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The Obesity Imperative

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ACP Clinical Guideline on Treatments of Overweight or Obese Adults

The American College of Physicians (ACP) in July 2026 published its first living clinical guideline addressing pharmacologic management of overweight and obesity in nonpregnant adults in outpatient settings. The guidelines importance is driven by striking epidemiology: 59% of the global population and 68.5% of US adults now have overweight or obesity.

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Cochrane systematic review of LBP Rx (8 RCTs, 501 cLBP pts) show that Lumbar supports may result in a small reduction in pain intensity if given w/ NSAIDs, but may offer little to no benefit for pain intensity & disability if used alone. Insufficient evidence to support their https://t.co/6Vq4CPXLvE
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NY Times reports Gallop poll: 15% Americans have used a wt-loss drug (11% currently taking) - up from 3% in 2024. These have been approved for use in NIDDM, weight loss, liver Dz, CV risk reduct. & sleep apnea. Also obesity in USA is fell to 36.4%, after peak of 39.9% in 2022. https://t.co/ghxUEcuoGr
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NEJM images: Jaccoud’s arthropathy is a chronic, deforming;from laxity of the ligaments & tendons (not damage to bone & cartilage). Deformities are reducible & no erosions on Xray. Jaccoud’s mimics RA, but most seen w/ SLE. https://t.co/99WDNcpT5c https://t.co/77zAjpQh9A
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Music and Pain Relief

If laughter is the best medicine, then music has to be second best. A new scoping review in Pain Reports by Bradt et al., examines the effect of music-based interventions (MBIs) on pain management. While its efficacy is well established, how or why music relieves pain has never been fully explained.

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Korean retrospective study compared NIDDM pts Rx w/ SGLT2 inhibitor (n 552,065) vs sulfonylurea (1,480,092) showed SGLT2 inhibitors were assoc w/ a signif 11% lower risk of incident autoimmune rheumatic disease (HR 0.89). Diff of −6.50 per 100K PYs over median ~9 mos F/U. https://t.co/uTiCjejkjL
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Lupus Research Alliance has awarded >$2 million in 2026 awards to studying innovative lifestyle interventions for people living with lupus. This includes studies on ginger supplementation, physical activity, and a whole health online programs https://t.co/C45y9laeHN https://t.co/6ifbPMWNt9
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Novartis & BMS CAR-T Cell Trials on Hold Reuters and the Wall Street Journal report that both Novartis and Bristol Myers Squibb (BMS) have paused their autoimmune disease CAR-T cell trials due to safety concerns, including deaths. https://t.co/ffcAHhtdBh https://t.co/pL3IQ6Dp9C
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Sleep and Obesity: A Bidirectional Relationship In July 2026, JAMA published a concise review of the bidirectional relationship between sleep health and obesity. Obesity affects roughly 40% of US adults, and sleep problems affect nearly one-third. This review outlines the https://t.co/cA6P4aOHR0
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EBR Journal Club: Dapirolizumab Pegol in SLE (PHOENYCS GO)

The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal to an important RCT in rheumatology. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How great are the benefits and harms? And what didn’t they show me? This edition: PHOENYCS GO (dapirolizumab pegol in SLE).

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“ABCDE” Approach to Difficult-to-Treat Rheumatoid Arthritis

The proposed approach to difficult-to-treat rheumatoid arthritis is based on the EULAR definition (having failed 2 or more b/tsDMARDs). The authors provide guidance in the form of an easy acronym, A B C D E, which covers both diagnostic and therapeutic considerations.

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MSK problems w/ Mobile gaming addiction (MGA)? Study of 364 Jordanian med students showed 9% had MGA- these has signif more UE MSK pain (71% vs 48%; p 0.012) vs nonaddicts. Elbow pain (41%) best predictor of MGA, but also neck (85%), upper back (65%), wrists (41%). https://t.co/51AWgHjrGC
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Chinese retrospective study of 140 Bx proven Kikuchi-Fujimoto pts shows very few evolve into #SLE. While 60% were ANA+ (11.3% other autoAbs) - none developed SLE (median F/U 39mos). KFD is benign, self limiting necrotizing lymphadenitis usually in young women. https://t.co/Ai7W9GCBVb
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VA (VARA) registry study of 2723 RA pts showed frailty was independently associated with increased cancer incidence. Age-adjusted CA incidence rates (per 1,000PYs) were 12.3 (robust), 15.5 (pre-frail), and 19.9 (frail). CA mortality rates were 7.8, 10.6, & 9.8/1,000PYs https://t.co/Ex52R56oT1
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EUSTAR Registry - Cancer in Systemic Sclerosis Cancer is a major cause of mortality in systemic sclerosis (SSc). A nested case-control study within the EUSTAR registry shows distinct patterns of cancer temporally related to SSc, serologic profiles, and traditional cancer risk https://t.co/BORvxu5QG8
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FDA Approves Brepocitinib to Treat Dermatomyositis The FDA and Priovant recently announced approval of brepocitinib (Lisraya), a JAK1/TYK2 inhibitor, for the indication of adults with dermatomyositis (DM). This is the first oral (once daily) agent approved for DM. https://t.co/JoE0p3UfSf
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Necrotizing arteritis is rare w/ IgA Vasculitis (IgAV). Review compared 30 IgAV-NA to 257 adult IgAV & 196 PAN pts. Overall IgAV-NA is a severe IgAV phenotype with life-threatening complications & should prompt vascular imaging and intensified immunosuppression. IgAV-NA had more https://t.co/XdPbGX770D
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The global inflammatory myopathies market size was valued at USD 1.81 billion in 2025 and is expected to reach USD 2.67 billion by 2033 (CAGR of 5.00%). This applies to: Polymyositis, Dermatomyositis, Inclusion Body Myositis, Juvenile Myositis, Corticosteroids, https://t.co/vb7zfM76pO
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Korean National Health Insurance claims study of 4,107 newly Dx gout on allopurinol x 24 mos (vs non-gout controls). Gout significantly higher risk of fractures (aHR 5.52_; 95% CI 4.19–7.26), highest in those with low-adherence to allopurinol (aHR 5.91). Consistent trends seen https://t.co/cTO4lGtYAy
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