Research has demonstrated that exercise-based physical therapy is as effective at maintaining knee function as surgery in patients with degenerative meniscal tears at risk of developing knee osteoarthritis.
Conflicts of Interest in Guideline Development: What to Do When Everyone Has a Conflict
Avoiding real and apparent conflicts of interest is a fundamental principle of guideline development, but what should we do when every thought leader is conflicted? An example of this conundrum in rheumatology has been the ACR’s ongoing effort to establish guidelines for the management of lupus nephritis, which has been stymied by the fact that…
ACR Image Competition 2022, Part 4
Periungual Erythema & Its Translation on Nailfold Videocapillaroscopy in a Patient with Very Early Systemic Sclerosis A 66-year-old woman presented with Raynaud’s phenomenon and periungual erythema. HEp-2 immunofluorescence assay was positive for antinuclear antibodies, showing a centromere pattern. The presence of anti-centromere antibodies was confirmed by chemiluminescent immunoassay. The patient was diagnosed with very early…
Case Report: Is It Cardiac Sarcoidosis or COVID-19 Myocarditis?
COVID-19 causes myriad cardiac dysfunctions, ranging from mild to fulminant disease, including myocarditis, acute congestive heart failure, cardiogenic shock and sudden cardiac death.1,2 COVID-19 myocarditis can mimic cardiac sarcoidosis clinically and on cardiac imaging, which can lead to diagnostic challenges and treatment delays. We present a case of cardiac sarcoidosis with interval development of metabolic…
ACR Releases New Vaccination Guideline
The ACR recently released its first guideline focused on vaccination in adult and pediatric patients with rheumatic and musculoskeletal diseases.1 The guideline recommends modifications to certain vaccine and medication schedules to increase immunogenicity and ensure patient safety, while encouraging providers not to miss vaccination opportunities. The Need Patients with rheumatic conditions who are on immunosuppressive…
Sarilumab Approved for the Treatment of Adults with Glucocorticoid-Resistant PMR
First described in 1888, polymyalgia rheumatica (PMR) is a chronic inflammatory condition that almost exclusively affects individuals older than 50.1 Until this week, no therapies for PMR had been approved by the U.S. Food & Drug Administration (FDA).2 Tuesday, Sanofi announced sarilumab (Kevzara) has been approved by the U.S. Food & Drug Administration for the…
Cardiovascular Safety with RA Treatments
Research by Chicre et al. found that Janus kinase inhibitors may significantly increase the risk of major adverse cardiac events and all-cause death in patients with rheumatoid arthritis (RA) when compared with other RA treatments. This study highlights the need for more comparative safety studies.
Supplemental Vitamin D May Not Protect Against Fractures in Healthy Adults
Supplemental vitamin D may not significantly lower the risk of fractures in generally healthy adults compared with placebo, according to a large study by LeBoff et al.
Point-of-Care Uric Acid Testing
In June 2022, I listened to several presentations on gout at EULAR’s European Congress of Rheumatology. Most began with data confirming a sad truth that we, as rheumatology providers, are all aware of: too many patients are taking subtherapeutic doses of urate-lowering therapy (ULT).1,2 Recommendations from the American College of Physicians in 2017 advocated for…
2022 ACR Guideline for Vaccinations in Patients with RMDs
This guideline provides evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases. It includes expanded indications for some vaccines, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy.
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