According to a large cohort study of pediatric patients, rituximab use is on the rise in the treatment of children diagnosed with vasculitis. Treatment with cyclophosphamide remains common, but it’s beginning to wane. Dialysis and mechanical ventilation also remain common, the study indicates. The retrospective study of hospitalized children in the U.S. included the largest…
Weight Change in Early RA & the Risk of Mortality
Sparks et al set out to investigate whether weight change during the early RA period is associated with subsequent mortality and to evaluate whether there is an RA-specific effect. They investigated weight change during the early RA period, because this is the window of time during which weight change is most likely to be related to RA-specific processes. They found that severe weight loss during the early RA period was associated with a subsequent increased mortality risk both for women with and without RA…
Does MRI Differentiate Osteoarthritis and Meniscal Tear in Knee Pain?
When a young patient arrives at a clinic complaining of knee pain with clicking or popping, a meniscal tear is often the culprit. “In young [people], there’s a pretty classic presentation of meniscal tear, with clicking and other mechanical symptoms, because the tear rubs up against different tissues,” says Jeffrey Katz, MD, MSc, a rheumatologist…
Long-Term Benefits, Risks of Biologic Disease-Modifying Anti-Rheumatic Drugs in Patients with RA
Two decades have passed since the first biologic disease-modifying anti-rheumatic drug (bDMARD) was approved. Studies on the long-term use of biologics in different disease states, such as for cardiovascular disease (CVD) and malignancy, as well as for knee/hip replacement, reveal some encouraging news. In clinical trials, bDMARDs have been shown to increase the risk of…
Rheumatology Drug Updates: Hip Fracture Rates After Bisphosphonate Drug Holidays, Plus More on Golimumab, Ustekinumab
Bisphosphonate Drug Holidays Drug holidays are common for patients on bisphosphonate therapy. Often, these breaks in treatment are related to known U.S. Food and Drug Administration (FDA) warnings and drug class adverse effects. Currently, data on fracture risk related to drug holidays are limited. In recent research highlighted at the 2017 ACR/ARHP Annual Meeting ,…
Fellows’ Forum Case Report: Progressive Weakness and Debilitation with Skin Rash
The Presentation A pale, quiet woman—her mother—wheeled the girl into my clinic. It was a blistering Florida day, and the girl was shivering. She glanced up at me when I said hello and asked her name. “Hi,” she said, giving me a broad smile. Her smile was the only broad thing about her. Her elbows…
Inside Cambodia’s Struggles with Poverty, Dearth of Trained Rheumatologists
It’s one thing for a developing country to lack physicians due to a scarcity of training. It’s quite another for such a vacuum to exist because the physicians were executed. In Cambodia in the 1970s, genocide perpetrated by the Khmer Rouge spared few of the educated class. If they were spared, chances were they lost…
Key Findings in Basic Science This Year Hold Promise for Potential Rheumatology Therapies
SAN DIEGO—After sifting through the nitty-gritty of the rheumatic disease literature on basic science, Richard Pope, MD—professor of medicine specializing in rheumatology at Northwestern University Feinberg School of Medicine—underscored several findings he thought stood out from the pack in his Year in Review talk at the 2017 ACR/ARHP Annual Meeting. He reviewed findings from November…
Cardiovascular Disease Rate Differs Between SLE Patients of Different Races, Ethnicities
A recent epidemiologic study of patients with systemic lupus erythematosus (SLE) investigated racial and ethnic differences in the risk for cardiovascular disease (CVD). Among SLE patients enrolled in Medicaid, the risk for myocardial infarction (MI) was lower in Hispanics and Asians compared with whites, and the risk of stroke was higher in blacks and Hispanics…
Is Rheumatoid Arthritis Preventable?
Is rheumatoid arthritis (RA) preventable? Results of a newly published study suggest that personalized medicine approaches may result in health behavior that may reduce RA risk. “We have gotten to the point where we’ve identified some modifiable behaviors that affect rheumatoid arthritis risk,” says Jeffrey A. Sparks, MD, MMSc, assistant professor of medicine in the…
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