Patients with systemic lupus erythematosus (SLE) are characterized by high-titer, highly specific, isotype-switched antibodies against DNA and RNA. Patients have both CD4+ T helper (Th) cell- dependent as well as Th cell-independent autoantibody production. Two mouse models of lupus demonstrate T-cell–independent autoantibody production: the pristane model of lupus, as well as in the MRL/lpr mouse…

Ixekizumab Clinical Trials Continue; FDA Updates Warning Label for Varenicline
It seems to have begun in Norway, the international pressure to switch patients from well-known brand biologic agents, such as Remicade (infliximab), to biosimilar agents, due to a significant cost advantage.1 This biosimilar came with a 39% price markdown last year compared with the brand, and when Norway called for bids, the discount went to…

Rheumatoid Arthritis, Periodontal Disease Link Suggests Benefits in Behavioral Change
Although compelling data exist to support a link between periodontal disease (PD) and the development of rheumatoid arthritis (RA), cementing the association will require extensive investigative work.1 However, in reviewing the literature of the past 10 years, Elliot D. Rosenstein, MD, director, Institute for Rheumatic and Autoimmune Diseases at Overlook Medical Center, Summit, N.J., and…

Rheumatoid Arthritis Practice Performance Project Spots Problems in RA Management
Rheumatologists have growing concerns about how we manage rheumatoid arthritis (RA) and the disease outcomes we are achieving.1 Over the past two years, clinician rheumatologists have begun working together to address these problems through the Rheumatoid Arthritis Practice Performance (RAPP) Project, a nationwide clinical quality-improvement initiative. The RAPP Project has now grown to 168 participants…

Tips for Treating Insomnia in Rheumatology Patients
Chronic insomnia is a common complaint for patients with rheumatic diseases and conditions. In fact, sleep disturbances are among the most common symptoms of both fibromyalgia and rheumatoid arthritis (RA), with more than 50% of chronic pain patients reporting sleep disturbances. Pain combined with insomnia can lead to a vicious cycle, says Ruth Gentry, PhD,…

Diagnostic Imaging in Patient with Soft Tissue Calcification: Findings
View the question. Findings/Diagnosis The radiographs demonstrate diffuse sheetlike and tumefactive calcifications throughout the subcutaneous tissues, muscle and fascia of the pelvis and right hand. The underlying bones and joint spaces appear normal. The differential diagnosis for soft tissue calcification is extensive and includes metabolic disturbances (particularly of calcium and phosphate), trauma (e.g., injection sites,…

Diagnostic Imaging in Patient with Soft Tissue Calcification: History
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 These radiographic images are of a 25-year-old woman with a known…

COPA Genetic Mutation Identified in Lung Disease, Arthritis
Researchers from California and Texas have identified a new genetic syndrome that is characterized by systemic autoimmune disease of the lung and joints. The syndrome is driven by a genetic variant of a vesicular transport protein and is the first documented association between intracellular transport and autoimmunity. Levi B. Watkin, PhD, postdoctoral fellow at Baylor…

How Celebrities, Senators, Dietary Supplements Muddle Medicine
It’s disheartening to stand by and watch helplessly as your patient dies a slow, painful death. In spring 1990, I had the misfortune of living through such a distressing experience. Strange happenings in New Mexico & Japan Ellen was a bookkeeper in her late 40s, living quietly in suburban Boston. For years, she hid a…

ACR/ARHP Annual Meeting Research Abstract Submission Tips
The American College of Rheumatology (ACR) and the Association of Rheumatology Health Professionals (ARHP) invite you to submit an abstract and take advantage of the opportunity to have your work peer reviewed by experts in rheumatology. Reasons to Submit Opportunity for Publication—The Annual Meeting draws thousands of abstracts submitted by rheumatology professionals from around the…
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