Staying active had always been second nature to Shelly Brown. It was how she lived her life and stayed connected to the things she loved. But everything began to shift around her 50th birthday.
“I used to be constantly moving, walking the neighborhood, going up and down stairs, even dancing in the kitchen,” said Shelly. “But then my knees started acting up. At first, it was just annoying, but eventually, the pain got so bad I could hardly walk.”
Knee pain that held her back
Now 61, Shelly spent over a decade battling chronic knee pain caused by arthritis. As the condition worsened, both knees deteriorated to bone-on-bone contact, complicated by floating bone fragments. Everyday tasks became painful obstacles, and simple joys like walking her dog or enjoying nature trails became impossible.
“I took ibuprofen every single day for ten years just to function,” said Shelly. “At that point, I knew something had to change.”
Staying active had always been second nature to Shelly Brown. It was how she lived her life and stayed connected to the things she loved. But everything began to shift around her 50th birthday.
“I used to be constantly moving, walking the neighborhood, going up and down stairs, even dancing in the kitchen,” said Shelly. “But then my knees started acting up. At first, it was just annoying, but eventually, the pain got so bad I could hardly walk.”
Knee pain that held her back
Now 61, Shelly spent over a decade battling chronic knee pain caused by arthritis. As the condition worsened, both knees deteriorated to bone-on-bone contact, complicated by floating bone fragments. Everyday tasks became painful obstacles, and simple joys like walking her dog or enjoying nature trails became impossible.
“I took ibuprofen every single day for ten years just to function,” said Shelly. “At that point, I knew something had to change.”
Staying active had always been second nature to Shelly Brown. It was how she lived her life and stayed connected to the things she loved. But everything began to shift around her 50th birthday.
“I used to be constantly moving, walking the neighborhood, going up and down stairs, even dancing in the kitchen,” said Shelly. “But then my knees started acting up. At first, it was just annoying, but eventually, the pain got so bad I could hardly walk.”
Knee pain that held her back
Now 61, Shelly spent over a decade battling chronic knee pain caused by arthritis. As the condition worsened, both knees deteriorated to bone-on-bone contact, complicated by floating bone fragments. Everyday tasks became painful obstacles, and simple joys like walking her dog or enjoying nature trails became impossible.
“I took ibuprofen every single day for ten years just to function,” said Shelly. “At that point, I knew something had to change.”
Staying active had always been second nature to Shelly Brown. It was how she lived her life and stayed connected to the things she loved. But everything began to shift around her 50th birthday.
“I used to be constantly moving, walking the neighborhood, going up and down stairs, even dancing in the kitchen,” said Shelly. “But then my knees started acting up. At first, it was just annoying, but eventually, the pain got so bad I could hardly walk.”
Knee pain that held her back
Now 61, Shelly spent over a decade battling chronic knee pain caused by arthritis. As the condition worsened, both knees deteriorated to bone-on-bone contact, complicated by floating bone fragments. Everyday tasks became painful obstacles, and simple joys like walking her dog or enjoying nature trails became impossible.
“I took ibuprofen every single day for ten years just to function,” said Shelly. “At that point, I knew something had to change.”
Staying active had always been second nature to Shelly Brown. It was how she lived her life and stayed connected to the things she loved. But everything began to shift around her 50th birthday.
“I used to be constantly moving, walking the neighborhood, going up and down stairs, even dancing in the kitchen,” said Shelly. “But then my knees started acting up. At first, it was just annoying, but eventually, the pain got so bad I could hardly walk.”
Knee pain that held her back
Now 61, Shelly spent over a decade battling chronic knee pain caused by arthritis. As the condition worsened, both knees deteriorated to bone-on-bone contact, complicated by floating bone fragments. Everyday tasks became painful obstacles, and simple joys like walking her dog or enjoying nature trails became impossible.
“I took ibuprofen every single day for ten years just to function,” said Shelly. “At that point, I knew something had to change.”
Staying active had always been second nature to Shelly Brown. It was how she lived her life and stayed connected to the things she loved. But everything began to shift around her 50th birthday.
“I used to be constantly moving, walking the neighborhood, going up and down stairs, even dancing in the kitchen,” said Shelly. “But then my knees started acting up. At first, it was just annoying, but eventually, the pain got so bad I could hardly walk.”
Knee pain that held her back
Now 61, Shelly spent over a decade battling chronic knee pain caused by arthritis. As the condition worsened, both knees deteriorated to bone-on-bone contact, complicated by floating bone fragments. Everyday tasks became painful obstacles, and simple joys like walking her dog or enjoying nature trails became impossible.
“I took ibuprofen every single day for ten years just to function,” said Shelly. “At that point, I knew something had to change.”
In the prospective, single-arm RAMUS study, adults with rheumatoid arthritis at risk for sarcopenia initiated tofacitinib as standard care and underwent quantitative MRI at baseline, one month, and six months. Among fifteen completers, lower limb muscle volume rose significantly after six months, with a mean increase of 242 cm³ and a 95% confidence interval of 44 to 441. Gains were most pronounced in the thigh, aligning with the protocol’s focus on vastus lateralis biopsy to explore mechanistic signals in skeletal muscle.
Disease Control, Muscle Function, and Safety
Inflammation improved promptly. Disease Activity Score 28 using C-reactive protein decreased at one month with a reported p value of 0.0064 and showed no further change by six months. Despite increased muscle volume, appendicular lean mass index, measured strength, and functional performance did not show significant differences over six months, indicating structural changes may precede measurable functional benefit. Serum creatinine increased significantly with a reported p value of 0.0011, consistent with either increased muscle mass or a pharmacologic effect on skeletal muscle. Twenty-eight adverse events were recorded in thirteen participants; one serious event involved hospitalization for COVID-19 pneumonitis before tofacitinib initiation.
JAK Inhibition in Rheumatoid Arthritis: Clinical Takeaways
These experimental medicine data suggest JAK inhibition in rheumatoid arthritis can increase skeletal muscle volume over six months without parallel strength gains. The observed creatinine rise may reflect greater muscle mass or reduced inflammation rather than nephrotoxicity, although this requires confirmation. The single-center, single-arm design and small sample emphasize the need for larger, controlled studies to verify efficacy, delineate mechanism, and clarify whether effects are specific to tofacitinib. Until then, clinicians should view the MRI muscle signal as hypothesis-generating while continuing to center decisions on established outcomes, safety monitoring, and individualized risk–benefit discussions.
Janice Schindler enjoyed an active lifestyle and a career as a mental health counselor – until back pain that began in 2013 changed everything.
At first, it was a discomfort she tried to manage, but over time, it affected every aspect of her daily life. Simple plans, like traveling out of town or navigating an airport, became major obstacles.
“My plans revolved around how far I could travel in the car or how far I could go through the airport,” said Janice. “And I always had to get a wheelchair due to how much my back hurt.”
A Lifelong Challenge
Janice was diagnosed with degenerative disc disease due to scoliosis, which not only limited her ability to perform everyday activities but also led to a noticeable curvature in her spine. Her pain eventually became so debilitating that it often kept her confined to bed. “There were many days, more often than not, that I was in bed all day long,” said Janice. “So, it really had an impact on my day-to-day living, and I was constantly thinking about it.”
Janice Schindler enjoyed an active lifestyle and a career as a mental health counselor – until back pain that began in 2013 changed everything.
At first, it was a discomfort she tried to manage, but over time, it affected every aspect of her daily life. Simple plans, like traveling out of town or navigating an airport, became major obstacles.
“My plans revolved around how far I could travel in the car or how far I could go through the airport,” said Janice. “And I always had to get a wheelchair due to how much my back hurt.”
A Lifelong Challenge
Janice was diagnosed with degenerative disc disease due to scoliosis, which not only limited her ability to perform everyday activities but also led to a noticeable curvature in her spine. Her pain eventually became so debilitating that it often kept her confined to bed. “There were many days, more often than not, that I was in bed all day long,” said Janice. “So, it really had an impact on my day-to-day living, and I was constantly thinking about it.”
Janice Schindler enjoyed an active lifestyle and a career as a mental health counselor – until back pain that began in 2013 changed everything.
At first, it was a discomfort she tried to manage, but over time, it affected every aspect of her daily life. Simple plans, like traveling out of town or navigating an airport, became major obstacles.
“My plans revolved around how far I could travel in the car or how far I could go through the airport,” said Janice. “And I always had to get a wheelchair due to how much my back hurt.”
A Lifelong Challenge
Janice was diagnosed with degenerative disc disease due to scoliosis, which not only limited her ability to perform everyday activities but also led to a noticeable curvature in her spine. Her pain eventually became so debilitating that it often kept her confined to bed. “There were many days, more often than not, that I was in bed all day long,” said Janice. “So, it really had an impact on my day-to-day living, and I was constantly thinking about it.”
