A 53-year-old female presented to the clinic for severe polyarticular joint pain and was found to have a seronegative inflammatory arthritis. Six months before, she had completed 10 months of treatment for stage IV metastatic melanoma with the immune checkpoint inhibitors, nivolumab and ipilimumab, achieving complete remission of her cancer. She said that throughout her…
Ipilimumab (Yervoy) is a monoclonal antibody directed against cytotoxic T-lymphocyte antigen 4 (CTLA-4). It was the first drug to demonstrate a survival benefit in advanced melanoma and was approved by the FDA in 2011.1 By blocking the CTLA-4 receptor, ipilimumab enhances the immune response against tumors via cytotoxic T lymphocyte activation and proliferation.2 However, immunopotentiating…
NEW YORK (Reuters Health)—Temporarily withholding methotrexate (MTX) can improve the efficacy of seasonal influenza vaccination in patients with rheumatoid arthritis (RA), according to a new randomized clinical trial. Response was strongest in patients who discontinued MTX for two weeks before and two weeks after receiving the flu shot, Dr. Eun Bong Lee of Seoul National…
Sirukumab Promising for RA Sirukumab, an investigational human monoclonal antibody that selectively binds to the interleukin (IL) 6 cytokine, has completed a randomized, double-blind, placebo-controlled, parallel-group, Phase 3 clinical trial (SIRROUND-T) in patients with rheumatoid arthritis (RA).1 During the trial, which took place between July 25, 2012, and Jan. 12, 2016, researchers randomized adult patients…
Doctors have had few options to treat the chronic rheumatoid arthritis-like symptoms associated with chikungunya virus infections beyond over-the-counter pain relievers. A recent study in Science Translational Medicine has spurred new optimism by finding that a combination therapy—the anti-rheumatic drug abatacept paired with a chikungunya-neutralizing monoclonal antibody—abolished acute symptoms in infected mice.1 The strategy must…
The FDA has approved a new formulation of methotrexate designed as an oral solution for pediatric patients. The agency has also recently introduced age restrictions for codeine and tramadol for children under age 12, citing their risks for slowed or difficult breathing and death…
The alarming statistics on prescription opioid overdoses are well known to medical professionals, thanks to the Centers for Disease Control and Prevention (CDC)’s widely cited finding that deaths from opioid analgesics have increased fourfold since 1999.1 Half of all fatal drug overdoses now involve opioids prescribed by a doctor. Meanwhile, a lack of rigorous research…
What does a new patient experience as symptoms develop and diagnosis is confirmed? Who is involved in the care of a newly diagnosed patient with rheumatoid arthritis (RA)? The ARHP Practice Committee has developed a case study that will help answer these questions . Meet Joy G., a 48-year-old woman with RA. Follow Joy through…
Collaboration among all providers—surgeon, rheumatologist, physical therapist, etc.—is essential for patients with a rheumatic disease who are about to undergo total joint arthroplasty to reach their goals, including reduced pain and improved mobility…
(Reuters Health)—Arthroscopic surgery won’t cure chronic knee pain, locking, clicking, a torn meniscus or other problems related to knee arthritis, according to a panel of international experts. Every year, more than two million people with degenerative knee problems have arthroscopic surgery. But guidelines published May 10 in the British Medical Journal recommend against the procedure…