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Vitamin D and Lupus Outcomes (11.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Why Brittle Bones Aren't Just a Woman's Problem
MedPage Today
Ronald Klein was biking around his neighborhood in North Wales, Pennsylvania, in 2006 and tried to jump a curb. "But I was going too slow -- I didn't have enough momentum," he recalled. As the bike toppled, he thrust out his left arm to break the fall. It didn't seem like a serious accident, yet "I couldn't get up," he said.
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NY Times on Osteoporosis in Men
The NY Times has addressed the problem of osteoporosis in men noting a need for increased awareness and screening. Takeaways:
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Osteoporosis Screening in High-Risk Men
A Veterans Affairs (VA) Health Systems study of older male veterans found benefits of a remote model of screening that significantly improved osteoporosis screening, treatment, and adherence compared with usual care, with high patient and clinician acceptance.
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Big Fat FDA Pink Slip (9.19.2025)
Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com. Today we cover GLP-1 agonists, acupuncture, what JAKs won’t do & an FDA Pink Slip.
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Colchicine prevents total joint arthroplasty (TJA). Study of 31,478 colchicine initiators, followed 4.5 yrs. W/ an overall 12% lower risk of TJA (HR 0.88 95% CI 0.81 to 0.96), and a 23% lower risk of TJA in those with knee/hip OA (HR 0.77) https://t.co/1JsZd8K0sI
Dr. John Cush RheumNow ( View Tweet)
25-Hydroxyvitamin D levels and Lupus Outcomes
Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/4nhACulIw0
Dr. John Cush RheumNow ( View Tweet)
Mesothelin as a biomarker and potential therapeutic target in rheumatoid arthritis? Mesothelin is elevated in RA & animal models & promothes osteoclast differentiation & bony destruction. Blocking mesothelin has the potential to reduce bone destruction. https://t.co/WRXG91AqmJ https://t.co/hMgddPXhxG
Links:
Dr. John Cush RheumNow ( View Tweet)
Bone Density in Ankylosing Spondylitis
At #ACR25, a retrospective study from China tackled this challenge using quantitative computed tomography (QCT), a more precise imaging modality that measures true volumetric bone density unaffected by cortical ossifications. https://t.co/1Z5cshkqjt
Dr. John Cush RheumNow ( View Tweet)
A 15-year-old girl has short stature and the hand finding shown . Labs show ↓Ca²⁺, ↑PO₄³⁻, ↑PTH.
What is the most likely diagnosis? https://t.co/afPUeaqfZT
Dr. Nikhil Agrawal DrNikhilMD ( View Tweet)
#2660 In >8000 women, serum urate rose sharply during the menopausal transition, then plateaued after menopause.
Hyperuricemia reached 4-5% post-menopause, up to 18% in obesity or low eGFR.
Healthy body weight & kidney function pre-menopause may decrease HU later @RheumNow #ACR25 https://t.co/v6ai3lgAd2
Mrinalini Dey DrMiniDey ( View Tweet)
What exercise best for steroid-induced osteoporosis? Does it have to be weight bearing?
Turns out anything helps - get out there and don’t let perfect be the enemy of good!
Laura Coates in the #ACR25 meeting review @RheumNow https://t.co/VGH2rz3dzb
David Liew drdavidliew ( View Tweet)
#1727
360k+ postmenopausal women w osteoporosis: >1/3 untreated patients were at v high fracture risk, yet few received recommended anabolic or antiresorptive therapy.
Even among treated women at very high risk, >50% were still on oral bisphosphonates
@RheumNow #ACR25 https://t.co/9S66tAU68P
Mrinalini Dey DrMiniDey ( View Tweet)
Why Brittle Bones Aren't Just a Woman's Problem
Osteoporosis is more common in women, prompting routine screenings for them at age 65. As a result, men might overlook getting a scan, which may not be suggested by an orthopedic specialist. However, about 20% of men over 50 will https://t.co/ggyse5ZDPV
Dr. John Cush RheumNow ( View Tweet)
Osteoporosis Screening in High-Risk Men
A VA Health Systems study of older male veterans found benefits of a remote model of screening that significantly improved osteoporosis screening, treatment, and adherence compared with usual care, with high patient and clinician https://t.co/Kt3mJLahdq
Dr. John Cush RheumNow ( View Tweet)
SLE and Osteoporosis
Systemic Lupus Erythematosus (SLE) is a multisystem autoimmune disease that can present with a variety of signs and symptoms and organ involvement. Comorbidities further complicate the disease course that may lead to poor health-related quality of life and https://t.co/8ZmtLjzbqA
Dr. John Cush RheumNow ( View Tweet)
The overall prevalence of #osteoporosis in SLE is ~33-40% and is due to several factors with GC therapy being one of them.
Monitor DXA every 6-12 months (vs. 2 yrs for standard OP)
☝️Screen for GIOP
☝️Treat accordingly - once on GCs & esp w/long-term use
@RheumNow #APLAR25 https://t.co/E9FJDHrBUo
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sheila RHEUMarampa ( View Tweet)
Key takeaways of trabecular bone screening:
📌Complements but doesnt replace BMD/FRAX in fracture risk assessment
📌Dont exclude any lumbar spine unless w/significant change like laminectomy
📌Can use in monitoring untreated pts since TBS declines
@RheumNow #APLAR25 https://t.co/bcN83IDDja
sheila RHEUMarampa ( View Tweet)
Remember! ☝️
Trabecular bone screening should not be routinely used in pre-menopausal women.
@RheumNow #APLAR25 #osteoporosis https://t.co/hGMExyDYUX
sheila RHEUMarampa ( View Tweet)
Japanese retrospective real world study shows antifibrotic use assoc w/ better survival in Pulm Fibrosis-ILD for 1st 3 yrs & improved survival in progressive pulm. fibrosis (PPF) “despite management” (PPF subset prev Rx non-antifibrotic therapy) https://t.co/caiIuhg7j8 https://t.co/N0ST73TMoR
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Dr. John Cush RheumNow ( View Tweet)
