Big Fat FDA Pink Slip (9.19.2025)
Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com. Today we cover GLP-1 agonists, acupuncture, what JAKs won’t do & an FDA Pink Slip.
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SLE and Osteoporosis
Systemic Lupus Erythematosus (SLE) is a multisystem autoimmune disease that can present with a variety of signs and symptoms and organ involvement. Comorbidities further complicate the disease course that may lead to poor health-related quality of life and https://t.co/8ZmtLjzbqA
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The overall prevalence of #osteoporosis in SLE is ~33-40% and is due to several factors with GC therapy being one of them.
Monitor DXA every 6-12 months (vs. 2 yrs for standard OP)
☝️Screen for GIOP
☝️Treat accordingly - once on GCs & esp w/long-term use
@RheumNow #APLAR25 https://t.co/E9FJDHrBUo
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Key takeaways of trabecular bone screening:
📌Complements but doesnt replace BMD/FRAX in fracture risk assessment
📌Dont exclude any lumbar spine unless w/significant change like laminectomy
📌Can use in monitoring untreated pts since TBS declines
@RheumNow #APLAR25 https://t.co/bcN83IDDja
sheila @RHEUMarampa( View Tweet )
Remember! ☝️
Trabecular bone screening should not be routinely used in pre-menopausal women.
@RheumNow #APLAR25 #osteoporosis https://t.co/hGMExyDYUX
sheila @RHEUMarampa( View Tweet )
Japanese retrospective real world study shows antifibrotic use assoc w/ better survival in Pulm Fibrosis-ILD for 1st 3 yrs & improved survival in progressive pulm. fibrosis (PPF) “despite management” (PPF subset prev Rx non-antifibrotic therapy) https://t.co/caiIuhg7j8 https://t.co/N0ST73TMoR
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SLE and Osteoporosis
In one of the SLE sessions at the APLAR 2025 Congress, Prof. Sandra Navarra discussed the assessment and management of osteoporosis in SLE patients, particularly glucocorticoid-induced osteoporosis (GIOP) and this article reviews the highlights and key takeaways from her talk.
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What to give next?
Bone sequencing therapy provides a novel perspective in #osteoporosis treatment.
Several sequential approaches exist.
Better treatment plan = better patient outcomes
#APLAR25 @RheumNow @rheumarhyme https://t.co/XvwnT9ZCU2
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sheila @RHEUMarampa( View Tweet )
Dr. Josef Smolen discusses 2025 EULAR updates for RA.
He highlighted the importance of OP A - that tx should be a shared decision making between px and rheuma in order to ensure better care and disease control.
@RheumNow #aplar25 #APLAR25 https://t.co/KOJbiK87TS
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Crepitus Does Not Predict Earlier/Worse OA
EurekAlert!
Young adults who experience grinding or clicking sounds in their knees post-surgery may be alarmed, but new research from La Trobe University suggests these sounds may not signal early-onset osteoarthritis.
Knee crepitus, the sound of cracking or grinding in the knee joint is very
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Osteoporosis in Older Men
JAMA has publish an invited commentary on Screening for Osteoporosis (OP) in Older Men. They point out that a simple screening strategy for older men based on previous fracture history and bone density screening at age 70 or 75 years is a reasonable means of screening for OP in older men.
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TriNetX database study shows Beta blocker use assoc w/ more hip replacements (THA). 23K propensity matched pts (mean age 69) on or off BB compared. After 3 yrs BB use was assoc w/ higher risk of THA (HR 1.49; 1.4–1.59), esp w/ alpha-BBs (HR 1.64) https://t.co/W6ocMYI653 https://t.co/EiQ4WH94cD
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Chondrocalcinosis Increases Osteoarthritis Risk
Analysis of data from two large, prospective cohort studies show that knee chondrocalcinosis was associated with an increased risk of incident knee osteoarthritis.
https://t.co/Jd1Wb9lWpT https://t.co/QwXn2ehNie
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Study of 110 #SLE pts found 41% w/ osteoporosis, 35% of whom had Lupus nephritis (LN). SLE w/ lower BMD assoc w/ LN classes III & IV, U1-RNP Abs, high CRP, & longer Dz duration, also w/ higher age, HAQ, C3 levels. 86% were on glucocorticoids, mean age 48 yrs. https://t.co/dqutqbvnjB
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Mild cognitive impairment (MCI), (a reversible precursor to dementia) is increased in elderly RA (n=378) and is signif. assoc w/ course of disease(OR 1.07), DAS28 (OR 1.31), high CRP (OR 1.01) & osteoporosis (OR 1.88) as independent risk factors. https://t.co/45DY03sD23 https://t.co/kdX9TnykVK
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CKD & Osteoporosis Rx Revisited (7.25.2025)
Dr. Jack Cush reviews the news, journal and FDA updates from this past week on RheumNow.
https://t.co/k78DRpWIJS https://t.co/aYKvIhmJN1
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Osteoporosis Drug May Lower Osteoarthritis Risk
A target trial emulation study using administrative claims suggests that romosozumab was associated with a lower risk of osteoarthritis than teriparatide among individuals with osteoporosis, particularly for knee osteoarthritis. https://t.co/fWWw2t2jzR
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Osteoporosis Drug May Lower Osteoarthritis Risk
A target trial emulation study using administrative claims suggests that romosozumab was associated with a lower risk of osteoarthritis than teriparatide among individuals with osteoporosis, particularly for knee osteoarthritis.
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1 in 5 Patients are Unaware of their Arthritis Diagnosis
Current CDC numbers suggest that arthritis (any type) affects an estimated 67.1 million (27.9% ) adults in the USA. Interestingly, 1 in 5 do not know their arthritis subtype (21.6%, 14.4 million).
This most recent analysis of the prevalence and distribution of arthritis subtypes
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Osteoporosis treatment benefits people older than 80
People who are older than 80 should be considered for osteoporosis treatment after a fracture to avoid further risk, according to a study being presented Saturday at ENDO 2025, the Endocrine Society’s annual meeting in San https://t.co/ry3V4Nmq7E
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Osteoporosis treatment benefits people older than 80
EurekAlert!
People who are older than 80 should be considered for osteoporosis treatment after a fracture to avoid further risk, according to a study being presented Saturday at ENDO 2025, the Endocrine Society’s annual meeting in San Francisco, Calif.
“The burden of osteoporosis is rising as the
Survey shows only 1% of men are concerned about bone density; but 2 million men have osteoporosis, and 16 million men have osteopenia. https://t.co/DA4vSmj0vd? https://t.co/V4OChN022V
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Simple Measures are Effective in Knee Osteoarthritis
EurekAlert!
Knee braces, water therapy and exercise are the most promising non-drug therapies for treating knee osteoarthritis, according to a new meta-analysis publishing June 18, 2025 in the open-access journal PLOS One by Yuan Luo of the First People’s Hospital of Neijiang, China.
Knee
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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
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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
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