Anti-citrullinated protein antibodies (ACPAs) are now viewed as critical diagnostic and prognostic markers for rheumatoid arthritis (RA). Research into the pathophysiology of these autoantibodies has proven to be a ripe area of investigation, opening up many promising avenues for better understanding the etiology and pathogenesis of RA. Ultimately, work utilizing these autoantibodies may also allow…
A 60-year-old man returns for a follow-up related to his diagnoses of rheumatoid arthritis and chronic gout of his right ankle and foot, without tophi. He reports the gout flares have subsided in his ankle. He takes 450 mg of allopurinol daily. He has rheumatoid factor-positive rheumatoid arthritis, which previously affected multiple sites, without organ…
Take the challenge. CPT: 20611-LT, J7325-EJ ICD-10: M17.12, E66.01, Z68.41 CPT: 99213 ICD-10: M1a.0710, M05.79 History—The history of present illness was extended. The review of systems was extended, and two past family social history elements were documented. This makes the history level detailed. Examination—Five systems were examined. This makes the exam level detailed. Medical decision…
(Reuters Health)—Adults who quit smoking decades ago may have a lower risk of rheumatoid arthritis (RA) than people who gave up cigarettes more recently, a U.S. study suggests. Smoking has long been linked to an increased risk of RA, and quitting can reduce this risk. But the new study offers fresh evidence that years of…
In a study, researchers found extracellular vesicles may contribute to the greater disease severity typically seen in patients with seropositive rheumatoid arthritis (RA). Specifically, in these patients, extracellular vesicles can activate mononuclear phagocytes and induce proinflammatory cytokines in vitro…
New research exploring the effects of etanercept on cardiovascular disease in treatment-naive, early RA patients suggests a treatment advantage with etanercept, a TNF inhibitor and methotrexate over treatment with methotrexate and a conventional synthetic disease-modifying anti-rheumatic drug…
CHICAGO—The body of literature on immunosuppressive drugs used to treat cancer and autoimmune diseases is growing, helping bring some clarity to their effects on the immune system and how well they work in patients. This has helped refine the questions that further research must answer, said an expert at the 2018 ACR/ARHP Annual Meeting. The…
CHICAGO—The path to the discovery of cortisone—a top-selling, important drug, with dozens of indications—was complicated by failure, false moves, desperation and obsession. The tale, recounted in the Philip Hench, MD, Memorial Lecture: Crossroads of History & Hope: Discovery & First Use of Cortisone for RA at the 2018 ACR/ARHP Annual Meeting in October, is an…
As we turn the corner on the second decade of biologic use for rheumatic disorders, a reappraisal of approach in our communication with patients is due. In practice, the impact these agents have on patients’ lives justifies the friction rheumatologists face when connecting patients to them. You can understand why older rheumatologists who apprenticed on…
New evidence from a clinical trial of rituximab has identified the pathogenetic role of B cells in the earliest, pre-arthritis stage of autoantibody-positive RA…