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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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Lyme disease is endemic in Massachusetts. EHR study shows Lyme dz incidence declined from 211 per 100 000 patients in 2012 to 86 per 100 000 in 2024 (P< .001), but this decr. was driven by 1 large practice group implemented a new initiative to reduce Lyme Dx & Rx in pts w/ https://t.co/lMCUA9o4Uc
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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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Recent study shows that betw 2018-2023 # of Concierge medicine practices in the USA has increased 78.4% (3,935 to 7,021); mostly in Texas (402), California (387), Florida (352), Georgia (139).” Notably a signif growth of corporate owned practices, increased from 9.2% to https://t.co/nVRPfnwjZv
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Wolters Kluwer surveyed 203 PAs: - 62% wish for more clinical experience prior to - Most adopted AI, majority need more AI training - 45% prefer title of “physician associate” https://t.co/96Hkh21wSr https://t.co/j7Xep47qMN
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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.

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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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Evaluation of Rheumatic Complaints https://t.co/cdizOgFqYf https://t.co/sqbrY2oGcH
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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 Arthritis Care & Research, an official journal of the American College of

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Role of the Nurse in the Care and Management of Rheumatic Diseases - EULAR Review

In 2023, a EULAR subcommittee set out to assess the roles of nurses and Advanced Practice Nurses (APN) in the care of arthritis as outlined in published EULAR guidelines. The scope of APN practices was first proposed in 2012 and revised in 2018. EULAR updated its recommendations for the role

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AANP survey of US 2338 Nurse Practitioners (mostly primary care) re: shared pts w/ rheumatologists. NPs managing RA want improved communication w/ rheums, & education on RA management. PC NP confidence w/ RA was 47% Somewhat confident, 6% very confident, 19% not confident. https://t.co/YVEpJua9hj
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Top 10 States to Practice Rheumatology 1 North Dakota 2 Wisconsin 3 Alaska 4 Montana 5 South Dakota 6 Nebraska 7 Minnesota 8 Washington 9 Utah 10 Maine https://t.co/x2tKflV2S7 https://t.co/fLMEhQV0js
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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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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
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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. 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
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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 https://t.co/iANvir1EFI
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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
Dr. John Cush @RheumNow( View Tweet )
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
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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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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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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
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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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
Dr. John Cush @RheumNow( View Tweet )
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