001). https://t.co/9O2MsLvwVe https://t.co/cBsm8Jt8Ks
Dr. John Cush @RheumNow( View Tweet )
B Cell Targeting in Idiopathic Thrombocytopenic Purpura
EurekAlert!
The New England Journal of Medicine has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune
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Cross-sectional study of 79 743 US primary care practices compared those with and without NPs. NP practices were more likely to be located in lower incomes and lower educational communities. NPs predominated in areas with highest need but lowest supply of PCPs. https://t.co/tSi1OnoSlA
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Cochrane review of nurse-led care (NLC) in RA, included 14 articles & 3369 RA pts. NLC proves highly effective in managing RA patients, surpassing usual care and equating to rheumatologist-led care in dz activity and some secondary (self efficacy, pain, QOL) outcomes https://t.co/gd9vbcOR8P
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British Society of Rheumatology Guideline for Monitoring DMARDs
The British Society of Rheumatology has published an update to their previous 2017 BSR/BHPR guideline regarding the use and monitoring of DMARDs (disease-modifying anti-rheumatic drugs) used to treat systemic autoimmune rheumatic diseases (SARDs).
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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/CVkRJegei9
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PROSPERO metanalysis of 22 studies & 2208 JIA associated uveitis (JIAU) showed severe visual impairment in 16.6% at ~18 yrs. Most frequent: Cataract (44.3%), followed by glaucoma, synechiae, band keratopathy and hypotony. Biologics were protective https://t.co/6OoupX64NE https://t.co/7bp0JtRken
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APPs in the News (12.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.
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Survey of 500 Rheum Patients, 37% reported having APPs (NP or PA) as primary rheum providers. APP patients had greater ease scheduling& more prefer to see APPs over rheumatologists (P < 0.01) & recommend APPs . No difference between MD vs APP experience https://t.co/VShREnhsMG https://t.co/glaIUPZ5qh
Dr. John Cush @RheumNow( View Tweet )
Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it?
Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) the data supporting its use is limited.
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DMARD Treatment Lags for Minority Groups with Rheumatoid Arthritis
MedPage Today
Use of disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) was markedly lower among all major racial-ethnic minority groups in the U.S. compared with white patients, analysis of federal survey data indicated, even after adjusting for income, education, and other factors
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Long-Term APP Retention: Building Success for Practices and Providers
Advanced Practice Providers (APPs) are vital in rheumatology due to rising patient numbers and the need for prompt care. Their integration enhances practice efficiency, improves patient access, and balances https://t.co/bZBkbWyWfI
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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