John Cush, MD: Rheumatology Year in Review

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Rheumatology Network sat down with John Cush, MD, to discuss his CCR West presentation “Rheumatology Year in Review: 2022.” Cush is the Executive editor of We recent FDA approvals and indications, trends in rheumatology, and his predictions for 2023.

Below is a preview of our conversation:

Rheumatology Network: What are your thoughts on the updated European Alliance of Associations for Rheumatology (EULAR) guidelines for rheumatoid arthritis (RA)?

John Cush, MD: I think that I think that there is a lot of there was a lot of acceptance for them in that most people felt that they were very prudent and wise and reasonable. They're different than American College of Rheumatology (ACR) guidelines in that they’re much more liberal as far as the use of prednisone. The fact is practitioners need steroids. And that's one of the problems in practice that ACR is addressing and EULAR is ignoring. Is there a downside? [A study was recently published reporting that] chronic use of corticosteroids in elderly RA patients works, but there's a lot of side effects. You're giving side effects to elderly people who have enough problems. Is that Is that a reasonable trade off? If you're if you're thinking patient safety, the answer is no. If you're ultimately thinking patient efficacy, the answer is yes. The problem is you have to think of both.

RN: Have you noticed any trends in the world of rheumatology?

JC: Dramatic trends in learning. What Rheum Now is all about, and what Rheumatology Network is all about, is providing reliable information in a timely fashion to people who need it, the vast majority of whom aren't at medical schools and don't go to a journal club every week, but need to be and want to be informed. The ACR has a big problem this year in that it dramatically increased the price of its registration and made it as expensive for virtual attendance, which means a lot of people are not going to go to ACR this year. This again forces people into offline asynchronous digital learning. We found out, as a result of the pandemic, that we can be good that.

RN: What do you predict for rheumatology moving into 2023?

JC: The general trend is more towards a younger, more female workforce. These are good things for rheumatology.