Moral Distress (3.27.2026)
Dr. Jack Cush reviews the journal reports and news from RheumNow.com. This week we discuss moral distress, FM in PsA, Lyme Vax is back & hidden but tangible benefits of the MDHAQ.
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A multi-center, retrospective chart review of 82 Still's disease pts (63% female; mean Dx age 6.4 ± 4 yrs; F/U ~2.8 yrs). When analyzing Dz course, 34% were monophasic, 46% polyphasic (higher-than-expected), 19.5% persistent Dz. non-monophasic predicted by active 3 mos from Dx https://t.co/XWJSsIE7Pn
Dr. John Cush @RheumNow( View Tweet )
Rheumatology Pitfalls (3.20.2026)
Dr. Jack Cush reviews the regulatory actions, news and journal reports from this past week on RheumNow.com.
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FDA has approved secukinumab (Cosentyx) for use pediatric patients (aged >12yrs) with moderate to severe hidradenitis suppurativa https://t.co/G1BtS15sWT
Dr. John Cush @RheumNow( View Tweet )
A multi-center, retrospective chart review of 82 Still's disease pts (63% female; mean Dx age 6.4 ± 4 yrs; F/U ~2.8 yrs). When analyzing Dz course, 34% were monophasic, 46% polyphasic (higher-than-expected), 19.5% persistent Dz. non-monophasic predicted by active 3 mos from Dx https://t.co/qtONtpeA22
Dr. John Cush @RheumNow( View Tweet )
2 RCTs of 699 children Tx in ER for acute limb injury compared 1 dose of oral acetaminophen or hydromorphone to ibuprofen - none significantly reduce self-reported pain scores at 60 minutes. Use of hydromorphone resulted in a 4-fold increase in adverse events. https://t.co/cqddDES9V0
Dr. John Cush @RheumNow( View Tweet )
UBER Rheumatology Ride (3.6.2026)
Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com
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New studies posted this week in Arthritis & Rheumatology:
Adalimumab ± MTX as first-line therapy for childhood-onset chronic uveitis
https://t.co/L4QiZZBBG7
Bisphosphonates & PPI/H2RA coprescriptions in polymyalgia rheumatica
https://t.co/62Pqt5Ab58
Phase 3b SOLSTICE trial: https://t.co/MsK4XC3eNh
Links:
American College of Rheumatology @ACRheum( View Tweet )
Spectrum of skin Sxs in 518 pts w/ Stills dz from AutoInflammatory Dz Alliance (AIDA) Network Registry dedicated to Still’s disease includes Salmon evanescent rash (64%), macules (7.7%), urticaria (6%), persistent pruritic papules & plaques (PPPP) (4.8%) https://t.co/DW9NoaxNPP https://t.co/U5GrCutYT0
Links:
Dr. John Cush @RheumNow( View Tweet )
Study of 90 adolescents (46 w. Juvenile fibromyalgia (JFM) & 44 controls) finds that JFM pts have greater sensitivity to non-painful sensory stimuli, such as sounds and bright lights; such hypersensitivity is closely related to the severity of the disease and brain function https://t.co/KGqzRK6e4a
Dr. John Cush @RheumNow( View Tweet )
DMARD Responses in Localized Scleroderma
JAMA Dermatology has published the results of a juvenile localized scleroderma (JLS) trial showing that mycophenolate mofetil (MMF) and methotrexate (MTX) are equally effective in treating JLS, noting low flare rates and possibly better https://t.co/6bDtVoCgRj
Dr. John Cush @RheumNow( View Tweet )
DMARD Responses in Localized Scleroderma
JAMA Dermatology has published the results of a juvenile localized scleroderma (JLS) trial showing that mycophenolate mofetil (MMF) and methotrexate (MTX) are equally effective in treating JLS, noting low flare rates and possibly better https://t.co/BbIS5rdRYU
Dr. John Cush @RheumNow( View Tweet )
DMARD Responses in Localized Scleroderma
JAMA Dermatology has published the results of a juvenile localized scleroderma (JLS) trial showing that mycophenolate mofetil (MMF) and methotrexate (MTX) are equally effective in treating JLS, noting low flare rates and possibly better tolerability with MMF.
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Emergencies, Independence & Hemorrhage (1.23.2026)
Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com
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Nurse Practitioner Independence
A JAMA Viewpoint article reports on a March 2025 Nurse Practitioner (NP) Entrepreneurship Summit in Boston in March 2025 identifying barriers and opportunities to NP-owned medical practices.
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A 2 yr. old female pt reported w/ a a novel P435S gain-of-function variant in TLR7 (thought pathogenic in SLE) - pt dx w/ juvenile SLE, recurrent infection, and neuroinflammatory features. A review of 12 other TLR7 GOF variants revealed similar SLE associations. https://t.co/NU553QwCtj
Dr. John Cush @RheumNow( View Tweet )
The 2025 Rheumatology Year in Review
The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.
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A 2 yr. old female pt reported w/ a a novel P435S gain-of-function variant in TLR7 (thought pathogenic in SLE) - pt dx w/ juvenile SLE, recurrent infection, and neuroinflammatory features. A review of 12 other TLR7 GOF variants revealed similar SLE associations. https://t.co/TGgKDQ0D7F
Dr. John Cush @RheumNow( View Tweet )
ADJUST trial (248 JIA pts w/ Uveitis & inactive >6mos, either continued or weaned off adalimumab. ADA weaning resulted in more flares (68% vs 14%, mostly uveitis) w/ no protection from background DMARD Rx. Restarting ADA was mostly effective. https://t.co/ZWHfPl2UNl https://t.co/xodyrbaQOj
Dr. John Cush @RheumNow( View Tweet )
Best of 2025: 2025 BSR Guideline for Treatment of Axial Spondyloarthritis
Editor's note: This article was originally published April 22, 2025, and is being shared again as part of RheumNow's 'Best of 2025' series as we close out the year. Enjoy!
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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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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).
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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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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
Dr. John Cush @RheumNow( View Tweet )
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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Advancing the Treatment Landscape for Pediatric Psoriatic Disease
Sponsored by Johnson & Johnson
Learn more about a treatment offering pediatric patients 6 years and older who also weigh at least 40 kg, and their physicians and adult caregivers, an option that may improve skin clearance for moderate to severe plaque psoriasis or treat active psoriatic arthritis, collectively known as psoriatic disease.
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Recent Blogs
Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.
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I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine.
How did we decide which words should perish? And by what criteria? Who has the final say?
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Still's disease: paediatrics to adults, a continuum or not?
Dr. Ilenia Di Cola and Dr. Piero Ruscitti
Still’s disease is a rare inflammatory disorder, affecting less than 1 person per 2000 people. This disease may occur in both children and adults, namely as systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD).
The paediatric form was described by George Still in 1896, whereas the adult variant later by Eric Bywaters in 1971. However only the adult disease is identified by the name of Still.
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