Dr. John Cush
@rheumnow.bsky.social
Know-it-Now. Info on RA, Stills disease, Lupus, Gout, Pregnancy, Spondylitis, Psoriasis, Drug Safety, Rheumatology Research, Medical Education & Drug Evaluation
Rheumnow.com
Rheumnow.com
Survey of 500 Rheum Pts, 37% reported having APPs (NP, 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 acrjournals.onlinelibrary.wiley.com/doi/abs/10.1...
acrjournals.onlinelibrary.wiley.com
December 5, 2025 at 12:03 AM
Survey of 500 Rheum Pts, 37% reported having APPs (NP, 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 acrjournals.onlinelibrary.wiley.com/doi/abs/10.1...
Retrospective study of 546 DM or clinically amyopathicDM. 5 factors were signif assoc w/ cancer (1 point ea): 1) TIFF-1-γ Ab (OR 3.8), poikiloderma (OR 3.1), DM subtype (2.8), anemia (2.4); ILD was protective (OR 0.4). Elevated DM cancer risk seen w/ scores 4-5 jamanetwork.com/journals/jam...
Predicting Malignant Disease in Adult Patients With Dermatomyositis
This cohort study validates the usefulness of a novel prediction model for cancer-associated likelihood in adult patients with dermatomyositis.
jamanetwork.com
December 4, 2025 at 10:54 PM
Retrospective study of 546 DM or clinically amyopathicDM. 5 factors were signif assoc w/ cancer (1 point ea): 1) TIFF-1-γ Ab (OR 3.8), poikiloderma (OR 3.1), DM subtype (2.8), anemia (2.4); ILD was protective (OR 0.4). Elevated DM cancer risk seen w/ scores 4-5 jamanetwork.com/journals/jam...
Changing Loan Limits for APPs
The "One Big Beautiful Bill" (OBBB) changes healthcare education funding by lowering loan limits for graduate programs--this aims to address the federal budget, reduce the DOE's role, and counter claims that unlimited loans raise tuition in the USA.
buff.ly/CQ9bJom
The "One Big Beautiful Bill" (OBBB) changes healthcare education funding by lowering loan limits for graduate programs--this aims to address the federal budget, reduce the DOE's role, and counter claims that unlimited loans raise tuition in the USA.
buff.ly/CQ9bJom
December 4, 2025 at 10:01 PM
Changing Loan Limits for APPs
The "One Big Beautiful Bill" (OBBB) changes healthcare education funding by lowering loan limits for graduate programs--this aims to address the federal budget, reduce the DOE's role, and counter claims that unlimited loans raise tuition in the USA.
buff.ly/CQ9bJom
The "One Big Beautiful Bill" (OBBB) changes healthcare education funding by lowering loan limits for graduate programs--this aims to address the federal budget, reduce the DOE's role, and counter claims that unlimited loans raise tuition in the USA.
buff.ly/CQ9bJom
December 4, 2025 at 8:01 PM
High Cost of Cancelling Knee Replacement Surgery
NHS knee replacement surgeries are often cancelled at short notice each year for preventable reasons, leading to millions in costs and longer waiting times for patients in severe pain, according to a study released on December 1st.
buff.ly/5bxJxW1
NHS knee replacement surgeries are often cancelled at short notice each year for preventable reasons, leading to millions in costs and longer waiting times for patients in severe pain, according to a study released on December 1st.
buff.ly/5bxJxW1
December 4, 2025 at 7:00 PM
High Cost of Cancelling Knee Replacement Surgery
NHS knee replacement surgeries are often cancelled at short notice each year for preventable reasons, leading to millions in costs and longer waiting times for patients in severe pain, according to a study released on December 1st.
buff.ly/5bxJxW1
NHS knee replacement surgeries are often cancelled at short notice each year for preventable reasons, leading to millions in costs and longer waiting times for patients in severe pain, according to a study released on December 1st.
buff.ly/5bxJxW1
Legislative Issues Affecting APPs
Major interstate “compacts” allow for cross state licensing for physicians. However, compacts for Advanced Practice Registered Nurse (APRN) are fewer and currently on hold - thereby limiting healthcare manpower and patient care.
rheumnow.com/news/legisla...
Major interstate “compacts” allow for cross state licensing for physicians. However, compacts for Advanced Practice Registered Nurse (APRN) are fewer and currently on hold - thereby limiting healthcare manpower and patient care.
rheumnow.com/news/legisla...
December 4, 2025 at 5:01 PM
Legislative Issues Affecting APPs
Major interstate “compacts” allow for cross state licensing for physicians. However, compacts for Advanced Practice Registered Nurse (APRN) are fewer and currently on hold - thereby limiting healthcare manpower and patient care.
rheumnow.com/news/legisla...
Major interstate “compacts” allow for cross state licensing for physicians. However, compacts for Advanced Practice Registered Nurse (APRN) are fewer and currently on hold - thereby limiting healthcare manpower and patient care.
rheumnow.com/news/legisla...
Hiring, Onboarding and Training APPs
Watch our kickoff webinar for this month's Mission: APP — Partners in Care campaign. Our panel of rheumatologists and experienced advanced practice providers share insights into hiring, onboarding, training, compensation, and more.
rheumnow.com/video/hiring...
Watch our kickoff webinar for this month's Mission: APP — Partners in Care campaign. Our panel of rheumatologists and experienced advanced practice providers share insights into hiring, onboarding, training, compensation, and more.
rheumnow.com/video/hiring...
December 4, 2025 at 4:00 PM
Hiring, Onboarding and Training APPs
Watch our kickoff webinar for this month's Mission: APP — Partners in Care campaign. Our panel of rheumatologists and experienced advanced practice providers share insights into hiring, onboarding, training, compensation, and more.
rheumnow.com/video/hiring...
Watch our kickoff webinar for this month's Mission: APP — Partners in Care campaign. Our panel of rheumatologists and experienced advanced practice providers share insights into hiring, onboarding, training, compensation, and more.
rheumnow.com/video/hiring...
QD Clinic: Flare or Beware
Lindsay Tom, PA-C and Phong Nguyen, MD, Reston, VA discuss today's case called "Flare or Beware", involving a patient who has psoriatic arthritis mutilans, presented as part of RheumNow's "Mission: APP Partners in Care" campaign.
buff.ly/S9g01Pu
Lindsay Tom, PA-C and Phong Nguyen, MD, Reston, VA discuss today's case called "Flare or Beware", involving a patient who has psoriatic arthritis mutilans, presented as part of RheumNow's "Mission: APP Partners in Care" campaign.
buff.ly/S9g01Pu
December 4, 2025 at 3:00 PM
QD Clinic: Flare or Beware
Lindsay Tom, PA-C and Phong Nguyen, MD, Reston, VA discuss today's case called "Flare or Beware", involving a patient who has psoriatic arthritis mutilans, presented as part of RheumNow's "Mission: APP Partners in Care" campaign.
buff.ly/S9g01Pu
Lindsay Tom, PA-C and Phong Nguyen, MD, Reston, VA discuss today's case called "Flare or Beware", involving a patient who has psoriatic arthritis mutilans, presented as part of RheumNow's "Mission: APP Partners in Care" campaign.
buff.ly/S9g01Pu
RheumNow Live 2026
Where the data meets the dialogue.
Join leading rheumatologists, researchers, and innovators at RheumNow Live 2026 — the meeting redefining rheumatology education.
🕓 Early Bird registration is open until 12/1.
Save now ➡️https://rheumnow.live
Where the data meets the dialogue.
Join leading rheumatologists, researchers, and innovators at RheumNow Live 2026 — the meeting redefining rheumatology education.
🕓 Early Bird registration is open until 12/1.
Save now ➡️https://rheumnow.live
December 3, 2025 at 10:00 PM
RheumNow Live 2026
Where the data meets the dialogue.
Join leading rheumatologists, researchers, and innovators at RheumNow Live 2026 — the meeting redefining rheumatology education.
🕓 Early Bird registration is open until 12/1.
Save now ➡️https://rheumnow.live
Where the data meets the dialogue.
Join leading rheumatologists, researchers, and innovators at RheumNow Live 2026 — the meeting redefining rheumatology education.
🕓 Early Bird registration is open until 12/1.
Save now ➡️https://rheumnow.live
A substantial number of patients with 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 (C2M-PsA)
Treatment-refractory PsA (TR-PsA)
buff.ly/0j5A6qq
Complex-to-manage PsA (C2M-PsA)
Treatment-refractory PsA (TR-PsA)
buff.ly/0j5A6qq
December 3, 2025 at 8:01 PM
A substantial number of patients with 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 (C2M-PsA)
Treatment-refractory PsA (TR-PsA)
buff.ly/0j5A6qq
Complex-to-manage PsA (C2M-PsA)
Treatment-refractory PsA (TR-PsA)
buff.ly/0j5A6qq
Hematologic Malignancies Increased in Systemic Sclerosis
Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.
rheumnow.com/news/hematol...
Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.
rheumnow.com/news/hematol...
December 3, 2025 at 7:00 PM
Hematologic Malignancies Increased in Systemic Sclerosis
Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.
rheumnow.com/news/hematol...
Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.
rheumnow.com/news/hematol...
Long-Term APP Retention: Building Success for Practices and Providers
Long-term APP retention is vital in rheumatology due to rising patient numbers and the need for prompt care. Integrating APPs improves practice efficiency, patient access, and clinician workload balance.
buff.ly/CDUIKQ3
Long-term APP retention is vital in rheumatology due to rising patient numbers and the need for prompt care. Integrating APPs improves practice efficiency, patient access, and clinician workload balance.
buff.ly/CDUIKQ3
December 3, 2025 at 5:01 PM
Long-Term APP Retention: Building Success for Practices and Providers
Long-term APP retention is vital in rheumatology due to rising patient numbers and the need for prompt care. Integrating APPs improves practice efficiency, patient access, and clinician workload balance.
buff.ly/CDUIKQ3
Long-term APP retention is vital in rheumatology due to rising patient numbers and the need for prompt care. Integrating APPs improves practice efficiency, patient access, and clinician workload balance.
buff.ly/CDUIKQ3
Turkey Tryptophan (11.28.2025)
Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
rheumnow.com/news/turkey-...
Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
rheumnow.com/news/turkey-...
December 3, 2025 at 4:00 PM
Turkey Tryptophan (11.28.2025)
Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
rheumnow.com/news/turkey-...
Dr. Jack Cush reviews the news and reports from this past week on RheumNow, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?
rheumnow.com/news/turkey-...
WHO recommendations on GLP-1 agonists: 1) conditional recommendation - GLP-1 drugs can be used for for long-term obesity treatment by adults, except pregnant women; 2) GLP-1a use should be paired with a healthy diet and physical activity. Access is a problem. www.reuters.com/business/hea...
www.reuters.com
December 3, 2025 at 3:01 PM
WHO recommendations on GLP-1 agonists: 1) conditional recommendation - GLP-1 drugs can be used for for long-term obesity treatment by adults, except pregnant women; 2) GLP-1a use should be paired with a healthy diet and physical activity. Access is a problem. www.reuters.com/business/hea...
U Colorado compared 10K Traditional Rheum consults (TC) to 670 eConsults. 75% eConsults completed without F2F & 73% w/in 3 days. eConsults referred to F2F had better 180d completion rates (36% vs 19% TC). Dx & Rx rates were similar. Most from PCPs. acrjournals.onlinelibrary.wiley.com/doi/abs/10.1...
acrjournals.onlinelibrary.wiley.com
December 3, 2025 at 12:01 AM
U Colorado compared 10K Traditional Rheum consults (TC) to 670 eConsults. 75% eConsults completed without F2F & 73% w/in 3 days. eConsults referred to F2F had better 180d completion rates (36% vs 19% TC). Dx & Rx rates were similar. Most from PCPs. acrjournals.onlinelibrary.wiley.com/doi/abs/10.1...
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 resources.healthgrades.com/pro/6-surpri...
- Rheum among lowest paid (~$284k)
- 2024 salaries rose 2%
- 53% say theyre underpaid
- 41% supplement their income
- 6/10 recv incentive bonuses resources.healthgrades.com/pro/6-surpri...
7 Fast Facts About Rheumatologist Compensation
Limited pay increases and pay dissatisfaction continue to challenge many rheumatologists. Learn about key trends in the specialty's pay and compensation.
resources.healthgrades.com
December 2, 2025 at 10:01 PM
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 resources.healthgrades.com/pro/6-surpri...
- Rheum among lowest paid (~$284k)
- 2024 salaries rose 2%
- 53% say theyre underpaid
- 41% supplement their income
- 6/10 recv incentive bonuses resources.healthgrades.com/pro/6-surpri...
TriNetX retrosp 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) www.amjmed.com/article/S000...
Sodium Glucose Co-Transporter-2 inhibitors in patients with systemic sclerosis with or without heart failure
Patients with systemic sclerosis are at heightened risk of developing heart failure. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown cardio-renal benefits in diverse populations with…
www.amjmed.com
December 2, 2025 at 8:01 PM
TriNetX retrosp 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) www.amjmed.com/article/S000...
Coccyx and Sacrococcygeal Joint Disorders
Coccyx and sacrococcygeal disorders cause rare and difficult-to-diagnose pain, often confused with lumbosacral, pelvic, or gastrointestinal issues. This review discusses the epidemiology, anatomy, biomechanics, symptoms, and more.
buff.ly/TQIDpzb
Coccyx and sacrococcygeal disorders cause rare and difficult-to-diagnose pain, often confused with lumbosacral, pelvic, or gastrointestinal issues. This review discusses the epidemiology, anatomy, biomechanics, symptoms, and more.
buff.ly/TQIDpzb
December 2, 2025 at 7:01 PM
Coccyx and Sacrococcygeal Joint Disorders
Coccyx and sacrococcygeal disorders cause rare and difficult-to-diagnose pain, often confused with lumbosacral, pelvic, or gastrointestinal issues. This review discusses the epidemiology, anatomy, biomechanics, symptoms, and more.
buff.ly/TQIDpzb
Coccyx and sacrococcygeal disorders cause rare and difficult-to-diagnose pain, often confused with lumbosacral, pelvic, or gastrointestinal issues. This review discusses the epidemiology, anatomy, biomechanics, symptoms, and more.
buff.ly/TQIDpzb
RNL 25 Replay: Vasculitis
Enjoy these excerpts from the RNL 2025 meeting, and join us for RNL 2026 in Dallas, TX - registration is now open! Visit rheumnow.live for complete details.
rheumnow.com/video/rnl-25...
Enjoy these excerpts from the RNL 2025 meeting, and join us for RNL 2026 in Dallas, TX - registration is now open! Visit rheumnow.live for complete details.
rheumnow.com/video/rnl-25...
December 2, 2025 at 5:07 PM
RNL 25 Replay: Vasculitis
Enjoy these excerpts from the RNL 2025 meeting, and join us for RNL 2026 in Dallas, TX - registration is now open! Visit rheumnow.live for complete details.
rheumnow.com/video/rnl-25...
Enjoy these excerpts from the RNL 2025 meeting, and join us for RNL 2026 in Dallas, TX - registration is now open! Visit rheumnow.live for complete details.
rheumnow.com/video/rnl-25...
Treating Refractory Still's Disease
A systematic review article explored treatment options for systemic juvenile idiopathic arthritis, or Still’s disease, focusing on patients with persistent arthritis, challenging macrophage activation syndrome (MAS), or interstitial lung disease.
buff.ly/TIyx7sd
A systematic review article explored treatment options for systemic juvenile idiopathic arthritis, or Still’s disease, focusing on patients with persistent arthritis, challenging macrophage activation syndrome (MAS), or interstitial lung disease.
buff.ly/TIyx7sd
December 2, 2025 at 4:02 PM
Treating Refractory Still's Disease
A systematic review article explored treatment options for systemic juvenile idiopathic arthritis, or Still’s disease, focusing on patients with persistent arthritis, challenging macrophage activation syndrome (MAS), or interstitial lung disease.
buff.ly/TIyx7sd
A systematic review article explored treatment options for systemic juvenile idiopathic arthritis, or Still’s disease, focusing on patients with persistent arthritis, challenging macrophage activation syndrome (MAS), or interstitial lung disease.
buff.ly/TIyx7sd
Scandinavian study of > 13.6 million PYs shows NO increased risk of myositis after SARS-CoV-2 (mRNA & adenoviral vector) vaccines. Data from 101 myositis events in 7,002 398 unvaccinated PYs. Adj IRR 180d risk was 0.84 (0.63–1.11) and 1.31 (0.72–2.36) respectively academic.oup.com/rheumatology...
SARS-CoV-2 vaccination and myositis in Norway and Sweden
AbstractObjectives. To characterize the risk of myositis after SARS-CoV-2 vaccination with mRNA or adenoviral vector vaccines.Methods. We conducted a popul
academic.oup.com
December 2, 2025 at 3:01 PM
Scandinavian study of > 13.6 million PYs shows NO increased risk of myositis after SARS-CoV-2 (mRNA & adenoviral vector) vaccines. Data from 101 myositis events in 7,002 398 unvaccinated PYs. Adj IRR 180d risk was 0.84 (0.63–1.11) and 1.31 (0.72–2.36) respectively academic.oup.com/rheumatology...
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 rmdopen.bmj.com/content/11/4...
rmdopen.bmj.com
December 2, 2025 at 12:00 AM
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 rmdopen.bmj.com/content/11/4...
A&R USA adult rheum workforce study showed in 2019, there were 5,667 rheumatologists & 379 APPs. Betw 2009-2020, rheumatologist #s increased 23%, while #APP #s increased 141%. There was a signif increase in female rheumatologists & APPs over time acrjournals.onlinelibrary.wiley.com/doi/10.1002/...
December 1, 2025 at 11:34 PM
A&R USA adult rheum workforce study showed in 2019, there were 5,667 rheumatologists & 379 APPs. Betw 2009-2020, rheumatologist #s increased 23%, while #APP #s increased 141%. There was a signif increase in female rheumatologists & APPs over time acrjournals.onlinelibrary.wiley.com/doi/10.1002/...
Congratulations to Professor Stuart Ralston (Versus Arthritis Professor of Rheumatology) from the University of Edinburgh. He has been honored with the RSE Sir James Black Medal by The Royal Society of Edinburgh for his research research & dedication to medical education rse.org.uk/outstanding-...
Outstanding endeavours recognised by 2025 RSE Medals
Academics have been celebrated for their outstanding achievements at an RSE Medals Ceremony this week.
rse.org.uk
December 1, 2025 at 11:02 PM
Congratulations to Professor Stuart Ralston (Versus Arthritis Professor of Rheumatology) from the University of Edinburgh. He has been honored with the RSE Sir James Black Medal by The Royal Society of Edinburgh for his research research & dedication to medical education rse.org.uk/outstanding-...
10 yr European retro study of haemophagocytic lymphohistiocytosis found 3345 deaths due HLH from 29 countries. Crude mortality rate = 5.3 per 10million PYs (range: 1.1-11.3). From 2011 to 2021, increasing from 3.9 to 6.6/10millPYs, varying by country, sex, age. www.thelancet.com/journals/lan...
Trends in mortality due to haemophagocytic lymphohistiocytosis across 29 European countries from 2011 to 2021: a retrospective, international, population-based study
Recorded rates of mortality due to haemophagocytic lymphohistiocytosis have nearly doubled over the past decade in Europe. Deaths were most common at the extremes of age and were more common in male…
www.thelancet.com
December 1, 2025 at 10:00 PM
10 yr European retro study of haemophagocytic lymphohistiocytosis found 3345 deaths due HLH from 29 countries. Crude mortality rate = 5.3 per 10million PYs (range: 1.1-11.3). From 2011 to 2021, increasing from 3.9 to 6.6/10millPYs, varying by country, sex, age. www.thelancet.com/journals/lan...