Current guidelines for the long-term management of gout recommend a combination of lifestyle management and/or pharmacotherapy to lower serum UA levels to <6.0 mg/dL in most patients or <5.0 mg/dL in patients with more severe disease. Allopurinol is the most widely used xanthine oxidase inhibitor and is recommended in treatment guidelines as a first-line urate-lowering…
Low Levels of Vitamin D3 May Increase OA Pain
In a study of patients with knee osteoarthritis (OA), researchers found that the cytokine IL-17A may play a role in the pain associated with the disease. Specifically, decreased serum levels of vitamin D3 may contribute to OA pain via the regulation of immune responses…
The OPAL Beyond Study: Tofacitinib Phase 3 Results Positive for Treating PsA
In a recent study, patients with psoriatic arthritis taking tofacitinib had a decrease in disease activity compared with placebo…
New Insights into Cartilage & Tendon Differentiation
By examining the phenotypic plasticity of cartilage and tendon cells, researchers found that oxidative stress and P13K signaling pathways are key modulators of the phenotype of musculoskeletal cells. Using monolayer and three-dimensional cultures, the experiments confirmed that dedifferentiation occurs via reductions in expression of genes for cartilage (Col2a1, Agcn) and tendon (Tnmd, Serpinf1)…
Statin Use Tied to Attenuation of Tocilizumab-Mediated Lipid Increases
NEW YORK (Reuters Health)—Statin treatment is associated with an attenuation of the increases in serum lipids experienced by rheumatoid arthritis patients on tocilizumab, according to a post-hoc analysis of clinical trials. Treatment with the interleukin-6 receptor-alpha inhibitor tocilizumab is known to raise total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride levels. To explore the possible effect of…
When Chronic Pain Is Personal
Opening up to patients about a medical condition is a personal choice for physicians. But for Richard Brasington, MD, who has chronic back pain and arthritis, it helps him communicate with and connect to some of his patients. In an interview, he provides insights into his experiences managing pain on the job…
The Future of Pediatric Rheumatology Grounded in Evolution of Childhood Arthritis and Rheumatology Research Alliance
Pediatric rheumatology was formally recognized as a specialty in 1991 by the American Board of Pediatrics. Prior to this time, children with rheumatic diseases were treated by a hodgepodge of providers. In addition to providers who had training as pediatric rheumatologists, general pediatricians, adult rheumatologists, allergist-immunologists, orthopedists, pediatric infectious disease specialists and others treated children…
Rheumatology Case Report: Systemic Capillary Leak Syndrome and Rheumatoid Arthritis
Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…
Assessing Autoimmune Disease Symptoms in Silicone Breast Implant Recipients
My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…
Infection Greater Worry Than Flare: Collaborative Guideline Offers Guidance to Prevent Joint Replacement Complications & Failure
WASHINGTON, D.C.—Total joint arthroplasty is one of the most common surgical procedures performed on adults with end-stage arthritis. One recent estimate showed that 2.5 million individuals in the U.S. are living with a total hip replacement and 4.7 million are living with knee replacements. For their patients with inflammatory arthritis, rheumatologists and orthopedic surgeons must…
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