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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

FDA Names Drugmakers Potentially Acting to Delay Cheap Generics

Michael Erman  |  

(Reuters)—The U.S. Food and Drug Administration on Thursday listed drugmakers, including Celgene Corp, Johnson & Johnson, Gilead Sciences and Novartis AG, who the regulator says are potentially blocking access to samples of their drugs to delay generic competition. Generic drugmakers may not be able to develop alternatives without access to samples of branded products they…

Avoid Billing Risks for New vs. Established Patients

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When coding evaluation and management (E/M) services provided to a patient, one of the most persistent concerns is whether a patient is new or established to the practice. Although this may seem like a simple coding answer, the distinction is an important one, because it enables providers to appropriately bill and receive reimbursement correctly. E/M…

Ethics Forum: Righting the Wrong Diagnosis

Joseph L. Green, DO  |  

A 54-year-old woman is establishing care in your clinic after retirement of her previous rheumatologist. Your review of her records suggests that she was diagnosed with systemic lupus erythematosus seven years ago on the basis of symptoms of body pain and fatigue, and serologic evidence of positive ANA 1:40 (speckled) and borderline anti-SSB antibody. She…

How Footwear Affects Patients with Medial Knee Osteoarthritis

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A patient’s gait, or how they walk, is an important predictor of the biomechanical load distribution that affects osteoarthritis (OA). This understanding comes from a growing body of literature in bio­mechanics to test and treat patients with OA, which takes into account a very practical treatment: a patient’s shoes. A focus on flexible footwear, along…

FDA to Review Abuse-Deterrent Oxycodone Capsule

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FDA to Review Abuse-Deterrent Oxycodone Capsule In June, the FDA will discuss the New Drug Application for Remoxy ER at an Advisory Committee meeting. Remoxy ER is a 12-hour, abuse-deterrent, extended-release oxycodone in a capsule formulation.1 The capsule contains a sticky, thick, high-viscosity formulation to deter unapproved drug administration routes, including injection, smoking or snorting….

Dr. St.Clair in his home office, showing off his Duke memorabilia. Dr. Bill St.Clair and his wife, Barb, at the 2015 NCAA basketball championship game in Indianapolis.

ACR Past President Dr. Bill St.Clair Is an Avid Duke Basketball Fan

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Bill St.Clair, MD, MACR, says one of the most exciting and proudest moments in his life wasn’t earning his medial degree or seeing his first published article on arthritis and rheumatology. Not even close. It was the 1991 National Collegiate Athletic Association (NCAA) basketball semifinal. Specifically, the basketball game between Duke University and the University…

Improved Family Planning Counseling Needed

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In the U.S. today, approximately 45% of pregnancies are unintended or unplanned.1 Although this rate is considerably lower than in the past, women with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or inflammatory myopathies tend to have better pregnancy outcomes if their disease is well controlled when they conceive. In addition, women taking certain medications…

5 Ways to Unlock the Power of Consultation

Eli M. Miloslavsky, MD, & Jakob I. McSparron, MD  |  

Think back to your time as a trainee. Do you remember an interaction with a consultant in which you learned something, felt your opinion was heard, were empowered to collaborate with the consulting team and knew you were pro­viding outstanding care? We suspect a number of examples come to mind, regardless of the amount of…

Tips & Tools for Dealing with Bad Patient Outcomes

Larry Beresford  |  

Bad things happen to good rheumatologists—and to their patients—and can have profound personal and professional consequences for the doctor. Sometimes recommended treatments can have predictable, but devastating, side effects. Even if the rheumatologist does everything right according to evidence-based best practice, patients can still have bad outcomes, even die—with resulting feelings of sadness, anger, guilt…

Neutrophil Extracellular Traps & Their Role in Autoimmunity

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Certain medications have been associated for decades with the development of drug-induced autoimmunity. New research published in March 2018 in Arthritis & Rheumatology suggests that NETs (neutro­phil extracellular traps) are potentially implicated in the mechanisms that lead to drug-induced autoimmunity.1 Peter Grayson, MD, MSc, head of the Vasculitis Translational Research Program at the National Institute…