Vitamin D and Lupus Outcomes (11.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Target emulation trial of 12,145 Pts (87% female; age 80 yrs), shows that compared to teriparatide, Rx w/ romosozumab was assoc w/ significantly lower risk of osteoarthritis (RR 0.79); especially for knee OA (0.79). https://t.co/nEdENoNae7 https://t.co/JiyRd6ThXu
Dr. John Cush @RheumNow( View Tweet )
25-Hydroxyvitamin D levels and Lupus Outcomes
Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/4nhACulIw0
Dr. John Cush @RheumNow( View Tweet )
Mesothelin as a biomarker and potential therapeutic target in rheumatoid arthritis? Mesothelin is elevated in RA & animal models & promothes osteoclast differentiation & bony destruction. Blocking mesothelin has the potential to reduce bone destruction. https://t.co/WRXG91AqmJ https://t.co/hMgddPXhxG
Links:
Dr. John Cush @RheumNow( View Tweet )
Bone Density in Ankylosing Spondylitis
At #ACR25, a retrospective study from China tackled this challenge using quantitative computed tomography (QCT), a more precise imaging modality that measures true volumetric bone density unaffected by cortical ossifications. https://t.co/1Z5cshkqjt
Dr. John Cush @RheumNow( View Tweet )
A 15-year-old girl has short stature and the hand finding shown . Labs show ↓Ca²⁺, ↑PO₄³⁻, ↑PTH.
What is the most likely diagnosis? https://t.co/afPUeaqfZT
Dr. Nikhil Agrawal @DrNikhilMD( View Tweet )
#2660 In >8000 women, serum urate rose sharply during the menopausal transition, then plateaued after menopause.
Hyperuricemia reached 4-5% post-menopause, up to 18% in obesity or low eGFR.
Healthy body weight & kidney function pre-menopause may decrease HU later @RheumNow #ACR25 https://t.co/v6ai3lgAd2
Mrinalini Dey @DrMiniDey( View Tweet )
What exercise best for steroid-induced osteoporosis? Does it have to be weight bearing?
Turns out anything helps - get out there and don’t let perfect be the enemy of good!
Laura Coates in the #ACR25 meeting review @RheumNow https://t.co/VGH2rz3dzb
David Liew @drdavidliew( View Tweet )
#1727
360k+ postmenopausal women w osteoporosis: >1/3 untreated patients were at v high fracture risk, yet few received recommended anabolic or antiresorptive therapy.
Even among treated women at very high risk, >50% were still on oral bisphosphonates
@RheumNow #ACR25 https://t.co/9S66tAU68P
Mrinalini Dey @DrMiniDey( View Tweet )
Why Brittle Bones Aren't Just a Woman's Problem
Osteoporosis is more common in women, prompting routine screenings for them at age 65. As a result, men might overlook getting a scan, which may not be suggested by an orthopedic specialist. However, about 20% of men over 50 will https://t.co/ggyse5ZDPV
Dr. John Cush @RheumNow( View Tweet )
Why Brittle Bones Aren't Just a Woman's Problem
MedPage Today
Ronald Klein was biking around his neighborhood in North Wales, Pennsylvania, in 2006 and tried to jump a curb. "But I was going too slow -- I didn't have enough momentum," he recalled. As the bike toppled, he thrust out his left arm to break the fall. It didn't seem like a serious accident, yet
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Osteoporosis Screening in High-Risk Men
A VA Health Systems study of older male veterans found benefits of a remote model of screening that significantly improved osteoporosis screening, treatment, and adherence compared with usual care, with high patient and clinician https://t.co/Kt3mJLahdq
Dr. John Cush @RheumNow( View Tweet )
NY Times on Osteoporosis in Men
The NY Times has addressed the problem of osteoporosis in men noting a need for increased awareness and screening. Takeaways:
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Osteoporosis Screening in High-Risk Men
A Veterans Affairs (VA) Health Systems study of older male veterans found benefits of a remote model of screening that significantly improved osteoporosis screening, treatment, and adherence compared with usual care, with high patient and clinician acceptance.
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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
Dr. John Cush @RheumNow( View Tweet )
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
Links:
sheila @RHEUMarampa( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
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
Links:
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
sheila @RHEUMarampa( View Tweet )
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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