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Osteoporosis: Thinking outside the box

Robert Chao, MD

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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Open-access Arthralgia Clinics

Jack Cush, MD

The early diagnosis in inflammatory arthritis (IA), particularly rheumatoid arthritis (RA), hinges on efficient referral and screening of arthralgia patients.

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Treat-to-Target and Cardiovascular Benefits in Gout

Jack Cush, MD

A new user cohort study of 109 504 gout patients, achieving a serum urate level less than 6 mg/dL, was associated with a significantly lower risk of cardiovascular events.

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Hydroxychloroquine Lowers SLE and RA Hospitalizations

Jack Cush, MD

A population based study from British Columbia, Canada, shows that antimalarial adherence was associated with a lower risk of hospital admission in patients with rheumatoid arthritis

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Progress in GCA and Takayasu's Arteritis

Robert Chao, MD

I recently attended a fascinating lecture by Dr. Anisha Dua on progress in the diagnosis and treatment of large-vessel vasculitis, with a focus on giant cell arteritis (GCA) and Takayasu's arteritis. She opened with what felt like the most honest “state of the union” slide you can show a room full of rheumatologists: steroid burden is still enormous.

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SATISFACTION (2.27.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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Equivalent Healthcare Outcomes by Nurses and Physicians

Jack Cush, MD

With increasing demand for health services in an aging population, serving complex patients with comorbidities, and increasing healthcare costs, the question of whether nurses can substitute for physicians was addressed by a recent Cochrane review.

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Retrospective study of 1553 IBD pts taking biologics or JAKi, w/ 5+ yrs of F/U, 6.8% developed MSK Sxs, with one-third subsequently Dx w/ SpA. HLA-B27 positivity (HR 3.7) and higher UC disease activity (HR 1.57) were associated with an increased risk of SpA. https://t.co/I2YSOLhkAb
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SATISFACTION (2.27.2026) Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow. https://t.co/IfbOUZV0dP https://t.co/nVxjdG8f26

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Diacerin, an IL-1β blocker, compared to placebo in a 262 pt RCT of knee pain, Knee #OA w/ inflammation. After 24 wks, 88% completed the trial & (vs PBO) diacerein did not improve knee pain (−19.9 vs −18.6 mm). 42% had AE/ GI Sxs were more w/ diacerein (42% vs 25% PBO https://t.co/QabS3xLN85
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Cross-sectional study of Joint hypermobility (JH) in 256 young adults (75% female) found JH in 42%, females w/ signif. higher Beighton scores. 88% had chronic MSK pain; 38% had acute MSK pain. MSK pain was signif higher in students with mild JH (BS 4–6/9 pts; P < 0.009) https://t.co/QZwJ9zHfEj
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OA & Exercise? Metanalysis of 5 reviews (n=8631) & 28 trials (n=4360) show little or no proof that exercise benefits OA. Exercise has small, short-term effects vs placebo & no-treatment for knee OA pain. Moderate evidence of no effects in hip, & small effects in hand OA. https://t.co/ycLGNlP8Sf
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The prevalence of Systemic lupus erythematosus (SLE) in Australia is 26,788 (16,294 certain, 10,494 uncertain cases). Betw 2010-2022 incidence was 77-127/100,000 (certain cases). About half had received SLE care in an outpatient setting. Australia is 1/13 the population of USA https://t.co/n1sbFNPRbn
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“Common sense is the measure of the possible; it is composed of experience and prevision; it is calculation applied to life” - Henri Frederic Amiel

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Epidemiology of Dry Eye Autoimmune Disease Rates upwards of 20% were seen across nine common autoimmune diseases other than Sjögren's, most often in rheumatoid arthritis (39.3%) with Crohn's disease bringing up the rear (23.0%), according to Chi-Chin Sun, MD, PhD, of Chang Gung https://t.co/Z8ZBGmqT93
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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
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Nice simple overview of SCLERITIS. https://t.co/BOgZK8y4Qq https://t.co/P0dLtA3nKy

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GLP-1s are known to improved knee OA. Using a mouse OA model w/ obesity, semaglutide yielded less pain, osteophytes & had strong chondroprotective effects, fia a wt loss-independent way. Changing from glycolysis to oxidative phosphorylation resulted in cartilage restoration. https://t.co/8zs34ys9o9
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American College of Chest Physicians has announced that advanced practice providers (APPs) can earn the CHEST Critical Care Advanced Practice Provider (CCAPP) designation; CCAPP Certification exam designed to validate clinical competence & Enhanced credibility/recognition https://t.co/Ip6YMjwOBc
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FDA Commissioner Marty Makary is seeking to make more drugs available without a prescription; and has stated “everything should be over-the-counter” unless the drug is addictive, unsafe, or requires monitoring. https://t.co/CGurlOWO8m https://t.co/bFwkpZ3kbn

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