Bad Actor Cofactor (10.17.2025) Save

Dr. Jack Cush reviews the news and journal reports, discusses pediatric reports, pregnancy data, diet and nutrition and more.

1. Muscle mass & JAKi? 15 active RA pts (+ sarcopenia risk) Rx w/ tofacitinib - signif. improved @1 mo. @6 mos muscle mass signif improved (+242 cm3, +4%, p=0·017) {less w/ NSAIDs); w/ signif creatinine incr (0.06 mg/dl) & decr in serum IL-6, IL-1 & TNF. No change in CK, myoglobin, LDH, AST https://buff.ly/Li3BVUx
2. BMJ Systematic review of 217 RCTs w/ 15 684 pts shows most beneficial exercises for Knee Osteoarthritis are aerobic activities such as walking, cycling, or swimming significantly mitigated pain during both short and mid-term follow-up periods https://t.co/WmQBFNis6t
3. Osteonecrosis: suspect with trauma, high-dose steroids, alcoholism, renal failure, transplantation, SLE, thrombotic states (e.g., sickle cell anemia, hemoglobinopathies), radiation injury, pancreatitis, gout, pregnancy, hyperlipidemia, & caisson disease (decompression sickness) https://t.co/y6iYd5fWZ2
4. JAMA Pediatrics study of 1,473 young US adult, finds 1/4 use cannabis or alcohol for sleep (18% cannabis; 7% EtOH), even though these may interfere with quality or ability to stay asleep. In those using cannabis in the last yr, 41 reported using cannabis to sleep. https://buff.ly/8tvUUzi
5. A cohort study of 1 548 538 mother-child pairs with antenatal exposure to steroids (ACS) found a significantly increased risk of resp & nonrespiratory infections in preterm & full-term children up to 21 years. (incidence rate, 65 vs 40 & 30 vs 18 per 1000 person-Yrs, https://t.co/Vh4TNYMXgo
6. Single center study of pregnancy outcomes in 189 women (131 RA, 29 SpA, 29 PsA). Stats for RA/SpA/PsA -- Live births 76%/90%/69%; Preterm 16%/12%/7%; IUGR 31 RA, none in SpA/PsA.. C-Sections ~1/3. TNFi used in 12% RA, but higher in SpA (48%) & PsA (31%) https://t.co/wVWOlRR0c0
7. ~1/3 non-IPF ILD progresses over time. KL-6, a new biomarker, retro study of 10 European centers, 303 pts - 37% progressed (⩾10% FVC decline) after 1yr. 5 predictors of progression: age, gender, BMI, FVC, KL-6. (superior to KL-6 alone) w/ 55% sensitivity, 73% specificity 67% accuracy https://t.co/i0Uc8DPHaM
8. Tertiary center study of 147 GPA pts (age ~45, 18 mos F/U) - total of 55 deaths& 179 relapses (in 117 pts;1.53/pt). Predictors of relapse (~2 fold incr) = Age > 55, male, ^^creatinine & CNS dz. Mortality assoc w/ ≥ 55 yrs, male, creatinine >1.3, CNS @baseline https://t.co/GzScokrN7G
9. Fibromyalgia in PsO & PsA is linked to greater treatment complexity and shorter biologic therapy survival. Retro matched 1:4 cohort study 61K PsO& 244K controls. FM prevalence 3.3% (OR 1.45). In PsA w/ FM, req more biologics w/ decr biologic survival (6 vs 10yrs) w/ incr switching (HR 1.82) https://buff.ly/TCc6Kc8
10. Scientific American takes a look at the beneficial effects of: Omega-3 Fatty Acids Vitamin D Curcumin (basic overview for all) https://t.co/jv5FrGQQLJ
11. Mediterranean Diet Efficacy in Psoriasis  MEDIPSO  small clinical trial found that a 16-week Mediterranean diet reduced psoriasis severity, presumably due to anti-inflammatory benefits of extra virgin olive oil, plant-based foods, and moderate meat consumption, according to a study https://t.co/nAVgtOq26l
12. Pediatric IBD and MSK Sxs   
13. Telitacicept Effective in Systemic Lupus Erythematosus