Nutrition/Obesity

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Do SGLT2 and GLP-1 therapies have a role in Lupus?

Maya Shumyatcher, MD  Arpitha Haranahalli Shivarudrappa, PhD ,  Jennifer H. Anolik, MD, PhD

Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) and Glucagon-like peptide-1 receptor agonists (GLP1-RA) were initially developed as glucose-lowering agents for the treatment of Type 2 Diabetes. Since their introduction, they have been noted to have a myriad of other benefits, including

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Risk Factors for Knee Osteoarthritis New research from the University of Sydney reveals that obesity, having a knee injury and occupational risks such as shift work and lifting heavy loads are primary causes of knee osteoarthritis. https://t.co/Kc686Zc8Xa https://t.co/ANyiE2pIxo

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Dr. John Cush @RheumNow( 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

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Dr. John Cush @RheumNow( 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/CulO1Sschf

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Dr. John Cush @RheumNow( View Tweet )
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Vitamin D Headlines (5.9.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy. 

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Finish Birth Cohort followed since 1986, who were asymptomatic, found abnormal MRI knee findings, esp cartilage defects in the patellofemoral (56%) & tibiofemoral joints (25%) joints. Small/doubtful patellofemoral (52%) & tibiofemoral (17%) osteophytes seen. Most w/ High BMI. https://t.co/nQKREE4XfU
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

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Dr. John Cush @RheumNow( View Tweet )
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D-Lay Trial: High-Dose Vitamin D Retards Multiple Sclerosis

Jack Cush, MD

A randomized clinical trial with oral high-dose cholecalciferol ( vitamin D3) was shown to prevent or delay the onset of clinically isolated syndrome (CIS), typical for multiple sclerosis (MS).

Vitamin D plays an important role in immune

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Finish Birth Cohort followed since 1986, who were asymptomatic, found abnormal MRI knee findings, esp cartilage defects in the patellofemoral (56%) & tibiofemoral joints (25%) joints. Small/doubtful patellofemoral (52%) & tibiofemoral (17%) osteophytes seen. Most w/ High BMI. https://t.co/LHqmRHM5wF
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/loRPcwv8B9 https://t.co/ul8ko9cU4K

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Dr. John Cush @RheumNow( View Tweet )
D-Lay MS trial: DBRPCT of Oral cholecalciferol 100 000 IU q2wks x 24 mos.signif reduced Dz activity in clinically isolated syndr(CIS) & early relapsing-remitting MS typical for MS. Dz activity seen in 60% w/ Vit D vs 74% w/ PBO (HR 0.66). Also time to Dz activity (432 vs 224d; https://t.co/GQsnnuWS9R
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Secondary Benefits to SGLT2 Inhibitor Use in SLE

Jack Cush, MD

An emulation trial of sodium–glucose cotransporter 2 inhibitors (SGLT2i) in systemic lupus erythematosus patients yielded a significantly reduced risk of several cardiorenal complications among patients with SLE and type 2 diabetes.

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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

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Dr. John Cush @RheumNow( View Tweet )
Vitamin D for Prevention of Disease JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults. Guideline committee experts, included adult and pediatric endocrinology, internal medicine, obstetrics/gynecology, nutrition, and https://t.co/zi3CpE0DVN
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Metformin Effective in Osteoarthritis

MedPage Today

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.

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Rheumatology: Believe It or Not (4/25/2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?

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Vitamin D for Prevention of Disease

Jack Cush, MD

JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults. Guideline committee experts, included adult and pediatric endocrinology, internal medicine, obstetrics/gynecology, nutrition, and epidemiology) advise that healthy nonpregnant persons

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Obesity is a risk factor for not achieving remission in early #RA (ERA), independent of comorbidity. 1285 ERA RA pts; remission failure @6 mos = 64% w/ obese, 52% if overWt & 48% if NL wt. RR 1.33 w/ no change after adjusting for RF/CCP, education, EtOH, smoking, phys activity, https://t.co/341ba1rCSk
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Diabetes Prevention with Hydroxychloroquine in Sjogren’s

Jack Cush, MD

A Taiwanese insurance claims analysis looked at hydroxychloroquine (HCQ) use in primary Sjögren syndrome (pSS) and showed that HCQ exposure significantly reduces the risk of new onset

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Daily purposeful walking assoc w/ lower risk of Knee OA (KOA). UK Biobank study of 89,969 persons, F/U 6.8 yrs - 2711 developed KOA. HRs for incident KOA were 0.84 (0.76-0.92), 0.81 (0.71-0.90), and 0.74 (0.64-0.85) if walking ~5000, ~7000, & ≥8000 steps/d, respectively https://t.co/St9QLuOy9R
Dr. John Cush @RheumNow( View Tweet )
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ACP: Best Practice Advice on Cannabis or Cannabinoids Use for Chronic Noncancer Pain

Jack Cush, MD

The American College of Physicians published a best practice advisory on cannabis or cannabinoids in the Annals of Internal Medicine.

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NIH Complimentary Medicine overview of Music Therapy - preliminary research suggests that music interventions may be helpful for anxiety, depression, pain control, dementia, multiple sclerosis, Parkinson’s disease, etc https://t.co/UGsfT7lITQ https://t.co/DrJm4JdEuY

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Dr. John Cush @RheumNow( View Tweet )
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Cancer Survival with TNF Inhibitors (3.28.2025)

Jack Cush, MD

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

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Of >105,000 participants with 30-year follow-up, only 9.3% achieved healthy aging (age 70, w/o any chronic diseases). Their diet was significantly associated with this outcome🧵 @NatureMedicine https://t.co/VHxmdLvoDe

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Eric Topol @EricTopol( View Tweet )
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Targeting Obesity in Rheumatic Disease Patients

Jack Cush, MD

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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Recent Blogs

Comorbidities in RA: Focus on Difficult-to-Treat Disease

Elena Nikiphorou, MD, PhD
Puzzle pieces
The presence of comorbidities naturally complicates treatment choice, patient adherence to medication and patient outcomes, increasing also the risk of making RA ‘difficult-to-treat’. Read Post

Comorbidities in Rheumatoid Arthritis: A Precarious Stack of Blocks

Cynthia S. Crowson, PhD
stack of blocks

Comorbidities can pile up like a stack of blocks for people with rheumatoid arthritis (RA).  At the time when RA is diagnosed, they already have more comorbidities than their peers, and after RA diagnosis they accumulate comorbidities faster than their peers.

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