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Maureen Dubreuil, MD MSc

@spondymd.bsky.social
259 followers 266 following 102 posts

Spondyloarthritis-focused Rheumatologist Boston U School of Med | VA Boston www.bumc.bu.edu/camed/profile/maure…

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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 04/09/2026
🔊 On behalf of SPARTAN, Dr. Abhijeet Danve and I co-led the *first* North American recommendations for referral of adults suspected of having Axial Spondyloarthritis to a Rheumatologist. Please share widely! acrjournals.onlinelibrary.wiley.com/share/VTKIEP... @spartanrheum.bsky.social
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 29/08/2026
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 22/07/2026
I brought a bell from my (late) grandmother's collection to keep presenters on time at our Rheum Research Retreat today. We heard from 29 researchers about the incredible work being done in our section! @bu-bmc-rheum.bsky.social
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 14/07/2026
North American Spine Society developed guidelines for coverage of SIJ Injections and RFA, including applications in spondyloarthritis. It was privilege to work on this project! Read the guidelines and provide feedback here: www.spine.org/Portals/0/as...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 25/06/2026
The 2026 ACR Axial Spondyloarthritis guideline summary is here! It has been a privilege to work on this project. rheumatology.org/axial-spondy...
rheumatology.org
Axial Spondyloarthritis Clinical Practice Guidelines | American College of Rheumatology
Read American College of Rheumatology recommendations for the treatment of axial spondyloarthritis.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 29/04/2026
The average person with axial spondyloarthritis has back pain without a diagnosis for *over 6 years*. This needs to change! Thanks to @spartanrheum.bsky.social and #PANLAR2026 for the opportunity to highlight this in the pre-congress symposium.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 20/02/2026
Funding rates for R01s decreased in 2025 for applicants from all career stages. grants.nih.gov/news-events/...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 18/01/2026
Scenes from CAThens @rheumcat.bsky.social
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 02/01/2026
🐎I just learned of this interesting treatment possibility for #axSpA: HIPPOTHERAPY! A simulator mimics movement of a horse. This makes sense bc of the lumbar spine & hip mobility that riding requires. My relative with axSpA said "Should I start horsing around?!" www.tandfonline.com/doi/full/10....
tandfonline.com
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 25/11/2025
It is an honor to continue serving on the board of SPARTAN alongside this esteemed group. We met last week to discuss the direction of #spondyloarthritis research and the future looks bright!💡 @spartanrheum.bsky.social @nigil-haroon.bsky.social @rheumcat.bsky.social
11 researchers in spondyloarthritis standing in front of a brick wall
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Reposted by Maureen Dubreuil, MD MSc
Jose Antonio Meade @josemeade.bsky.social · 14/10/2025
🧵 New study alert! 💊 Does early TNF inhibitor (TNFi) therapy reduce chronic opioid use in axial spondyloarthritis (axSpA)? 👉 We looked at real-world US data to find out. 📄 Arthritis Care & Research, 2025 🔗 acrjournals.onlinelibrary.wiley.com/doi/10.1002/... @rheumcat.bsky.social
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Reposted by Maureen Dubreuil, MD MSc
Rheum Cat @rheumcat.bsky.social · 22/09/2025
Our paper looking at annual prescription rates of opioids 💊 vs NSAIDs 💊and TNF inhibitors 💉for people with axial spondyloarthritis in the US & UK is now out @acr-journals.bsky.social pubmed.ncbi.nlm.nih.gov/40977482/ @degirmenciberk2.bsky.social is preparing a visual abstract, so stay tuned
pubmed.ncbi.nlm.nih.gov
Trends in Opioid Prescriptions in Individuals with Axial Spondyloarthritis in the US and UK in the Last Two Decades: Analysis of Electronic Health Records and Insurance Claims Data - PubMed
Opioid prescriptions rates remained stable over time in the UK, while they slightly decreased in the US as TNFi uptake increased. These trends may reflect a US nationwide change in guidance for opioid...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 23/09/2025
🗣️ How might implementation science be applied in your field? Are there evidence-based interventions that need broader uptake?
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 23/09/2025
Proctor’s Conceptual model spans the intervention 💡, strategies 🧩, outcomes 🛠️ and efficacy/effectiveness 📊. pmc.ncbi.nlm.nih.gov/articles/PMC...
pmc.ncbi.nlm.nih.gov
Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda
An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. This paper advances the concept of “implementation outcomes” distinct from s...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 23/09/2025
CFIR (consolidated framework for implementation research) is a determinant framework addresses the inner and outer settings, the implementation process, the innovation and the individuals’ roles and characteristics. implementationscience.biomedcentral.com/articles/10....
implementationscience.biomedcentral.com
The updated Consolidated Framework for Implementation Research based on user feedback - Implementation Science
Background Many implementation efforts fail, even with highly developed plans for execution, because contextual factors can be powerful forces working against implementation in the real world. The Consolidated Framework for Implementation Research (CFIR) is one of the most commonly used determinant frameworks to assess these contextual factors; however, it has been over 10 years since publication and there is a need for updates. The purpose of this project was to elicit feedback from experienced CFIR users to inform updates to the framework. Methods User feedback was obtained from two sources: (1) a literature review with a systematic search; and (2) a survey of authors who used the CFIR in a published study. Data were combined across both sources and reviewed to identify themes; a consensus approach was used to finalize all CFIR updates. The VA Ann Arbor Healthcare System IRB declared this study exempt from the requirements of 38 CFR 16 based on category 2. Results The systematic search yielded 376 articles that contained the CFIR in the title and/or abstract and 334 unique authors with contact information; 59 articles included feedback on the CFIR. Forty percent (n = 134/334) of authors completed the survey. The CFIR received positive ratings on most framework sensibility items (e.g., applicability, usability), but respondents also provided recommendations for changes. Overall, updates to the CFIR include revisions to existing domains and constructs as well as the addition, removal, or relocation of constructs. These changes address important critiques of the CFIR, including better centering innovation recipients and adding determinants to equity in implementation. Conclusion The updates in the CFIR reflect feedback from a growing community of CFIR users. Although there are many updates, constructs can be mapped back to the original CFIR to ensure longitudinal consistency. We encourage users to continue critiquing the CFIR, facilitating the evolution of the framework as implementation science advances.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 23/09/2025
PARIHS is a determinant framework based on the concept that implementation is a function of: A. Evidence (research, clinical expertise, patient preferences), B. Context (setting, resources) and C. Facilitation through influence and relationships.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 23/09/2025
🖼️Frameworks exist in 3 forms: (1) Process: how to plan and execute a strategy, (2) Determinant: factors that impede or enable the implementation process and (3) Evaluative: selection of outcomes to study
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 23/09/2025
IS uses conceptual frameworks to systematically understand why people do what they do (patients, clinicians, healthcare systems), how to operationalize an intervention, how to scale it and how to assess outcomes
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 23/09/2025
✅ IS takes places following efficacy and effectiveness studies, within controlled settings and in practice. 3 types of hybrid IS studies: Type 1: primary aim is to determine effectiveness, Type 2: Codetermining effectiveness & feasibility, Type 3: focuses on implementation
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 23/09/2025
💡Implementation science (IS) is the study of methods and strategies that facilitate uptake of evidence based interventions into routine practice.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 23/09/2025
We at BU Rheum had the pleasure of learning from Drs. Divya Shankar and Mari-Lynn Drainone to speak today on Implementation Science. sites.bu.edu/ciis/ @bu-bmc-rheum.bsky.social
sites.bu.edu
CIIS
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 12/09/2025
We found that adults with axSpA or PsA had ⬇️ odds of hip/knee replacement with use ofTNFi, non-TNFi biologics or DMARDs as compared to NSAIDs. Odds w/ JAK inhib was also lower but not statistically significant. Use this info in shared decision-making!
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 11/09/2025
Veterans I care for at VA Boston showed me so much love today with tasty treats! Incredible tomatoes, spaghetti & meatballs and homemade BBQ sauce! @vaboston.bsky.social
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 01/07/2025
Uterus, on the other hand, gets mixed reviews.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 17/06/2025
This is critically important to our understanding of SpA!
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
blue.mackuba.eu/skythread/?a...
blue.mackuba.eu
Skythread
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
🥅 NETs also important in SpA! Uveitis has high serum NETs (human & mouse studies). When neutrophil function is blocked using anti-Ly6G, IL-17 is 🔻 in ocular fluid. NETs provoke intraocular inflammation and also IL17-mediated systemic inflammation. acrjournals.onlinelibrary.wiley.com/doi/10.1002/...
acrjournals.onlinelibrary.wiley.com
Neutrophil Extracellular Traps–Associated RNA Impedes CD4+ Treg Differentiation by TLR7–IRF7 Axis in Ankylosing Spondylitis
Objective Our objective was to investigate the role of neutrophil extracellular traps (NETs) in the pathogenesis of inflammatory disorders in ankylosing spondylitis (AS). Methods Local and circula.....
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
Neutrophils are important in SpA! Card9 was found in axSpA GWAS (gain of function). It is involved a canonical NFKB pathway ➡️ inflammation via IL-1beta. Ruth Napier et al. found Card9 in neutrophils potentiates IL-17 production by CD4+ T cells doi.org/10.1136/ard-...
doi.org
Redirecting
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
CD74 is on MHC I & is the receptor for macrophage migration inhibitory factor (MIF). Anti-CD74 are ⬆️ in SpA and MIF concentration is associated with rapid axSpA progression. MIF is made by mesenchymal stem cells under stress promotes Th17 differentiation. www.science.org/doi/10.1126/...
science.org
Macrophage migration inhibitory factor drives pathology in a mouse model of spondyloarthritis and is associated with human disease
Macrophage migration inhibitory factor produced by neutrophils worsens spondyloarthritis by inducing a pathogenic TH17 phenotype in Tregs.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
⛔ How might HLA-B27 *negative* axSpA develop? Mechanisms include anti-CD74, MIF, Card9 and NETs! acrjournals.onlinelibrary.wiley.com/cms/asset/11...
acrjournals.onlinelibrary.wiley.com
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
CD8+ T cells expressed marker for mucosal trafficking and differentiation including CD161 and integrins. Early activation of pathogenic T cells may occur in enteric organs, and then migrate to gut and eye. df6sxcketz7bb.cloudfront.net/manuscripts/...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
🦠 Blood and synovial fluid in axSpA contains T cell clones w/ specific TCR beta chains (e.g. TRBV9). TRBV9 cells were screened against a peptide library 📚 finding YEIH, a peptide conserved in bacteria (E. coli, salmonella, shigella, klebsiella, yersinia). www.nature.com/articles/s41...
nature.com
Autoimmunity-associated T cell receptors recognize HLA-B*27-bound peptides - Nature
A study shows that cross-reactivity of microbial antigens and self-antigens presented by HLA-B*27 may be important in the pathogenesis of diseases associated with HLA-B*27 and identifies the shared bi...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
Peptide processing is altered in axSpA. Peptides are trimmed in the endoplasmic reticulum by enzymes ERAP 1 & 2. ERAP variants have been identified through GWAS in axSpA but some studies have shown that ERAP knock out is *protective* against axSpA. More research is needed.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
🧬 Risk of axSpA differs based on HLA-B27 subtype. HLAB27 is the gene that codes for MHC Class I, which presents peptides to CD8+ T cells. ❄️HLAB27 MHCs are unique- they misfold as a homodimers 👯 which leads to a conserved cell stress response: the unfolded protein response (UPR) and inflammation.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 08/05/2025
The SPARTAN Review Course is on! Dr. Aki Nakamura presented on the pathogenesis of axial spondyloarthritis, highlighting new science around HLA-B27, arthritogenic peptides and mechanisms of disease independent of HLA-B27. deptmed.queensu.ca/index.php/pe...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 06/05/2025
💫As part of our T32 lecture series @bu-bmc-rheum.bsky.social welcomed Drs. Sarah Bagley (GIM) and Vanessa Xanthakis (Preventive Med) to discuss LIFE HACKS FOR BUSY RESEARCHERS. Highlights here. Do you have any tips to share? www.bumc.bu.edu/rheumatology...
A graphic describing how to think about an invitation for a new role or project, and strategies for productivity.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
Thread Reader version of this 🧵https://blue.mackuba.eu/skythread/?author=did%3Aplc%3Ava3cyz6x2xepedxhm4pldsd5&post=3lo25x7fd7c23
blue.mackuba.eu
Skythread
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
⬆️🦴 How to choose an anabolic agent? PTH analogs increase provide new osteocytes, maybe better for vertebral fracture, avoid if hypercalcemia/calcuria. Romo is a dual antiresorptive and anabolic; no increased cortical porosity, history ONJ or high risk MACE. dx.doi.org/10.1007/s119...
dx.doi.org
Anabolic Agents for Postmenopausal Osteoporosis: How Do You Choose? - Current Osteoporosis Reports
Purpose of Review There are now three anabolic agents available for the treatment of postmenopausal women at high risk for fracture. The purpose of this review is to supply a rationale to aid in deter...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
🗓️ How quickly do therapies work? Bisphosphenates take about 1 year. Teraparitide ~10 months. Abaloparatide even earlier.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
✅ How good is BMD as a proxy for fracture risk? Meta-analysis shows for a 2% or 6% improvement in total hip BMD, we might expect a 16% or 40% reduction in hip fracture risk onlinelibrary.wiley.com/doi/10.1002/...
onlinelibrary.wiley.com
Change in Bone Density and Reduction in Fracture Risk: A Meta‐Regression of Published Trials
Meta-analyses conducted >15 years ago reported that improvements in bone mineral density (BMD) were associated with reduction in vertebral and nonvertebral fractures in osteoporosis trials. Numerous...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
🏆 How effective are various therapies on BMD? The best is romosozumab for 1 year followed by denosumab. www.ncbi.nlm.nih.gov/core/lw/2.0/...
ncbi.nlm.nih.gov
PubMed Central Image Viewer.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
💊 💉 Treatments include: PTH analogs (abeloparatide, teriparatide), RANKL inhibitor (denosumab), sclerostin inhibitor (romosozumab) and bisphosphenates. Choice depends on mechanism, route, $. “The best OP therapy is the one the patient is willing to take!” www.sciencedirect.com/science/arti...
sciencedirect.com
American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis—2020 Update
The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American Colle…
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
🧮 FRAX+ is an improvement on previous FRAX. This includes recency of fracture, higher GC use, trabecular bone score, number of falls, duration of DM, lumbar spine BMD and hip axis length www.fraxplus.org/calculation-...
fraxplus.org
Frax Calculator | FRAXplus®
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
‼️ What is *very high* fracture risk? History of fractures, T-score -1.5 to -4 and frx history. Other risks: age, sex, weight, height, FH fractures, smoking/etOH, inflammatory arthritis, & glucocorticoid use (>=pred 5 mg daily for 3+ mo) link.springer.com/article/10.1...
link.springer.com
Similarities and differences between European guidelines for the management of postmenopausal osteoporosis - Archives of Osteoporosis
Summary We conducted a review of 10 national guidelines from five EU countries to identify similarities or differences in recommendations for the management of patients with osteoporosis. We found gen...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
📏 Examine patients for thoracic spinal fractures by testing occiput-to-wall distance >0cm or rib-pelvis distance less than 2 finger breadths. jamanetwork.com/journals/jam...
jamanetwork.com
Does This Woman Have Osteoporosis?
Context Although recent US Preventive Services Task Force guidelines recommend bone densitometry for all women older than 65 years, identifying younger women at increased risk for osteoporosis and wom...
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
🌞 What is the right level of Vitamin D? Most of the world considers 20+ to be sufficient
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
🦴 Risk of 2ndry causes is higher in men, premenopausal women and those with Z-score <-2, weight loss, dental issues, bone pain/tenderness. Look for osteomalacia, hyperparathyroidism, multiple myeloma, Cushings, Hyperthyroid and Celiac disease.
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
✖️Low BMD *isn’t always osteoporosis*. BMD only gives info about hydroxyapatite, not the matrix. A limited eval for 2dry osteoposis identifies 98% of secondary causes: CBC, CMP, 25-OH Vit D, phosphate, 24h urine calcium, TSH.
pmc.ncbi.nlm.nih.gov
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 30/04/2025
Today we learned from osteoporosis expert Dr. Alan Malabanan about management of patients at very high risk for fracture. @alanmalabanan.bsky.social www.bumc.bu.edu/medicine/pro...
bumc.bu.edu
Alan Malabanan | Medicine
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Maureen Dubreuil, MD MSc @spondymd.bsky.social · 28/04/2025
🌏The 7th Annual Global Spondyloarthritis Summit is May 2nd & 3rd! Enjoy interactive activities, rooms, networking, gamification, exercise and yoga classes, poster hall, exhibit hall, swag bags, social media wall and more. spondyloarthritissummit2025.vfairs.com
spondyloarthritissummit2025.vfairs.com
SAA Global Spondyloarthritis Summit 2025
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