In this comparative effectiveness clinical trial, Yan et al. set out to compare nontitrated, low-dose benzbromarone (not approved in the U.S.), a renal urate transporter 1 inhibitor, with low-dose febuxostat as the first-line therapy in gout patients with renal uric acid underexcretion.
The ACR/CHEST ILD Guidelines in Practice, a video
In collaboration with the American College of Chest Physicians, the ACR released two new comprehensive guidelines aimed at improving the screening, monitoring, and treatment of patients with interstitial lung disease (ILD) secondary to systemic autoimmune rheumatic diseases (SARDs). Recently, Sindhu R. Johnson, MD, PhD, professor of medicine at the University of Toronto, Canada, director of the Toronto Scleroderma Program and principal investigator for the guideline, and Elana J. Bernstein, MD, MSc, Florence Irving associate professor of medicine in the Division of Rheumatology at Columbia University, New York City, and co-first author, presented a webinar to talk about how the guidelines were developed and present some of the recommendations and their rationale: Watch the recording now!

Duke Researchers Create a Type 1, Type 2 Lupus Disease Model
A new disease model for lupus tackles issues with fatigue and other serious conditions that, although quite common among patients, get less attention because they fall outside classic symptoms associated with inflammation, a debilitating force behind systemic lupus erythematosus (SLE). The model features subtypes to categorize two main groups of symptoms into type 1, typically…

Advocacy Involvement ‘An Antidote to Burnout,’ Says New Government Affairs Chair Christina Downey, MD
The new chair of the ACR’s Government Affairs Committee, Dr. Downey says physicians play a vital role in helping policymakers understand how policies and laws affect patients and the practice of rheumatology.
Big Utilization Management Reform Wins in Pennsylvania, Massachusetts
Prior authorization and step therapy reform bills recently enacted in Pennsylvania and Massachusetts offer case studies into how substantive policy change can take persistence, patience and a bipartisan approach to achieve success.

Gout Research at a Glance
PHILADELPHIA—Approximately 60 research abstracts on gout were accepted for presentation at ACR Convergence 2022, including two plenary abstract presentations. It is exciting to see a wealth of research on gout being undertaken worldwide. Here, we highlight important points from seven of these studies. 1. Abstract 1810: Frequency and Patterns of Opioid Use in the Management…
ACR Scores Wins for Rheumatology Community at AMA House of Delegates Interim Meeting
Key successes for the rheumatology community secured by the ACR’s delegation include passage of the ACR’s resolution addressing pharmacy benefit administrators, advances in policies to protect rheumatologists and patients in the post-Dobbs landscape and retention of the rheumatology’s representation in the AMA House of Delegates.

Ethics Forum: Has the Patient Asked for More Than Can Be Ethically Allowed?
The patient, a 76-year-old woman, had very active polyarticular rheumatoid arthritis (RA), despite triple therapy with conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs), low-dose corticosteroids and occasional intra-articular injections—the latter providing only transient symptomatic relief. She had elevated inflammatory markers and a 28-joint Disease Activity Score (DAS-28) score of 7.4. Because of the severity of her…

3 AC&R Study Summaries: MoCA Screening in SLE, Pediatric Social Disadvantages & Surgical Weight Loss Interventions
MoCA as a Screening Test in SLE Assessing the utility of the Montreal Cognitive Assessment (MoCA) By Oshrat E. Tayer-Shifman, MD, Kimberley Yuen, BSc, MD, & Zahi Touma, MD, PhD, FACP, FACR Why was this study done? Cognitive impairment is a common manifestation of systemic lupus erythematosus (SLE), with a prevalence of 40% based on…

ACR Provides Preliminary Analysis of CY23 Medicare Physician Fee Schedule Final Rule
On Nov. 1, the CMS finalized the Medicare Physician Fee Schedule for 2023. The rule finalizes many policies, significantly: a 4.5% decrease in the conversion factor, a delay in split/shared implementation, continued refinement of evaluation and management coding and documentation, and telehealth flexibilities that will remain in place through 2023. Thanks to ACR advocacy, the CMS reinstated five-minute pre- and post-service times for musculoskeletal ultrasound codes.
Self-Initiated Care May Reduce Workforce Gap
Seppen et al. developed a smartphone application for patients with RA to assess the safety and efficacy of patient-initiated care, compared with usual care. By answering a weekly Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire, patients were able to monitor their own disease activity between clinic visits.
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