Skip to main content


Post-Menopausal Osteoporosis Review and Recommendations

Dec 04, 2023

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.

Read Article
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…
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
Nov 14, 2023
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
Nov 14, 2023
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
Nov 14, 2023
@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
Nov 13, 2023
#Denosumab and what to do IF you stop it #ACR23 #osteoporosis #Bisphosphonate #CTX
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
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%)
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.

ACR 2022 Guideline on Glucocorticoid-Induced Osteoporosis

Oct 24, 2023

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.

Despite increasing treatment options to prevent and treat GIOP, many GC-

Read Article
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%)

Methotrexate in OA (10.20.2023)

Oct 20, 2023

Dr. Jack Cush discusses the news, journal articles and regulatory actions. This week we discuss JAKne, DLE and SLE and more.

Read Article

Hip Replacement Surgery After Age 90

Aug 28, 2023

Potentially modifiable comorbid conditions and complications have a major impact on the risks of total hip arthroplasty (THA) for people in their nineties, reports a study in The Journal of Bone & Joint Surgery.

Read Article

Fracture Risk Quantified for Older Spondyloarthritis Patients

MedPage Today
Aug 22, 2023

Medicare beneficiaries with ankylosing spondylitis (AS) incur frequent bone fractures, a new study indicated, with the risk boosted by some unsurprising factors but also including one that was not expected.

Fee-for-service Medicare claims data from 2016-2018 showed that AS patients

Read Article

English for the Biologically-Challenged (8.4.2023)

Aug 04, 2023

Dr. Jack Cush reviews the news and journal articles from the past week on  This week highlights Veterans, Vegetarians and Antenatal Corticosteroids.

Read Article
Vegetarians have a significantly higher hip fracture risk (HR 1.50) than regular meat-eaters, partly (28%)explained by BMI. UK Biobank compared meat-eaters (n=regular 258,765, occasional 137,954), pescatarians (9557), & vegetarians (7638)
Adding Trabecular Bone Score (TBS) to FRAX and BMD enhances Fx risk prediction in osteoporosis. TBS is validated index of bone microarchitecture from LS spine DEXA. TBS is good at fragility Fx risk and monitoring response to OP Rx

"Ask Cush Anything" Returns (7.21.2023)

Jul 21, 2023

Dr. Jack Cush reviews the news and journal reports and this week, takes on 5 cases/questions from "Ask Cush Anything"

Read Article
In AUSTRALIA, 30% (~ 7million) have a chronic #MSK condition, costing $14.6 billion (10% of all healthcare spending) in 2019-20. Overall, 4 million w/ back problems, 3 million arthritis, 900,000 osteoporosis, 450,000 w/ #RA.

Opioids Ineffective in Acute Lower Back and Neck Pain

Jun 29, 2023

A randomised controlled trial including 347 participants with lower back or neck pain found there was no benefit of taking opioid pain relievers compared to placebo. 

There was no significant difference in pain scores in patients with lower back or neck pain who were given opioid pain

Read Article

How Often Do You Monitor MTX? (6.16.2023)

Jun 15, 2023

Dr. Jack Cush reviews the news and journal reports from this past week on, including new drug approval, a new SpA variant and new rules for methotrexate (MTX) monitoring and depression screening. 

Read Article
Remember to discuss bone density in your pts with #gout! Bone mineral density was significantly lower in pts with hyperuricemia, more so in males and elderly. Large cohort wirh 9017 pts from China! @EULAR2023 @rheumnow abst#AB1639
Gut microbiome studies are implicated in all disease we study! 5 gut microbiota are suggested to have a causal relationship in #gout. 68k controls and 2k gout pts. Can experts comment if it's just data mining or discovery? #EULAR2023 @rheumnow abst#ab1237

EULAR 2023 – Day 1 Report

May 31, 2023

EULAR 2023 launched today to crowds of attendees.  The opening Plenary session and presidential address by Dr. Ian McInnes was followed by a number of overview and review sessions with but a half-day of abstracts presentations, on several therapeutic areas including osteoarthritis, JIA, COVID

Read Article