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Osteoarthritis, Obesity and GLP-1s

Tom Appleton, MD, PhD

We all know that osteoarthritis is the most common form of arthritis in the world, and that obesity is its most modifiable risk factor. What I really want to focus on is the role that GLP-! receptor agonists might be playing in our management of osteoarthritis. So why does this matter?

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Treating Obesity is Disease-Modifying (9.4.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  New drugs approved, new drugs halted and some drugs out of control. Ready to test your knowlege? Take this week's quiz!

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ACP Clinical Guideline on Treatments of Overweight or Obese Adults

Jack Cush, MD

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

Jack Cush, MD

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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FDA Approves Brepocitinib to Treat Dermatomyositis

Jack Cush, MD

The FDA and Priovant recently annouced 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.

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Meta-analysis 24 studies (3015 hidradenitis suppurativa pts) taking IL-17 inhibitor, IBD adverse events were rare, w/ no difference in IBD risk betw IL-17i & PBO (0.23% vs 0 of 2572 vs 1066 pts respectively) thru wk 16. The reported assocn of IL-17 inhibitors w/ IBD risk is https://t.co/kDwR5Fc1zI
Dr. John Cush RheumNow ( View Tweet)
Treating Obesity is Disease-Modifying (9.4.2026) Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow. New drugs approved, new drugs halted and some drugs out of control. https://t.co/ojBOosSWMX https://t.co/K4DvUK24Pb

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Dr. John Cush RheumNow ( View Tweet)
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 https://t.co/1jAvPfRI0m
Dr. John Cush RheumNow ( View Tweet)
Join us for the first of four webinars this month! This Journal Club will explore the TOGETHER PsA and STEP 9 trials, and what emerging evidence tells us about the complex relationship between obesity, weight loss and rheumatic disease. The authors and leading experts will: • https://t.co/xpnqim1VKH
Dr. John Cush RheumNow ( View Tweet)
12 mos Danish study of 157 822 first-time semaglutide for obesity management (SOM) intiators. 77 483 discontinued treatment w/in 12 mos. (13% at 3 mo, 27% 6 mos, 39% @ 9 mos. D/C more likely in younger, men, low-income, on GI or psych meds, & pts with comorbididities. Few https://t.co/oJLnrxXFz0
Dr. John Cush RheumNow ( View Tweet)
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/blsl1365XS
Dr. John Cush RheumNow ( View Tweet)
EBR Journal Club: Dapirolizumab Pegol in SLE (PHOENYCS GO) The EBR Journal Club Companion applies my adapted JAMA approach to critical appraisal to an important rheumatology RCT. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How https://t.co/kereLii5J6
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
Small series of 5 Idiopathic inflammatory myopathy (IIM) pts Rx w/ obinutuzumab for refractory myositis (2 antisynthetase syndr, 1 DM, 2 overlap myositis). 4/5 patients achieved complete response. Lung improved/stabilized in ILD patients. Two required second obinutuzumab cycle. https://t.co/0uW6xXQQ2S
Dr. John Cush RheumNow ( View Tweet)
Rheums! Do you have a Rheumatology question or case for Dr. Cush? Record it here, and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/LZ59KW8HdA https://t.co/DwHdvpTYax

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Dr. John Cush RheumNow ( View Tweet)
SELECT-PsA 2 subanalysis of 195 active PsA not responding to TNFi shows switching to upadacitinib 15 (vs PB) was superior @wk 24 - ACR20 (58% vs 22%), ACR50 (38% vs 9.5%), ACR70 (22% vs 0%), MDA (24% vs 3%) & maintained thru wk 152. Switching MOAs makes sense! https://t.co/YEkZuQ95Mu
Dr. John Cush RheumNow ( View Tweet)
JAK inhibitors work & have a dose dependent effect in severe alopecia areata (AA). Metanalysis of 10 Rxs, 3866 AA pts (used the SALT20 endpoint) showed the best efficacy was deuruxolitinib_12 mg, and baricitinib_4 mg (OR: 2.59, 95% CI: 1.98–3.38). https://t.co/k86f2RvCEJ https://t.co/N1fsrbbmDw

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Dr. John Cush RheumNow ( View Tweet)
Phase 1/2 COMPARE trial of CD19 CAR-T Rx in 6 ACPA+ RA pts w/ severe refractory Dz; after lymphodepletion, given mivocabtagene autoleucel (miv-cel), followed < 52wks. All had CRS, No ICANSs or serious AEs. All had CD19 cell depletion & Decr in AutoAbs. Efficacy: 3/6 had ACR70 & https://t.co/28dWMGWbKB
Dr. John Cush RheumNow ( View Tweet)
CAR-T Reality Check! The hype is outrunning the evidence, which now lives in a handy dashboard created and presented by Dr. Mike Putman @EBRheum. There are almost as many studies as there are CAR-T treated patients. Few numbers, limited F/U - Yet everyone is gaga about CAR-T. https://t.co/6tLLJDVI8x
Dr. John Cush RheumNow ( View Tweet)
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