Continuing in my app era - new free app! rheumlens.org — image-based rheumatology flashcards. 134 cards live and building a question bank. Images from the ACR Rheumatology Image Library, used with permission for education.

Medicaid work requirements don't filter out people who won't work. They filter out people who can't file paperwork on time — which in rheumatology is most of my sickest patients. Public comment is open: https://www.federalregister.gov/d/2026-11094

LabLens — a free Mac app to organize your lab results from every portal in one place, with plain-English explanations. Everything stays on your own computer. https://www.glaze.app/app/lablens-GkByoP

Almost 350,000 comments on the proposed OMB rule aimed at politicizing and undermining American science (among other things). Well done everyone!! 👏👏👏 The fight isn't over but this was an excellent first round 🥊

It's online! I gathered a group of people within the rheumatology community with diverse experiences & perspectives to write about improving conference accessibility www.jrheum.org/content/jrhe...

Today is the last day to comment on the OMB rule that would hand federal research-grant decisions to political appointees instead of scientific peer review. Nearly every drug I prescribe for vasculitis and lupus exists thanks to NIH-funded science. regulations.gov/commenton/OMB-2026-0034-0001

New national data on giant cell arteritis: even after years of "steroid-sparing" messaging, patients still averaged 7.6 g of prednisone over two years — and every gram tracked with higher mortality. There is no free steroid dose. doi.org/10.1136/rmdopen-2026-006866

What a great article not only on faculty workloads, but how little our salaries actually factor in to most university budgets. A few highlights. First, our salaries are falling:

New insights in lupus nephritis show abnormal IgG glycosylation triggers podocyte injury via CLEC7A-SYK signaling. Blocking this pathway preserved podocyte function, uncovering a potential novel therapeutic strategy for LN Arthritis & Rheumatology doi.org/10.1002/art....

NIH wants to cap how many grants one scientist can hold. Sounds tidy — in practice it kneecaps the most productive labs and the trainees they fund. Public comment's open till Aug 3, and anyone can write one: https://grants.nih.gov/grants/guide/notice-files/NOT-OD-26-086.html

New Health Affairs piece names what most of us already feel: AI is no longer just "decision support" — it's quietly making prior-auth calls. https://doi.org/10.1093/haschl/qxag141

A House committee is now pressing NIH over the OMB rule that would rewrite how research gets funded. You don't need a lab to weigh in — public comment is open to anyone through July 13. Two minutes: https://www.regulations.gov/commenton/OMB-2026-0034-0001

New EGPA data (30-patient retrospective study): mepolizumab started within 30 days of steroids roughly halved a year's cumulative prednisolone — 25 vs 69 mg/kg. Hypothesis-generating, not practice-changing, but the right direction. https://pubmed.ncbi.nlm.nih.gov/42324522/

New on the Rheumify Substack — Osteoporosis Module 1: bone remodeling and why the osteoclast/osteoblast tug-of-war decides who fractures. https://open.substack.com/pub/rheumify/p/osteoporosis-module-1

The free Notion template I built to run the academic publishing cycle — manuscripts, submissions, paper ideas, abstracts — just added AI agents that draft cover letters and suggest target journals. Still free for rheum: notion.com/templates/scriptcycle

Vision loss in GCA is usually arteritic anterior ischemic optic neuropathy — from occlusion of the posterior ciliary arteries that supply the optic nerve head, not the central retinal artery. Once it's lost, it rarely comes back. pubmed.ncbi.nlm.nih.gov/9559737

Most prior-auth denials are never appealed. In Medicare Advantage, only 11.7% of denied requests were appealed in 2023 — and when patients did appeal, 81.7% were overturned. The friction is the point: deny, and bank on people not fighting back. kff.org

Post a comment to the Federal Register: USPS to impose regulations that impact mail in ballots - based on an Executive Order www.federalregister.gov/documents/20...

Ballot Mail for Federal Elections

The Postal Service is proposing to amend the Mailing Standards of the United States Postal Service, Domestic Mail Manual (DMM), regarding the transmission of mail-in or absentee ballots for federal el...

federalregister.gov

GCA is filed under "headache and vision loss," but a 12,955-patient cohort tells a quieter story: higher all-cause mortality and markedly more MI, stroke, and heart failure. It's a cardiovascular disease wearing a temporal-artery disguise. pubmed.ncbi.nlm.nih.gov/42249005

Three federal comment deadlines are quietly stacking up, but this one closes first: the OMB rule that would let political appointees cancel research grants at will. Comment by July 13. regulations.gov/commenton/OMB-2026-0034-0001

New PMR/GCA trial (RESCUE): even on ≤5mg prednisolone, patients can develop adrenal insufficiency that quietly tanks quality of life. It's testing "sick-day" hydrocortisone for the fatigue we too often wave off as "just the disease." pubmed.ncbi.nlm.nih.gov/42276802

The new NIH plan to cap how many grants one scientist can hold won't spread money to the little guy — it'll gut the labs running the trials that gave my lupus and vasculitis patients their drugs. Comments open till Aug 3. NOT-OD-26-086: regulations.gov

ANCA vasculitis: the FDA is moving to withdraw avacopan (Tavneos), alleging ADVOCATE remission endpoints were re-adjudicated after database lock — flipping a nonsignificant result to significant — and citing 76 serious liver-injury cases. Comment by June 29. fda.gov/media/192160/download

Medicaid "work requirements" don't create jobs — they create paperwork that drops eligible, working people from coverage. For my lupus and vasculitis patients, a month off meds can mean a kidney or an eye. Public comments open through the Federal Register: regulations.gov

As of this month in Washington, an AI can approve your prior authorization — but it can't deny it. Only a human can. It sounds like a small rule. It's one of the more sensible sentences in health policy this year, and it should be the national floor. healthcaredive.com

I'm a rheumatologist. About 1 in 4 of my patients is on Medicaid, and many are seriously ill. The proposed Medicaid work requirement (CMS rule, public comments open through July 31) will hurt them. Here's why I'm commenting against it. 🧵

If your coverage is a self-funded employer (ERISA) plan, state "bad faith" law is preempted. Half of insured Americans are in these plans. blog.ifebp.org/erisa-preemption-101/

New French cohort (~13,000 patients): giant cell arteritis carries higher long-term risk of MI, stroke, heart failure, and death vs matched controls. We treat GCA to save vision — but it's a cardiovascular disease too, and we should manage it like one. pubmed.ncbi.nlm.nih.gov/42249005/

There's a federal rule that would let political appointees shape which science gets funded. Comments close July 13. The drugs that keep my GCA patients from going blind exist because review used to reward merit, not loyalty. regulations.gov/commenton/OMB-2026-0034-0001

A federal panel just told Congress what every rheumatologist already knew: an algorithm shouldn't get to deny your medication. MACPAC wants every prior-auth denial reviewed by an actual human with relevant expertise. The bar is on the floor — and we still had to ask. macpac.gov