According to results of a recent study of all-cause and cause-specific mortality trends of end-stage renal disease due to lupus nephritis from 1995 to 2014, the all-cause premature mortality rate improved among white, African American and Hispanic patients, with reduced risk of death from CVD and infection. Jorge et al. observed a 32% reduction in mortality. This improved survival may be explained by a combination of improvements in the management of ESRD and of underlying SLE…
Articles by Arthritis & Rheumatology
Does Loss of Skeletal Muscle Mass Increase the Risk of Knee OA?
Obesity is a well-known risk factor for knee osteoarthritis (OA), but data regarding the association of body composition (fat and muscle mass) with the risk of knee OA are lacking. Thus, it is not clear whether the effects of BMI, typically interpreted as effects of obesity, are truly due to excess adiposity rather than to overall loading due to the combined weight of body mass. Misra et al. undertook this study to examine the longitudinal association of body composition categories based on fat and muscle mass with the risk of incident knee OA…
New Guideline for the Treatment of Psoriatic Arthritis
ACR guidelines include recommendations for the management of patients with particular conditions or diseases. Guidelines are developed using a systematic process and are based on available evidence and the clinical experience and expertise of rheumatologists and other interested stakeholders. In the January issue of Arthritis & Rheumatology, Arthritis Care & Research and the Journal of…
Gene Therapy for OA
Background & objective: One of the major challenges in the treatment of chronic joint diseases, such as osteoarthritis (OA), is the need to provide sustained bioavailability of a therapeutic agent within the joint. Systemically administered drugs cannot sufficiently reach the synovial space, and intra-articularly injected agents are cleared from the joint fluid rapidly by the…
TNFi Exposure in Utero
Vinet et al. evaluated the risk of serious infections in children of women with RA exposed to TNFi’s in the gestational period compared with unexposed offspring of women with RA, as well as with children from the general population. Although the research did not demonstrate a marked excess risk for serious infections, the authors could not exclude a differential risk according to specific TNFi, with infliximab potentially resulting in a threefold increase in the risk of serious infections compared with other TNFi’s. More studies are needed…
An Improved State of Mind?
Evidence suggesting common inflammatory pathways in RA and depression is increasing. However, this study found that improved physical health through pharmacologic treatment does not by itself improve mental health. …
SLE Is a Leading Cause of Death Among Women
Systemic lupus erythematous (SLE) is a chronic inflammatory disease that predominantly affects women and can involve virtually any organ. The authors of this study analyzed secular trends and population characteristics associated with SLE mortality. Objective: Mortality statistics from the Centers for Disease Control and Prevention (CDC) are used for planning healthcare policy and allocating resources….
Pain Links Fibromyalgia & RA
Many patients with rheumatoid arthritis (RA) report pain despite excellent control of inflammation with immunotherapies. Variable degrees of coexisting fibromyalgia (FM) may explain this disparity. RA patients who have the highest 2011 ACR FM survey criteria scores appear to share neurobiologic features consistently observed in FM patients. This study is the first to provide neuroimaging evidence that RA is a mixed pain state, with many patients’ symptoms being related to the central nervous system rather than to classic inflammatory mechanisms…
Getting Past the Noise to Identify SpA
Objective: Low-grade bone marrow edema (BME) has been reported in the sacroiliac (SI) joints of 25% of healthy individuals and patients with nonspecific mechanical back pain, thus challenging the specificity and predictive value of magnetic resonance imaging (MRI) for the identification of early spondyloarthritis (SpA). It is unknown whether stress injury in competition sports may…
The Science Behind Biosimilars
Although six biosimilar agents have now been approved by the U.S. Food & Drug Administration for use in rheumatology, scientific, clinical, economic and prescribing questions about the use of biosimilars abound. In fact, at the 2017 ACR/ARHP Annual Meeting in San Diego, Joseph Huffstutter, MD, a rheumatologist in private practice in Chattanooga, Tenn., said that…
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