In a controlled, large-cohort, longitudinal study from Canada, Atiquazzaman et al. found that use of non-steroidal anti-inflammatory drugs (NSAIDs) substantially contributes to increased cardiovascular disease risk among people with osteoarthritis (OA).1 This is the first study to evaluate the mediating role that NSAIDs play in the association between OA and cardiovascular disease (CVD), and the…
Drug-induced lupus erythematosus and ANCA-associated vasculitis (AAV) are both autoimmune conditions associated with the use of hydralazine, a commonly prescribed drug for hypertension and congestive heart failure. Although the pathogenesis is unknown, it is believed that hydralazine alters neutrophil and lymphocyte function and promotes exposure of antigens, leading to the development of anti-neutrophil antibodies (ANCA)…
Renal arteriosclerosis is common in lupus patients with nephritis and occurs two decades earlier than it does in people without lupus nephritis (LN), report investigators in a study that examined the prevalence of renal arteriosclerosis in LN patients compared with healthy controls.1 The finding suggests that renal arteriosclerosis could be used as a biomarker for…
Hydralazine has been in use as a treatment for hypertension, most notably in heart failure patients, since 1951.1 The drug is a known cause of autoimmune disease, most specifically hydralazine-induced lupus. Hydralazine-induced lupus occurs in 7–13% of those taking the medication.2-4 It often presents with constitutional symptoms, arthritis/arthralgias, cutaneous lesions, serositis, myalgias and/or hepatomegaly. Features…
COVID-19 is responsible for many things, including placing public attention on clinical trials and the worldwide race to approve a vaccine. The words rushed to market usually strike fear in the minds and hearts of clinical research coordinators. Many have seen investigational products with aggressive timelines withdrawn mid-study or during late-stage trials. This year, we…
The Medical University of South Carolina (MUSC), Charleston, has established a $1 million endowed chair to support world-class autoimmune research and scholarship. The Silver chair is a tribute to the distinguished career and contributions of former Rheumatology & Immunology Division Director Richard M. Silver, MD, MACR, distinguished university professor and active division member. The inaugural holder…
On Friday, Nov. 20, 2020, the U.S. Department of Health and Human Services (HHS) published a Notice through the Federal Register announcing the withdrawal of guidance documents that established the Unapproved Drugs Initiative. This Notice brings to an end a 14-year-old program that has been blamed for significantly contributing to the rising cost of some…
A team of healthcare practitioners and researchers, spearheaded by the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the ACR, has developed updated evidence-based clinical practice guidelines for the prevention, diagnosis and treatment of Lyme disease. The 2020 guidelines cover a wide variety of Lyme disease manifestations, including Lyme arthritis. Linda…
The ARP’s revised Fundamentals of Rheumatology Course (FRC) will soon be released on the ACR website. The course was revamped by interdisciplinary rheumatology professionals emphasizing an inter-professional approach to patient care. It is intended to reach a broad audience, including nurses, occupational therapists, pharmacists, physical therapists, psychologists and social workers to name a few. However,…
Scleroderma renal crisis is a true medical emergency in rheumatology, one that requires prompt diagnosis and treatment. Here, we review the historic introduction of the angiotensin-converting enzyme inhibitors in this context, and highlight management and key questions moving forward. Background Awareness of renal disease in scleroderma dates back many years. The revered physician William Osler…