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CKD & Osteoporosis Rx Revisited (7.25.2025)
Dr. Jack Cush reviews the news, journal and FDA updates from this past week on RheumNow.com.
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Osteoporosis Drug May Lower Osteoarthritis Risk
A target trial emulation study using administrative claims suggests that romosozumab was associated with a lower risk of osteoarthritis than teriparatide among individuals with osteoporosis, particularly for knee osteoarthritis.
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Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors
Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer.
Subclinical Synovitis Among Psoriasis Patients
A systematic review shows that imaging can be used to detect subclinical synovitis among patients with psoriasis and may identify individuals at risk for future psoriatic arthritis.
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Dr. John Cush RheumNow ( View Tweet)
Survival in #RA pts undergoing cervical spine surgery is not good! Retrospective study of 139 RA pts who underwent Cx surgery shows higher mortality risk if they are older, w low albumin levels, high-dose pred. and have subaxial subluxation. https://t.co/hKvgaas2gh https://t.co/ygtJjb4mVl
Dr. John Cush RheumNow ( View Tweet)
Subclinical Synovitis Among Psoriasis Patients
A systematic review shows that imaging can be used to detect subclinical synovitis among patients with psoriasis and may identify individuals at risk for future psoriatic arthritis.
https://t.co/2603Aax8PP https://t.co/2XDtDg1QHh
Dr. John Cush RheumNow ( View Tweet)
New CDC report confirms a record number of Measles cases in the USA, now at 1,319 (in 39 states), the highest since 1992. National cases are more than 4.5 times higher than the entirety of last year, which had an estimated 285 cases reported. https://t.co/KkqQu9C4cO https://t.co/bND6hPDUNA
Dr. John Cush RheumNow ( View Tweet)
Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors
Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer. https://t.co/usK8pG7LbQ
Dr. John Cush RheumNow ( View Tweet)
If severe refractory SLE is defined as SLEDAI-2K≥10 despite steroids & immunosuppressives; Cohort of 3,744 SLE - 14% (578) had srSLE. Median SLEDAI-2K = 12, & decreased to 6 at 6m & 12m> < 25% achieved LLDAS & only 1% attained GC-free remission @ 12 mos https://t.co/NZ9cgj7llQ https://t.co/jdP5ER6oUX
Dr. John Cush RheumNow ( View Tweet)
Clinical Associations with Anti-RNA Polymerase III Antibodies
A systematic review of anti-RNA polymerase III antibodies (ARA) in systemic sclerosis (SSc) patients finds ARA positivity in only 9% of SSc patients, but come with a higher risk of many potentially worrisome https://t.co/p1KVUFPJvN
Dr. John Cush RheumNow ( View Tweet)
Emapalumab Approved for MAS in Still’s
On June 27th, 2025, the FDA approved emapalumab for macrophage activation syndrome (MAS) in known or suspected Still’s disease (including both adult-onset Still’s disease (AOSD) and systemic juvenile idiopathic arthritis (sJIA)) with https://t.co/YmP0WCgWwZ
Dr. John Cush RheumNow ( View Tweet)
US CDC study of age-standardized mortality rate (ASMR) from 1990-2020, there were 39,496 deaths related to scleroderma (SSc) & and 5,163 from SSc w/ renal failure. Deaths lower in males (22%) than females w/ renal failure (78%). Mortality rate of SSc w? renal failure was https://t.co/OT3BHt3E85
Dr. John Cush RheumNow ( View Tweet)
Congrats to Barbara Anne Eberhard, MD, she has been awarded with the James T. Cassidy Award from the American Academy of Pediatrics (AAP). For her dedication to research/leadership in pediatric rheumatology. She is at Northwell Health’s Cohen Children’s Medical Center & Feinstein https://t.co/USGajXCMLD
Dr. John Cush RheumNow ( View Tweet)
40 kids w/ Psoriasis compared to 40 juvenile PsA pts. Those w/ jPsA were more likely to be:
- Obese/overweight (80 vs 17.5%)
- passive smoking (37.5 vs (25%)
- Signif higher ESR and CRP (P < 0.001)
- Nail PsO (65 vs 22%) https://t.co/3uBHnxZYC2 https://t.co/rW48EQta2s
Dr. John Cush RheumNow ( View Tweet)
RA Lung Disease Portends Poor Outcomes
A retrospective Harvard affiliates study shows that rheumatoid arthritis (RA) patients with lung disease have higher mortality, especially respiratory and infection-related mortality than those without lung disease (LD). https://t.co/13h2u26ecb
Dr. John Cush RheumNow ( View Tweet)
Pesticides and Rheumatoid Arthritis?
Women exposed to pesticides through farm work or as farmers' wives face increased risk for developing rheumatoid arthritis (RA), a new analysis of Agricultural Health Study (AHS) data indicated.
https://t.co/ISddKbnxMY https://t.co/E5tpX5D70X
Dr. John Cush RheumNow ( View Tweet)
Diminishing trend in serious infections assoc w/ TNFi use in inflammatory arthritis over the years. ICEBIO study 1387 Rx w/ 1st TNFi 2003–2018 (vs 6936 comparators. Over tme the SI rate dropped 52% (IRR 0.48; 0.25–0.94), but not for controls (Abx use stable) https://t.co/jDsKlCrd0p
Dr. John Cush RheumNow ( View Tweet)
New ICD-10 Diagnostic Code -- R76.81 -- for ’At-Risk RA’ (AKA Clinically suspect arthralgia or Pre-clinical RA); this applies to pts w/ abnormal RF or ACPA without having RA. Thanks to Dr. Kevin D. Deane for leading this effort. https://t.co/14I6RCZrXb https://t.co/YxTwPB0YDQ
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Dr. John Cush RheumNow ( View Tweet)
TNFi are relatively contraindicated in RA pts w/ #MS. Literature review suggests for pts w/ MS and RA, teriflunomide and anti-CD20 therapies are the most suitable, and Cladribine may also be considered https://t.co/wlAOhM9q3F https://t.co/1a5UXah7Ha
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Dr. John Cush RheumNow ( View Tweet)