OP/Bone

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

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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
Dr. John Cush @RheumNow( View Tweet )
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

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Dr. John Cush @RheumNow( View Tweet )
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Vitamin D in Rheumatic Disease - is it Good Enough?

Jack Cush, MD

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
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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

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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

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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
Dr. John Cush @RheumNow( View Tweet )
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Prescribing Lessons (4.17.2026)

Jack Cush, MD

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

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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
Dr. John Cush @RheumNow( View Tweet )
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

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The Lancet Diabetes & Endocrinology @TheLancetEndo( View Tweet )
RA erosions bone ACR

b/ts-DMARDs Do Not Arrest Bone Loss in RA

Jack Cush, MD

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

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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

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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
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 )
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3 Months of Romosozumab in Postmenopausal Osteoporosis

Jack Cush, MD

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.

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New studies posted this week in Arthritis & Rheumatology: Adalimumab ± MTX as first-line therapy for childhood-onset chronic uveitis https://t.co/L4QiZZBBG7 Bisphosphonates & PPI/H2RA coprescriptions in polymyalgia rheumatica https://t.co/62Pqt5Ab58 Phase 3b SOLSTICE trial: https://t.co/MsK4XC3eNh

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American College of Rheumatology @ACRheum( View Tweet )
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A Modern Approach to Osteoporosis Management

Adela Castro, MD

Currently, fewer than half of patients diagnosed with osteoporosis receive appropriate pharmacologic therapy. This treatment gap reflects several challenges in osteoporosis management, including limited disease awareness, barriers to medication access, clinician discomfort with therapy selection

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RT @richardPAconway Updated data on RA-ILD from Olmstead County. Cumulative incidence of 15.3% over 20 years! #RNL26 https://t.co/wVrTc3QM6Y
Dr. John Cush @RheumNow( View Tweet )
TOPKAT Trial: Partial vs Total Knee Replacement Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little bit https://t.co/MNpVeHQbJ2
Dr. John Cush @RheumNow( View Tweet )
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Canada's 2025 Top 10 Funded Rheumatology Projects

Arthritis Society

Arthritis Society Canada (ASC) is Canada’s largest charitable funder of cutting-edge arthritis research, investing more than $240 million in research projects since its founding, and over $7 million invested in 2024-2025. Below are the investigators and projects that were funded in 2025.

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Consensus on Managing Vertebral Fractures in Advanced CKD A coalition of leading international experts has released the first comprehensive Consensus Statement on the Management of Vertebral Fractures in Chronic Kidney Disease (CKD) Stages G4–G5D. The statement highlights a https://t.co/gilX13EaUi
Dr. John Cush @RheumNow( View Tweet )
Rheum Survey> 40 yoF RA pt on Prednisone 5 mg/d is at increased risk for ?

Dr. John Cush @RheumNow( View Tweet )

Rheum Survey> 40 yoF RA pt on Prednisone 5 mg/d is at increased risk for ?

Dr. John Cush @RheumNow( View Tweet )

In Dec 2025, the FDA qualified total hip bone mineral density (BMD) assessed by DXA as a validated surrogate endpoint for osteoporosis clinical trials. Previously OP trials required fracture endpoints as primary efficacy measures, necessitating large 2-5 yr studies https://t.co/5t9rftwX4A
Dr. John Cush @RheumNow( View Tweet )

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PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives. 
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