Bone density still fell in controlled RA without osteoporosis treatment, and lupus nephritis care that follows EULAR is linked to less damage

The edition in brief

In 797 Japanese patients with rheumatoid arthritis followed for a median 3.1 years on biologic or targeted synthetic DMARDs, disease activity fell sharply, but T scores at the femoral neck and radius declined significantly in those not taking osteoporosis treatment, while they held steady in those who were; 58% overall lost bone density, and neither the duration of advanced therapy nor disease activity predicted bone preservation. An expert panel developed 17 quality indicators from the 2025 EULAR lupus nephritis recommendations; in a 130-patient tertiary cohort, high per-patient adherence was associated with lower odds of damage accrual (OR 0.29), while combination initial immunosuppression was used in only 10.7%. In a Japanese registry of 1,135 patients starting JAK inhibitors, reduced-dose initiation in those with preserved renal function had 24-month retention comparable to standard dosing, though standard dosing persisted better in patients with three or four poor prognostic factors. A pooled three-year analysis of 1,112 patients with psoriatic arthritis on bimekizumab, from two phase 3 trials and their open-label extension, reported sustained responses across joint, skin, nail, enthesis and dactylitis domains. The pearl: screen the retina on hydroxychloroquine and check the dose against actual weight.