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Depression and RA (3.8.2024)
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week.
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2023 EULAR Non-pharmacological Management of Hip and Knee Osteoarthritis: 2023 update
EULAR has published the 2023 updated recommendations for the optimal non-pharmacological management of hip and knee osteoarthritis (OA).
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RheumNow Podcast – Bill of Rights (12.15.2023)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Two major reports on fatigue and fibromyalgia misfired, and "ankylosing spondylitis" is sent to the Rheumatology dead word cemetery.
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Post-Menopausal Osteoporosis Review and Recommendations
A recent New England Journal review of post-menopausal osteoporosis (OP) provided updated information, strategies and a review of guidelines and clinical recommendations. Here are the salient highlights.
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ACR 2022 Guideline on Glucocorticoid-Induced Osteoporosis
The ACR has published its updated recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP) for patients receiving >3 months treatment with glucocorticoids (GCs) ≥2.5 mg daily.
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Australian study shows self-reported difficulties w/ ambulation (limited<=1 km) had a higher risk of hip and spinal fractures (32% to 219% more)/ Included 239 000 adults >45 yrs https://t.co/IWvKmPc2t8 https://t.co/CDYDzhMUoa
Dr. John Cush RheumNow ( View Tweet)
Could Weight-Loss Drug Improve Hip Replacement Outcomes?
The antidiabetic/weight-loss drug semaglutide either does or does not help patients undergoing THA avoid complications and other poor outcomes, according to 2 retrospective studies presented here.
https://t.co/bB2E4T2aiI https://t.co/EWVcQ01GuL
Dr. John Cush RheumNow ( View Tweet)
Acute CPPD at significantly higher risk of fractures. 1148 acute CPPD pts matched to 3730 comparators(mean 73 yrs old); Steroids and OP more in CPPD pts. Fx risk was twice as high in the acute CPPD pts (HR 1.8;1.3, 2.3). Fx risk highest forwrist (HR, 3.6) https://t.co/RkuzGKzoPv https://t.co/IHZBIfEmms
Dr. John Cush RheumNow ( View Tweet)
Danish study compared 106K adults w/ major osteoporotic fracture (hip, vertebrae, wrist, humerus) vs 1+ mill controls & found Mortality highest 30d following 1st index hip Fx (HR 10.98 women; & HR 16.40 men). Pneumonia most common cause of mortality https://t.co/0D7ynN4f5L https://t.co/qX61cgq1SL
Dr. John Cush RheumNow ( View Tweet)
Post-Menopausal Osteoporosis Review and Recommendations
A recent New England Journal review of post-menopausal osteoporosis (OP) provided updated information, strategies and a review of guidelines and clinical recommendations.
https://t.co/TkJjsX98Ww https://t.co/2Hi72GjEHM
Dr. John Cush RheumNow ( View Tweet)
TM61 at #ACR23
23 yo M p/w ~3mo of sternal swelling
- US probable abscess, drained + multiple abx w/ no improvement
- XR R shoulder + L elbow nl but MRI abn
- MRI L elbow: possible osteomyelitis (OM)
- MRI R shoulder; clavicular osteolysis
- Bone Bx clavicle + L Ulna: Chronic… https://t.co/7s9PIwByTs https://t.co/wKaKfnncP5
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
ROMO vs DEN.
Romosozumab was superior to denosumab
(ROMO +7.3±4.5%; p< 0.001) and (DEN +2.3±3.1%; p< 0.001) in raising the spine BMD but not in hip at month 12 in chronic GC users with high fracture risk
Mok C Abst#242 #ACR23 @RheumNow https://t.co/q2OKD6C2Me
Dr. Antoni Chan ( View Tweet)
Mok et al. Romosozumab superior to denosumab in high risk GIO. Superior in improving spine BMD. Not fracture. Fracture is what matters. Abstr#2429 #ACR23 @RheumNow https://t.co/5ModHOGsED
Richard Conway ( View Tweet)
TM83 #ACR23 @RheumNow
45yo M b/l sacroiliitis, Rx MTX -> ADA -> MTX + Tofa. No improv
Low Ca, & Phos, ALP 239. Nml Vit D, High PTH.
DEXA: Osteoporosis
FGF23 high
PET/CT showed soft tissue density in nasal septum, few cortical breaks
Dx: oncogenic osteomalacia 2/2 malignancy https://t.co/EOcYNtovBy
Eric Dein ( View Tweet)
@gurdeep_dulay I ask the same question always, why would you stop denosumab? Nothing comes close to fully ameliorating the negative consequences of doing so. Denosumab is for life, until we figure out how to safely get off it. Don't start it unless that is acceptable #ACR23
Richard Conway ( View Tweet)
#Denosumab and what to do IF you stop it
#ACR23 #osteoporosis #Bisphosphonate #CTX https://t.co/qwdQQjJJlb
Dr Gurdeep S Dulay ( View Tweet)
Year in Review: Dr. P Seo
⭐️Low dose colchicine assoc w/ ⬇️ incidence of hip/knee replacement
➡️ 5522 pts w/ stable CAD: colchicine 0.5 mg vs PBO for median of 28.6 months
➡️ Hip/knee: 2.5% vs 3.5%
➡️HR 0.69
Similar finding in 2020 CANTOS trial using Ilaris
#ACR23 @RheumNow https://t.co/PD26zoolDB
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Orthopedic cohort study of 274,403 pts (180K females, 94K males; mean age=55). The risk of future TKA was signif greater in pts w/ combination of Depression+Obesity group (11.9%); compared to Controls (8.3%), obese (10.2%) or Depression (7.8%) https://t.co/dltVS0Y6PY https://t.co/REgO5tjEUv
Dr. John Cush RheumNow ( View Tweet)
ACR 2022 Guideline on Glucocorticoid-Induced Osteoporosis
The ACR has published its updated recommendations for prevention and treatment of GIOP for patients receiving >3 months treatment with glucocorticoids (GCs) ≥2.5 mg daily.
https://t.co/uTDBmRvCV5 https://t.co/Qx6fZSTeS5
Dr. John Cush RheumNow ( View Tweet)
12.3 million Americans over 50 have osteoporosis; 47 million have osteopenia. W/ OP Fx the risk of repeat Fx is highest in 1st 6 mos, yet 8% of Medicare pts w/ Fx have a diagnostic bone density scan (less in African Americans 5%) https://t.co/xBHr7WffYf https://t.co/S27Vs8yyjY https://t.co/eWcOB8fjWH
Links:
Dr. John Cush RheumNow ( View Tweet)
