New ideas in gout management
Gout flares are associated with cardiovascular events. Treating gout to target serum urate level prevents flares, but whether such treatment can also prevent cardiovascular events is unknown.
https://t.co/C8G39JzP9Y https://t.co/NAClL0JLGX
Dr. John Cush @RheumNow( View Tweet )
#EULAR2025 Abstr#OP0035 SGLT2-i and GLP-1 agonist are increasingly used to treat diabetes. Population based study in Canada showed no significant difference in risk of developing an autoimmune rheumatic disease with GLP-1-RA or SGLT2i relative to DPP4i treatment @RheumNow https://t.co/CvPcOqehtl
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
3-year, RCT of Mediteranean diet vs usual care in 924 older adults w/ metabolic syndrome & BMI > 27. Med. diet shows signif wt loss (3.4% vs 0.4%), w/ improved BMD (by DEXA) at year 3, especially in women. https://t.co/mllx6l1QnM https://t.co/I5e8PXX2oX
Dr. John Cush @RheumNow( View Tweet )
GLP-1 agonists effective in Rxing MASH - metabolic dysfunction-assoc steatohepatitis (AKA NAFLD, NASH). DBRPCT w/ 1100 pts (mean BMI 34-35). A good perspective article from Sensible Medicine. https://t.co/NeaX5qcnPA https://t.co/5DHlKfH105 https://t.co/sCfvcm7g54
Links:
Dr. John Cush @RheumNow( View Tweet )
Metformin Effective in Osteoarthritis
The diabetes drug metformin provided overweight/obese patients with osteoarthritis (OA) of the knee with significantly greater pain relief than did placebo in a small randomized trial, researchers said.
https://t.co/7krvFFfRFC https://t.co/g1UyNjazUv
Dr. John Cush @RheumNow( View Tweet )
Metformin Effective in Osteoarthritis
The diabetes drug metformin provided overweight/obese patients with osteoarthritis (OA) of the knee with significantly greater pain relief than did placebo in a small randomized trial, researchers said.
https://t.co/7krvFFfRFC https://t.co/XY5BtiXkOB
Dr. John Cush @RheumNow( View Tweet )
CRP and Hidradenitis Supprativa
A post hoc analysis of 2 phase 3 randomized clinical trials (PIONEER I and II) of adalimumab vs Placebo in patients with active Hidradenitis suppurativa (HS) demonstrated more severe HS that was associated with elevated CRP had a higher BMI.… https://t.co/VxFRjt3cRw https://t.co/rdNIvzMaP8
Dr. John Cush @RheumNow( View Tweet )
Full read, comprehensive review of Hidradenitis Supprativa in Lancet Feb 1, 2025
Common assn; DM, IBD, Smoking, Obesity, metabolic syndr, NASH, SpA, RA
FDA approved Rx: Adalimumab, Secukinumab, Bimekizumab https://t.co/9er7TkNXpK https://t.co/N6sal9URv3
Links:
Dr. John Cush @RheumNow( View Tweet )
SLE pts have increased risk of atherosclerotic cardiovascular disease (ASCVD). Systemic inflammation & glucocorticoid exposure are significant drivers of ASCVD in SLE. Screening recommended - Framingham Risk Score, ACC/AHA risk score & others reviewed https://t.co/jJHNJOU606 https://t.co/JJxiBczMwi
Dr. John Cush @RheumNow( View Tweet )
GLP-1 Agonists Alleviate Knee Osteoarthritis
In October, the NEJM published a randomized clinical trial demonstrating the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1ra) in patients with obesity and knee osteoarthritis.
https://t.co/jlYGDTTsYZ https://t.co/O23mN1CPVO
Dr. John Cush @RheumNow( View Tweet )
FDA Approves First Generic of GLP-1 Receptor Agonist Victoza (liraglutide injection) to Lower Blood Sugar in Patients with Type 2 Diabetes https://t.co/1BYQFU2PsY https://t.co/jmbS9UDnhI
Dr. John Cush @RheumNow( View Tweet )
GLP-1 Agonists Alleviate Knee Osteoarthritis
In October, the NEJM published a randomized clinical trial demonstrating the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1ra) in patients with obesity and knee osteoarthritis.
https://t.co/3ETmyFWpWY https://t.co/wn1QDwKi3R
Dr. John Cush @RheumNow( View Tweet )
Post hoc study of Hidradenitis suppurativa (HS) phase 3 study w/ 588 pts rx w/ either PBO or adalimumab. 79% had elevated CRP. High CRP assoc w/ more severe HS, higher BMI (34 vs 28; P < .001), & lower odds of ADA response (OR 0.53). Activity or Obesity? https://t.co/ZQzumtW2LV https://t.co/FWaQMyP2TT
Dr. John Cush @RheumNow( View Tweet )
Benefit of Achieving Target Serum Urate Levels in Gout with Chronic Kidney Disease
A cohort study of gout patients with CKD stage 3 found that lowering serum urate (SUA) level to less than 6 mg/dL, lowered the risk for severe or end-stage kidney disease progression.… https://t.co/NsGUGvb5L5 https://t.co/QPBWA4VqTo
Dr. John Cush @RheumNow( View Tweet )
Data from Psoriasis Atherosclerosis and Cardiometabolic Disease Initiative & Stockholm Psoriasis Cohort (n=769 Pso Pts) finds that PsO severity (PASI) PASI assoc w/ GlycA levels (syst inflammation) & GlycA levels assoc w/ CVD risk (OR=1.23) https://t.co/IwUHILMpnI https://t.co/DnEF3yuTvg
Dr. John Cush @RheumNow( View Tweet )
Best of 2024: Mixed Long-term Effects of Calcium and Vitamin D in Postmenopausal Women
https://t.co/RxI1zlZ9YR https://t.co/vhsLi6HQAS
Dr. John Cush @RheumNow( View Tweet )
FDA has approved Eli Lilly’s GLP-1 drug Zepbound [tirzepatide] to treat moderate to severe obstructive sleep apnea in adults with obesity in combination with increased physical activity and a reduced-calorie diet.” https://t.co/rYiM6JzmDX https://t.co/hO6CgH9pVs
Dr. John Cush @RheumNow( View Tweet )
GLP-1 Agonists Show Promise in Slowing Kidney Disease in Lupus Nephritis
Glucagon-like peptide-1 receptor agonists (GLP-1Ra) have transformed the treatment landscape for type 2 diabetes and obesity. #ACR24
https://t.co/6QqEH8X2VJ https://t.co/Ch2i9zZYii
Dr. John Cush @RheumNow( View Tweet )
Mitochondria: the powerhouse of the cell—but the fuel behind gout flares?
#ACR24 @RheumNow https://t.co/lV4dovLV18
Akhil Sood MD @AkhilSoodMD( View Tweet )
Pts w #osteoarthritis and T2 DM
👇
Who Have
⬆️pain
Have
worse control of #diabetes
Even after adjusting for #BMI
Chicken or egg - which comes 1st
🤷♀️
#ACR24 @RheumNow @ACRheum
Abst#2110 https://t.co/eN2xAw0EMG
Janet Pope @Janetbirdope( View Tweet )
Updated ACR guidelines on management of lupus nephritis (LN). Consider early biopsy. Focus on triple therapy in LN. From the panel discussion, Tacrolimus can be an alternative to CNI (Voclosporin) where there is no access to this. Manage comorbidities such as CV risk, bone… https://t.co/4R02YnRXDP https://t.co/3J7YcF5ucQ
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Does adding a Clofutriben (HSD-1 inhibitor) w/ prednisone minimize the risks of steroid toxicities in #PMR patients?
VS placebo, PMR patients who received Clofutriben + Prednisone had substantial reductions in bone, lipid, and glycemic control parameters
@RheumNow #ACR24
Akhil Sood MD @AkhilSoodMD( View Tweet )
I have no doubt many of our RA patients will take GLP-1 agonists in the future.
Here's some data @UCLA showing significant differences in not just body weight and HbA1c, but pain.
Will be fascinating to see what it does for grumbling disease activity!
#ACR24 ABST2259 @RheumNow https://t.co/HdOPACEo3A
David Liew @drdavidliew( View Tweet )
Effective RA therapy is about more than just joints
🇪🇸 RA cohort
TNFi for first 24w led to:
Lean mass index i.e. muscle going up
Fat mass index i.e. fat trending down
Muscle & fat composition are important
Systemic Rx can deliver systemic benefits
#ACR24 ABST1348 @RheumNow https://t.co/mZjcHwxMgW
David Liew @drdavidliew( View Tweet )
Low uptake of SGLT2i in Lupus nephritis
SGLT2i users had similar adverse event rates as ACEi/ARB users
SGLT2i users experienced more weight loss
#ACR24 @rheumnow abst#1534 https://t.co/tB5o7tyhu5
Bella Mehta @bella_mehta( View Tweet )
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