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Biomarkers, Genetic Clues to Higher Cardiovascular Disease Risk in Patients with Lupus

Mary Beth Nierengarten  |  April 20, 2017

WASHINGTON, D.C.—Experts at the 2016 ACR/ARHP Annual Meeting session, Systemic Lupus Erythematosus—Clinical Aspects and Treatment IV: Biomarkers, reported on a number of recent studies showing advancement in our understanding of the disease mechanisms underlying systemic lupus erythematosus (SLE) that place these patients at risk for cardiovascular disease (CVD) and other comorbidities. Mechanisms of CVD Risk…

Effectiveness of Novel Therapies for Cutaneous SLE Explored

Thomas R. Collins  |  April 20, 2017

WASHINGTON, D.C.—A new, humanized anti-BDCA2 monoclonal antibody can trigger inhibition of the production of interferon, cytokines and chemokines derived from plasmacytoid dendritic cells in patients with cutaneous systemic lupus erythematosus (SLE), according to research presented at the 2016 ACR/ARHP Annual Meeting. The findings were discussed during a session on SLE treatment, drug adherence and the…

Drug Reduction Strategies, Disease Control for Patients with RA in Remission

Mary Beth Nierengarten  |  April 20, 2017

WASHINGTON, D.C.—Clinical aspects of managing patients with rheumatoid arthritis (RA) in remission were discussed by a panel of experts at the 2016 ACR/ARHP Annual Meeting during the session titled Rheumatoid Arthritis—Clinical Aspects IV: Managing Patients in Remission. Among the issues raised were strategies to taper or discontinue biologic therapies, as well as clinical predictors of…

Human Immune System Likened to Model of Military Efficiency

Thomas R. Collins  |  April 20, 2017

WASHINGTON, D.C.—Speaking at the 2016 ACR/ARHP Annual Meeting in a session titled ARHP: Immunology Boot Camp I: Basis of Targeted Therapy, a rheumatologist and immunology expert gave a guided tour of the immune system, described what can go wrong with it and outlined what physicians can do when it does. Troy Torgerson, MD, PhD, associate…

Rheumatology Coding Corner Question: Billing Infusion Procedure with JW Modifier

From the College  |  April 20, 2017

An 82-year-old female established patient diagnosed with ankylosing spondylitis in multiple joints returns to the office for her second infliximab infusion. She denies any fevers, cough or concurrent illness. Her joint pain is 7 on a scale of 1–10. She complains of achy pain in the cervical, lumbar and sacral regions of her spine. She…

Rheumatology Coding Corner Answer: Billing Infusion Procedure with JW Modifier

From the College  |  April 20, 2017

Take the challenge. CPT: 99214-25, 96413, 96375, 96361-59, J1745 x 4 J1745 JW* x 36, J1200 x1 ICD-10: M45.09, T50.995A, R06.02, E66.3, Z68.2 Rationale Modifier 25 is appropriate to use because it indicates the patient received a significant, separately identifiable E/M service on the same day as the infliximab infusion. This E/M service entailed the…

Rheumatology Case Report: Bullous Lesions in Patient with Lupus

Mitali Sen, MD, Corrado Minimo, MD, & Ruchika Patel, MD  |  April 20, 2017

Systemic lupus erythematosus (SLE) is a heterogeneous disease associated with multiple acute or chronic cutaneous manifestations, including the relatively rare category of bullous lupus. The development of vesiculo-bullous lesions may be associated with a high morbidity, hence they warrant an urgent investigation, including a skin biopsy to identify the diagnosis and initiate prompt treatment. With…

Brodalumab Approved for Plaque Psoriasis, Plus Baricitinib Effiicacy Studied for RA

Michele B. Kaufman, PharmD, BCGP  |  April 20, 2017

Brodalumab Approved for Plaque Psoriasis The U.S. Food and Drug Administration has approved brodalumab, a monoclonal antibody that targets interleukin 17 (IL‑17).1,2 Brodalumab (Siliq) was approved for treating moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy and have failed to respond to, or have lost response to, other…

Biosimilar Drugs Raise Questions around Treatment Efficacy, Quality, Safety

Thomas R. Collins  |  April 20, 2017

WASHINGTON, D.C.—Challenges abound for the manufacturing of biosimilar drugs—from their sheer size compared with small molecule drugs to the unknowable proprietary aspects of the originator drugs—an expert said at the 2016 ACR/ARHP Annual Meeting in a session titled Immunology Update: Biologic Agents: From Nature to Protein Engineering to Biosimilars. Above all, because biosimilars are copies…

How to Survive MACRA

Kelly Tyrrell  |  April 19, 2017

The year 2015 brought the end of the much-maligned Sustainable Growth Rate (SGR), sometimes known as the “doc fix.” The SGR established limits on Medicare reimbursement for physicians, and each year, physicians and those lobbying on their behalf were forced to stave off drastic cuts to their payments. “The SGR was Congress’s attempt to control…

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