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Count Your Telangiectasias (5.29.2026)
Dr. Jack Cush reviews the news, journal articles and missed quiz questions.
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Vitamin D in Rheumatic Disease - is it Good Enough?
Vitamin D deficiency or insufficiency of is highly prevalent and has been often associated with inflammatory rheumatic diseases, raising the question of whether inadequate vitamin D status contributes to immune dysregulation, incipient disease, increased disease activity, or poor skeletal outco
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Prescribing Lessons (4.17.2026)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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b/ts-DMARDs Do Not Arrest Bone Loss in RA
In RA, the goal is to control or arrest inflammation such that articular and bony damage is halted. While we have many effective therapies, it is not clear that biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) can prevent or improve osteoporosis outcomes in RA. A current real-world study showed that 1 year of b/tsDMARDs use did not arrest osteoporosis progression.
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Osteoporosis: Thinking outside the box
As rheumatologists, most of us manage osteoporosis in some form every single day. We have newer agents, newer sequencing strategies, and an increasing number of patients asking for “less medicinal” options that go beyond a prescription. At RWCS, Dr. Gina Woods opened her talk by reframing osteoporosis as a comprehensive approach to bone and muscle health rather than a narrow discussion about a DEXA report.
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RA comorbidities are changing. ILD, anxiety, depression increasing. Less extraartic. manifestations, CA & CV dz. Consider screening for cervical CA, ILD, CV dz & OP (for pts on steroids) https://t.co/WVITFXNva7 https://t.co/tggdaO9RJB
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Cross-sectional study of 339 IBD pts (64% women, median 42yrs (32–53) found osteopenia by BMD in 34%, OP in 12%. Predictors not identified by multivariable analysis. Rheum eval led to OP Rx in 7% & vitamin D in 45% https://t.co/a9RSo9PxHS https://t.co/nIOR9AUjQs
Dr. John Cush RheumNow ( View Tweet)
Korean claims data on FX in RA (2010-2017; n = 43,677). RA had more FX (aHR 1.68), regardless of b/tsDMARD use. Seropositive had more Fx (aHR 1.19), Vertebral Fx (aHR 1.4) & hip Fx (aHR 1.55) VS seronegative RA https://t.co/5Fm3o841H7 https://t.co/V0L87JYtba
Dr. John Cush RheumNow ( View Tweet)
Cross-sectional study of 339 IBD pts (64% women, median 42yrs (32–53) found osteopenia by BMD in 34%, OP in 12%. Predictors not identified by multivariable analysis. Rheum eval led to OP Rx in 7% & vitamin D in 45% https://t.co/CNs7hb9KX8 https://t.co/aoesaW1pKw
Dr. John Cush RheumNow ( View Tweet)
FDA has approved a dosing update for burosumab-twza (Crysvita, Kyowa Kirin) to allow for increased dose and frequency when needed in adults with X-linked hypophosphatemia (XLH). https://t.co/EPyp6tDsaf https://t.co/1HEaQRk9BR
Dr. John Cush RheumNow ( View Tweet)
Vitamin D in Rheumatic Disease - Is It Good Enough?
Vitamin D in rheumatic disease — is it sufficient? Vitamin D deficiency/insufficiency is common and linked to inflammatory rheumatic diseases, raising the question of whether low vitamin D drives immune dysregulation, disease https://t.co/CLBFii2TbR
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Femoral BMD & osteoporosis are independent predictors (nverse relationship) of all-cause mortality in postmenopausal women. NHANES study(2005-2018) of 2,977 postmenopausal F, OP yielded 47% incr mortality (HR 1.47) https://t.co/67Jv63X0Hx https://t.co/4vbFDydTY7
Dr. John Cush RheumNow ( View Tweet)
True or False: In a meta-analysis, RA was associated with a significantly increased risk of osteoporotic fractures in female patients but not in male patients. See if you got it right in the latest RheumIQ quiz at https://t.co/HCxOwRl2Tq. https://t.co/O9WRKQKmu4
Dr. John Cush RheumNow ( View Tweet)
Presented at AACE Annual Meeting, FREEDOM Real-World Study looked atypical femoral Fxs & found a low AFF risk - 24 AFFs w/ denosumab (0.89/1KPY) vs 397 AFFs w/ bisphosphonates (0.82/1KPY) but no active comparators & excluded pts w/ comorbidities. https://t.co/vRwkfHSXxh https://t.co/xzgC0D5ZTu
Dr. John Cush RheumNow ( View Tweet)
Cross-sectional study from UK Clinical Practice Research Datalink Aurum looked at > 40K w/ #PMR Rx w/ steroids - 67% were coprescribed bisphosphonates (BP) & 79% Rx PPIs/H2RAs (less in males & pts deprived areas) resulting more Fx w/in 12 mos (2.32% vs 1.4%). https://t.co/b2DFJMjqCu
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Predictors of Calcinosis Cutis in Systemic Sclerosis
Calcinosis cutis (CaC) is a common and disabling non-lethal manifestation in systemic sclerosis (SSc). This study used SSc patients from the EUSTAR database to clinically characterize patients and identify risk factors for https://t.co/uXbcCa04Lv
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Portugese multicentre retrospective of 748 adults with JIA (age 28 yrs; Dz duration 21 yrs). Oligoarticular JIA was the most common subtype (29.9%). HTN (9%), psychiatric dz (8%), & osteoporosis (5%) were most prevalent comorbidities. bDMARD use reduced risk of psych Dz https://t.co/xCrTDxirlj
Dr. John Cush RheumNow ( View Tweet)
#Glucocorticoid-induced #osteoporosis results from direct suppression of osteoblast & osteocyte function, a transient stimulation of osteoclast formation & activity, catabolic effects on #bone matrix & muscle protein, and metabolic alterations https://t.co/ZmMFAOJkmw
#OpenAccess https://t.co/6CubKRbjin
Links:
The Lancet Diabetes & Endocrinology TheLancetEndo ( View Tweet)
3 Months of Romosozumab in Postmenopausal Osteoporosis
A report in The Lancet Diabetes & Endocrinology suggested that 3 months of romosozumab (ROMO) followed by denosumab is as effective at increasing hip bone mineral density (BMD) as the standard 12-month course. https://t.co/HPM7DdRFBM
Dr. John Cush RheumNow ( View Tweet)
3 Months of Romosozumab in Postmenopausal Osteoporosis
A report in The Lancet Diabetes & Endocrinology suggested that 3 months of romosozumab (ROMO) followed by denosumab is as effective at increasing hip bone mineral density (BMD) as the standard 12-month course. https://t.co/6HfGFZqavF
Dr. John Cush RheumNow ( View Tweet)
