In an international clinical trial, adding the drug belimumab to standard maintenance therapy for patients in remission with vasculitis did not lower the relapse rate. The double-blind, placebo-controlled study evaluated the safety and efficacy of belimumab as adjunctive therapy to maintain remission in anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Results of the multi-center, industry-sponsored…
Patients with chronic kidney disease (CKD) often experience joint pain due to various etiologies, including crystalline arthropathies, renal osteodystrophy, amyloid arthropathy, erosive osteoarthritis, avascular necrosis and even erosive spondylarthrosis.1 Below, we present a case of crystalline arthropathy in a patient with chronic kidney disease, mistaken for gout. The Case A 29-year-old man was admitted to…
Methotrexate (MTX) remains the predominant medication used by rheumatologists to treat rheumatoid arthritis (RA). Doses of 7.5–25 mg per week with daily folic acid are generally prescribed. Despite its common use, MTX must be prescribed cautiously given the potential adverse effects when taken incorrectly or without folic acid supplementation. Cases of MTX-induced cutaneous ulceration have…
Many, if not all, rheumatologists seek to grow as clinicians so they can provide consistently exceptional care to patients and serve as role models for colleagues and trainees. In this series, Lessons from a Master Clinician, we compile insights from clinicians who have achieved a level of distinction in the field of rheumatology. Gail Kerr,…
The ACR will soon submit the updated Rheumatoid Arthritis Alternative Payment Model to the Physician-Focused Payment Model Technical Advisory Committee for review and feedback.
In September 2018, the U.S. Food & Drug Administration (FDA) granted fast-track status to FCX‑013, a gene therapy product developed to treat moderate to severe localized scleroderma (morphea). Previously, the treatment received an orphan drug designation for localized scleroderma, as well as a rare pediatric disease designation. Phase 1 and 2 studies will assess safety…
Autoinflammatory diseases are genetically diverse, but clinically similar, conditions distinct from autoimmune illnesses, such as systemic lupus erythematosus or rheumatoid arthritis. Clinically, they are defined by recurrent episodes of inflammation that follow a characteristic pattern each time they occur. Some have a set length of time during which fever, peritonitis or arthritis manifest. Others are…
Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome or allergic granulomatosis and angiitis, is a rare small- and medium-vessel vasculitis. This disease was first described by American pathologists Jacob Churg and Lotte Strauss in 1951.1 Although the vasculitis is often not apparent in the initial phases of the disease, EGPA can affect any…
Although the true cause of systemic sclerosis (SSc), or scleroderma, remains unknown, researchers have made progress in detecting the autoimmune disease’s early presence. Beyond the physiological signs of Raynaud’s phenomenon, a capillaroscopy can detect alterations in microcirculation and lab tests can confirm the presence of telltale autoantibodies, such as anti-topoisomerase 1, anti-centromere and anti-RNA polymerase…
Psoriatic arthritis (PsA), scleroderma and lupus often require management input from both rheumatologists and dermatologists. Usually patients see the two specialists separately. Combining both in a single rheumatology/dermatology clinic appointment can improve outcomes and increase both provider and patient satisfaction. “Physicians talk about tearing down silos of care, where each specialist focuses on their part…