Outcomes

cannabis,weed,marijuana

Medical Cannabis for Pain Management

Jack Cush, MD

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

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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

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Dr. John Cush @RheumNow( View Tweet )
purpura

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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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British Society of Rheumatology Guideline for Monitoring DMARDs

Jack Cush, MD

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
Dr. John Cush @RheumNow( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
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APPs in the News (12.5.2025)

Jack Cush, MD

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

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Dr. John Cush @RheumNow( View Tweet )
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Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it?

Jack Cush, MD

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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DMARDs,biologics,RA

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
Dr. John Cush @RheumNow( View Tweet )
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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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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High Cost of Cancelling Knee Replacement Surgery

Jack Cush, MD

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

Jack Cush, MD

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

Jack Cush, MD

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
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/KOZwedtnxo
Dr. John Cush @RheumNow( View Tweet )
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Turkey Tryptophan (11.28.2025)

Jack Cush, MD

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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Recent Blogs

rheumthought

CNS Lupus (NPSLE)

Jack Cush, MD
Cush RhTh CNS
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose? Read Post

Hydroxychloroquine for Everyone

Jack Cush, MD
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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 patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit. Read Post
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