I tell my patients there are three types of science: 1) investigative science, which sometimes gets it right; 2) science in the courtroom, which is junk science; and 3) science in Washington, D.C., which is political science. Our decisions are based on art and science; our patients’ medications are brought to market based on science….
After years of speculation about potential cost savings and debates on safety, biosimilars are about to step onto the stage of rheumatic disease treatment. On Feb. 9, the Arthritis Advisory Committee of the U.S. Food and Drug Administration (FDA) met in Washington, D.C., and recommended the approval of CT-P13, a proposed biosimilar to infliximab (Remicade),…
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History A 49-year-old woman presents with one year of chronic left ankle…
Radiographic imaging showed circumferential soft tissue swelling of the ankle with a soft-tissue density seen in the tibiotalar and posterior subtalar joints, as well as a large, lobulated effusion. MRI of the left ankle shows cystic changes within the talus and first cuneiform bones, as well as a lobulated abnormal soft tissue density with low…
Subjectivity and the differences in how patients with autoimmune and other diseases perceive pain make the study and treatment of pain difficult. But Yvonne Lee, MD, says future advances in neuroimaging may aid in the objective study of pain and innovative treatments…
As much as 80% of employee turnover can be attributed to bad hiring decisions, the Harvard Business Review reported.1 And turnover costs are high—one report estimated them to be 100–300% of the base salary of a replaced employee (with 150% commonly cited).2 Given this, the importance of hiring the right employees can’t be underestimated. So…
SAN FRANCISCO—To unravel how out-of-control inflammation begins in rheumatoid arthritis and other diseases, one target for immunologists is the macrophage. Researchers discussed macrophage activation and other key drivers of inflammation at the 2015 ACR/ARHP Annual Meeting on Nov. 7. How macrophages behave when recognizing damage-associated molecular pathways (DAMPs) tells us more about why some inflammation doesn’t…
SAN FRANCISCO—What factors help determine whether or not inflammation resolves, leading to healing, or becomes chronic, leading to disease and tissue destruction? A number of important cells, including toll-like receptors, mast cells, anti-citrullinated protein antibodies, complement and interferon, all play their own role in this process. By understanding how they act in innate and adaptive…
SAN FRANCISCO—Early in his career, Daniel Kastner, MD, PhD, scientific director at the National Human Genome Research Institute, saw a 24-year-old patient with a lifelong history of recurrent fever and severe episodes of arthritis. A colleague told him it was most likely familial Mediterranean fever (FMF). There was little then known about its mechanisms, and…
SAN FRANCISCO—Penetrating the dense extracellular matrix of cartilage is a challenge for administering osteoarthritis drugs, but an answer might lie in the matrix itself—in particular, its electrical charge, researchers reported at the 2015 ACR/ARHP Annual Meeting. Electrical Affinity Investigators at the Massachusetts Institute of Technology have found—at least in vitro and in animals—that delivering drugs…