Nutrition/Obesity

Shedding Weight and Pain: The Promise of Anti-Obesity Medications in RA For years, rheumatologists have championed weight loss as a cornerstone of care for patients with rheumatoid arthritis (RA) and obesity. RA is an independent risk factor for cardiovascular disease (CVD), a… https://t.co/iozo0FQFzj https://t.co/93e4nZMHJo
Dr. John Cush @RheumNow( View Tweet )
Potential Impact of Weight Loss Drugs in Rheumatic Diseases Dr. Arthur Kavanaugh highlights a session regarding weight loss and improvement in disease outcomes, specific weight loss drugs (SGL-2 and GLP-1), along with downsides when patients stop these medications. Reporting… https://t.co/Ilu2FXK2xi https://t.co/7CKSnfuey4
Dr. John Cush @RheumNow( View Tweet )
Food for thought 🤔 Abstract 1900 found non-diet soda and certain supplements (folate, B-vitamins, fish oil) were higher among individuals with incident SpA compared to controls @RheumNow #ACR24 https://t.co/qUXcxSfTxE

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Akhil Sood MD @AkhilSoodMD( View Tweet )
bathroom scale

Shedding Weight and Pain: The Promise of Anti-Obesity Medications in RA

Caoilfhionn Marie Connolly, MD

With the advent of FDA-approved anti-obesity medications such as semaglutide and tirzepatide, a new avenue for managing this challenging patient population has emerged. But how might these drugs impact the trajectory of RA, and are we on the cusp of a paradigm shift?

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2023 @ACRheum guidance recommends #MediterraneanDiet in RA What are barriers/facilitators to following the diet? Many pts are willing to try but don't follow it Barriers➡️ food insecurity & aversions Many are unaware Do you talk to your pts about diet? Ab1673 #ACR24 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

Dietary changes are intermittent fasting are common in axial spondylarthritis (axSpA) patients, possibly reducing inflammation. A study found 55% currently on a diet and 31% fasting. Many believe these practices improve disease activity. Abstr#1459 #diet #axSpA @RheumNow #ACR24

Antoni Chan MD (Prof) @synovialjoints( View Tweet )

Meeting audience conference

ACR 2024 - Day 1 Report

Jack Cush, MD

ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings.  The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.

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Medication-assisted weight loss has boomed in recent yrs. How does weight loss affect disease activity & PROs in RMDs? ≥5% weight loss, after taking a med, led to better disease activity & QoL Data may inform RCTs to explore effect of these meds in RMDs Ab0845 #ACR24 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

Does alcohol consumption affect radiographic progression in axSpA? Canadian cohort study over 6 years found greater radiographic progression among alcohol consumers. Still a lot of confounding factors to fully establish an association. Abst#0822 #ACR24 @RheumNow https://t.co/GG0rXq3kjC

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Adela Castro @AdelaCastro222( View Tweet )
A 6-year study of the link between alcohol consumption and spinal radiographic progression in axial spondyloarthritis (axSpA). Results indicate that alcohol may worsen spinal damage, particularly in males and those with radiographic axSpA. Future research should explore… https://t.co/IIvTyq7kBe

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )

To GLP or not to GLP—is it still even a question in obesity management given pluripotent benefits 👇🏻 Dr. Louis Aronne recommends ➡️ Start low and titrate slow 💊 ➡️ Provide pt education on GI side effects, ondansetron effective for nausea #ACR24 @RheumNow https://t.co/SzVg2dopCo

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Caoilfhionn Connolly @CaoilfhionnMD( View Tweet )
Planned to post so much more from #ACR24; my favorite slides from today will have to suffice. From the #BCRC Dr Monica Guma’s - diet and microbiome. Dr @NamrataRheum -a reminder that we are all aging. Dr Connie Weyand’s -metabolic checkpoints in RA T cells and macrophage. https://t.co/MtsheVsUEQ

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Kristen Young @kristenyoung( View Tweet )
Where do SGLT2i have proven benefits for CVD? 👉 Diabetes w/high CV risk 👉Heart failure (all EF) 👉CKD Dr Weber @rheumnow #ACR24 https://t.co/vFYddrLP1Y

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TheDaoIndex @KDAO2011( View Tweet )
SELECT trial noted reduction in CV death, MI and stroke in obese pts without diabetes (other benefits: reduction in waist circumference, BP, lipids) @rheumnow # ACR24 https://t.co/GPK4Vg5bOt

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TheDaoIndex @KDAO2011( View Tweet )
#obesity causes a lot of diseases including #arthritis. How? ⬆️ IL-6 ⬆️ leptin ⬆️ TNF-a @RheumNow #ACR24 @rheumarhyme https://t.co/qeqTZUOEZy

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sheila @RHEUMarampa( View Tweet )
The Plants for Joints RA continuation made it to #ACR24! whole-food plant-based diet, exercise, sleep/stress Rx (added on to usual RA care i.e. DMARDs) Gains made during program were sustained, can't undersell lifestyle as part of the overall picture! #ACR24 ABST0530 @RheumNow https://t.co/XSLIwYitpH https://t.co/RfiTX8Z6ff

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David Liew @drdavidliew( View Tweet )
Year in review: Semaglutide reduced knee pain over 68 weeks in patients with high BMI and moderate knee #osteoarthritis pain But mechanism of knee pain improvement not yet known if due to wgt loss or other mechanisms. @Rheumnow #ACR24 @rheumarhyme @theactiverheum https://t.co/PkrcIMbgPl

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sheila @RHEUMarampa( View Tweet )
Weight Loss from Anti-Obesity Medications Prevents Gout A population based study looked at the effect of the weight loss drug, Orlistat, in obese individuals. Compared to those untreated, orlistat over 1 year was associated with significant weight loss and significantly lower… https://t.co/P1iRjtHgHV https://t.co/MoohUKGvUn
Dr. John Cush @RheumNow( View Tweet )
obese.waist_.jpg

Weight Loss from Anti-Obesity Medications Prevents Gout

Jack Cush, MD

A population based study looked at the effect of the weight loss drug, Orlistat, in obese individuals. Compared to those untreated, orlistat over 1 year was associated with significant weight loss and significantly lower risks of incident gout and recurrent gout flares among overweight or obese

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NHANES study of 11264 adolescents (12–17 yrs) found Hyperuricemia (≥ 5.5 mg/dL) in 33%, (51% males, 13% females) and was more prevalent with obesity and in non-Hispanic Asians https://t.co/rwUt1Cgg9b https://t.co/dFr1LeX0nC

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Dr. John Cush @RheumNow( View Tweet )
EULAR Review of Lifestyle Improvements for Rheumatic Patients A EULAR taskforce evaluated lifestyle behaviors' effects on rheumatic and musculoskeletal diseases (RMDs), finding moderate evidence for minor benefits from certain dietary components. However, high-level evidence on… https://t.co/maaz8W5IUT https://t.co/QiE6Oo1MzX
Dr. John Cush @RheumNow( View Tweet )
Weight Loss Drugs and the Loss of Skeletal Muscle Mass A commentary in The Lancet emphasizes the importance of skeletal muscle mass in medically induced weight loss, especially with the use of GLP-1 receptor agonists. While these drugs are effective for obesity treatment, there… https://t.co/8AOgDUajw6 https://t.co/0vntwZSpLy
Dr. John Cush @RheumNow( View Tweet )
Survey of UK Rheumatology pts (n 876 found 55% take daily supplements costing £10 to £200 per month (most common: vit D, C, B complex, MVI Omega 3/6). 82% take Prescription, OTC, or non-prescription pain meds, 13% sleep aids. Half of NSAID pts also take OTC supplements… https://t.co/VpMG9SiE1E https://t.co/SJYUfogeVJ
Dr. John Cush @RheumNow( View Tweet )
refridge.crisper.storage.jpg

EULAR Review of Lifestyle Improvements for Rheumatic Patients

Jack Cush, MD

A EULAR taskforce has evaluated the effect of lifestyle behaviors in rheumatic and musculoskeletal diseases (RMDs) and concluded that there is moderate evidence for a small benefit for certain dietary components, but overall, high-level evidence regarding dietary exposures on outcomes in RMDs is

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Scale,weight

Weight Loss Drugs and the Loss of Skeletal Muscle Mass

EurekAlert!

A recent commentary published in The Lancet journal highlights the critical importance of skeletal muscle mass in the context of medically induced weight loss, particularly with the widespread

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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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