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MTX Fails Knee OA (6.6.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com
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Methotrexate Fails in Knee Osteoarthritis
MedPage Today
We'll be blunt: methotrexate flopped in a randomized placebo-controlled trial among patients with osteoarthritis (OA) of the knee.
Contrary to results from a previous trial in hand OA, the old-line disease-modifying anti-rheumatic drug (DMARD) failed to bring any improvement relative to placebo in either pain or an objective measure of joint inflammation after a year of treatment, according to Changhai Ding, PhD, MD, of Southern Medical University in Guangzhou, China, and colleagues.
Denosumab and Osteoporosis - A JAMA Review
An overview of denosumab use in osteoporosis (OP) by Bauer and Ensrud was published in JAMA.
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Intraarticular IL-1Ra Gene Therapy in Knee Osteoarthritis
In a dose-escalation trial in nine participants, they observed that a single intra-articular injection of the gene product led to an increase in IL-1Ra in the synovial fluid that remained elevated for up to a year. There https://t.co/YDuUg44ebu
Dr. John Cush RheumNow ( View Tweet)
EULAR Classification criteria for hemachromatosis, presented by Prof. Kiely shows clinical pearls in diagnosis - Hook osteophytes @MCP 2/3, & Iron Fist sign w/ elevation of MCPs 2&3. #EULAR2025 https://t.co/S8iA0C4pwG
Dr. John Cush RheumNow ( View Tweet)
Using high-resolution peripheral quantitative computed tomography (HR-pQCT), patients with psoriatic arthritis (PsA) & psoriasis (PsO) show reduced cortical volumetric bone mineral density (vBMD) & thinner cortex vs controls. Bone mechanics impaired: reduced stiffness & failure https://t.co/ghH2cwOYJc
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Denosumab and Osteoporosis - A JAMA Review
An overview of denosumab use in osteoporosis (OP) by Bauer and Ensrud was published in JAMA
https://t.co/3d7Q61nVKM https://t.co/i3DjtcsuWo
Dr. John Cush RheumNow ( View Tweet)
Denosumab and Osteoporosis - A JAMA Review
An overview of denosumab use in osteoporosis (OP) by Bauer and Ensrud was published in JAMA
https://t.co/3d7Q61nVKM https://t.co/PdI235k9jh
Dr. John Cush RheumNow ( View Tweet)
Unmet needs in #lupus are many
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Timely #diagnosis
Morbidity - CV, metabolic, OP, mental health
Premature mortality - CAD, active #SLE, infection
Issues w pregnancy
#steroid side effects
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Pts
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Janet Pope Janetbirdope ( View Tweet)
Periprosthetic femoral Fx (PPFF): metanalysis of 36 studies found PPFF risk factors: Uncemented stems (OR 3.36), major teaching hosp (2.0), female (1.6), obesity (1.4), Hi comorbidity(1.4), RA (1.89), (1.67), revised THR (2.6). OA = protective (0.51) https://t.co/y2BpH8LUb6 https://t.co/EjX6R9QTK3
Dr. John Cush RheumNow ( View Tweet)
Periprosthetic femoral Fx (PPFF): metanalysis of 36 studies found PPFF risk factors: Uncemented stems (OR 3.36), major teaching hosp (2.0), female (1.6), obesity (1.4), Hi comorbidity(1.4), RA (1.89), (1.67), revised THR (2.6). OA = protective (0.51) https://t.co/y2BpH8LUb6 https://t.co/hX2lcjI4Kg
Dr. John Cush RheumNow ( View Tweet)
3-year, RCT of Mediteranean diet vs usual care in 924 older adults w/ metabolic syndrome & BMI > 27. Med. diet shows signif wt loss (3.4% vs 0.4%), w/ improved BMD (by DEXA) at year 3, especially in women. https://t.co/mllx6l1QnM https://t.co/I5e8PXX2oX
Dr. John Cush RheumNow ( View Tweet)
3-year, RCT of Mediteranean diet vs usual care in 924 older adults w/ metabolic syndrome & BMI > 27. Med. diet shows signif wt loss (3.4% vs 0.4%), w/ improved BMD (by DEXA) at year 3, especially in women. https://t.co/mllx6l1QnM https://t.co/CulO1Sschf
Dr. John Cush RheumNow ( View Tweet)
Managing CKD in Lupus Nephritis
Dr. Hans-Joachim Anders explores how to treat LN patients with chronic kidney disease, balancing disease control and renal preservation.
🎯 Don’t miss these expert pearls.
👉 Full update on RheumNow: https://t.co/frHvcd1xMw
#LupusNephritis https://t.co/VedtGaHkMj
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Dr. John Cush RheumNow ( View Tweet)
Pitfalls in sacroiliitis imaging: Bone marrow edema may also be seen in young-middle-aged postpartum women, & athletes & kids (ongoing bone growth) & w/ advancing age (DJD) https://t.co/bwS047wlmI https://t.co/FvWlEcZ5JP
Dr. John Cush RheumNow ( View Tweet)
Finish Birth Cohort followed since 1986, who were asymptomatic, found abnormal MRI knee findings, esp cartilage defects in the patellofemoral (56%) & tibiofemoral joints (25%) joints. Small/doubtful patellofemoral (52%) & tibiofemoral (17%) osteophytes seen. Most w/ High BMI. https://t.co/LHqmRHM5wF
Dr. John Cush RheumNow ( View Tweet)
Japan IORRA RA registry shows from 2011 to 2023, despite better Rx & control & less pred, Fractures went up in RA. From 2011 to 2023- DAS resmission 38 to 65%, bDMARD use 14 to 42%, GC use 38 to 22%, OP Rx 32 to 38%; But all FX incr 47 to 53/1000 Pys. https://t.co/cgz0Gkasai https://t.co/D2Uro7mEAT
Dr. John Cush RheumNow ( View Tweet)
Japan IORRA RA registry shows from 2011 to 2023, despite better Rx & control & less pred, Fractures went up in RA. From 2011 to 2023- DAS resmission 38 to 65%, bDMARD use 14 to 42%, GC use 38 to 22%, OP Rx 32 to 38%; But all FX incr 47 to 53/1000 Pys. https://t.co/cgz0Gkasai https://t.co/ziZr3BegDz
Dr. John Cush RheumNow ( View Tweet)
Osteoarthritis Initiative (OAI) longitudinal study analyzed 1075 #OA knees (1/pt) in 96 mo. MRI study to predict outcomes. Infrapatellar fat pad (IPFP volume & signal) predicted future knee replacement & long-term damage. IPFP correlated w/ cartil. volume & BM lesions; Not Sxs. https://t.co/Xsju7JdEVE
Dr. John Cush RheumNow ( View Tweet)
Osteoarthritis Initiative (OAI) longitudinal study analyzed 1075 #OA knees (1/pt) in 96 mo. MRI study to predict outcomes. Infrapatellar fat pad (IPFP volume & signal) predicted future knee replacement & long-term damage. IPFP correlated w/ cartil. volume & BM lesions; Not https://t.co/VrLfiSGWGA
Dr. John Cush RheumNow ( View Tweet)
