Practice

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Optimizing Hydroxychloroquine Blood Levels in Lupus

Jack Cush, MD

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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Metabolic Bone Pearls Join Betsy Kirchner, NP for a quick video today on tips and tricks related to metabolic bone disease. https://t.co/426ddCGo3f https://t.co/SxHhGWWAhj

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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/1p7o10kLPR
Dr. John Cush @RheumNow( View Tweet )
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Five Fractures You Don’t Want to Miss

Jordan Lyons, MS, PA-C

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. Below are five fractures that warrant a high index of suspicion due to

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APP QD Clinic: Difficult AxSpA Philip Mease, MD and Christy Vath, PA-C, Seattle discuss a difficult to treat axial spondyloarthritis (axSpA) case. This APP QD clinic is presented as part of RheumNow's "Mission: APP Partners in Care" campaign during the month of December. https://t.co/VY0O26l7XC
Dr. John Cush @RheumNow( View Tweet )
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 https://t.co/iANvir1EFI
Dr. John Cush @RheumNow( View Tweet )
The 1st Nurse Practitioner program was launched in 1965 (@ Univ Colorado), since then the profession has grown to >461,000 licensed NPs nationwide (up from 385,000 in 2023). ~1 billion patient visits are delivered by NP’s every single year https://t.co/Ma9wHHiy8E https://t.co/gytIMsd2wt

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Evaluation of Rheumatic Complaints https://t.co/dZjD1Y5IBn https://t.co/WwhMbUysZl

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QD Clinic: Weakness with Fibromyalgia ack Cush, MD and Leilani Law, APN, Dallas, TX, discuss a case about weakness with fibromyalgia and how to best treat the complaints she presents with. This APP QD clinic is presented as part of RheumNow's "Mission: APP Partners in Care" https://t.co/OHeTdemtra
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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Reefer Madness (12.12.2025)

Jack Cush, MD

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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FDA has issued its final guidance on: Promotional Labeling and Advertising Considerations for Prescription Biological Reference Products, Biosimilar Products, and Interchangeable Biosimilar Products: Questions and Answers https://t.co/69sbgoWnSW https://t.co/kpTgdPOkka

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Dr. John Cush @RheumNow( View Tweet )
FDA has issued its final guidance on: Promotional Labeling and Advertising Considerations for Prescription Biological Reference Products, Biosimilar Products, and Interchangeable Biosimilar Products: Questions and Answers https://t.co/bjiV4S0Fur https://t.co/dDyJqhV5VF

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Dr. John Cush @RheumNow( View Tweet )
The countdown is on! ⏱️ Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one. ✅ Register now at https://t.co/4UQlqwujiR 🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu

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Dr. John Cush @RheumNow( View Tweet )
APP QD Clinic: Difficult AxSpA Philip Mease, MD and Christy Vath, PA-C, Seattle discuss a difficult to treat axial spondyloarthritis (axSpA) case. This APP QD clinic is presented as part of RheumNow's "Mission: APP Partners in Care" campaign during the month of December. https://t.co/qlBUtt6zWr
Dr. John Cush @RheumNow( View Tweet )
APP QD Clinic: Unweanable PMR APP QD Clinic: Unweanable PMR Jack Cush, MD, and Leilani Law, APN, Dallas, TX, discuss a case regarding unweanable polymyalgia rheumatica. This APP QD clinic is presented as part of RheumNow's "Mission: APP Partners in Care" campaign during the https://t.co/Gl8iQJf1d2
Dr. John Cush @RheumNow( View Tweet )
INITIAL Goal is to not miss Red Flag Conditions (Fx, septic or crystal arthritis [all acute monarticular})! Then provide timely Dx & Rx by establishing acute vs chronic, inflam vs noninflam, & articular vs nonarticular.

Dr. John Cush @RheumNow( View Tweet )

The Essential Role of Physician Assistants in Rheumatology Ready to bring a PA into your rheumatology practice? This blog post breaks down the key facts you need to know about PA training, scope of practice, and the recent changes to the profession's title. https://t.co/0aCTUpWMab
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Focus on Guidelines https://t.co/Dgu0F5UiNY

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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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APPs in the news (12.5.2025) Dr. Jack Cush reviews the news and journal reports from https://t.co/V10S4oVFsv, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salaries concerns. https://t.co/znsjhTqTEv https://t.co/F0eu5w232C

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Dr. John Cush @RheumNow( View Tweet )
RHEUM Survey> What is the goal for every new MSK patient evaluation?

Dr. John Cush @RheumNow( View Tweet )

DMARD Treatment Lags for Minority Groups with Rheumatoid Arthritis Use of disease-modifying anti-rheumatic drugs (DMARDs) for 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, https://t.co/eZOLAN4KVr
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/MfmzWwvtZx https://t.co/5Fe2AQgkN2

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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 )

Recent Blogs

Advanced Practice Rheum

Evaluation of Rheumatic Complaints

Jack Cush, MD
Evaluation of MSK cover
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice. Read Post
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
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