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The Rheumatologist: August 2021

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FDA’s Arthritis Advisory Committee Narrowly Endorses Avacopan Approval

Ruth Jessen Hickman, MD  |  August 11, 2021

On May 6, the U.S. Food & Drug Administration’s (FDA’s) Arthritis Advisory Committee narrowly voted in support of avacopan, a C5a receptor inhibitor, for the treatment of adult patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. Although the panelists were excited about the possibility of a steroid-sparing therapy, some raised questions about whether results from…

The Story of the N95 Mask

Philip Seo, MD, MHS  |  August 11, 2021

On Dec. 17, 1903, at 10:35 a.m., the restraining wire was released. The Wright brothers—Orville and Wilbur—owned a bicycle sales and repair shop called the Wright Cycle Exchange, in Dayton, Ohio. At the time, the popularity of bicycles was exploding, thanks to an innovation that made them much easier (and safer) to ride. The money…

2 Cases of SLE-Associated Diffuse Alveolar Hemorrage

2 Cases of SLE-Associated Diffuse Alveolar Hemorrhage

Abhimanyu Amarnani, MD, PhD, Nicole K. Zagelbaum Ward, DO, MPH, Lauren Mathias, MD, Nathan Lim, MD, Baljeet Rai, MD, Sky Wang, MD, & William Stohl, MD, PhD  |  August 12, 2021

Pulmonary manifestations in patients with systemic lupus erythematosus (SLE) include pleuritis, acute pneumonitis, interstitial lung disease, pulmonary arterial hypertension, shrinking lung syndrome and diffuse alveolar hemorrhage (DAH). DAH is a rare, but devastating, complication of SLE, with high mortality rates. The incidence of DAH in SLE ranges from 0.6% to 5.4%, but the mortality rate…

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COVID-19 Vaccination in Patients with Rheumatic Disease

Ruth Jessen Hickman, MD  |  August 11, 2021

With a large percentage of the U.S. population unsure whether they will get vaccinated against COVID-19, rheumatology patients remain vulnerable. On May 13, the ACR hosted a virtual town hall highlighting ways rheuma­tology providers might effectively approach their patients who have not yet decided to get a COVID-19 vaccine. Get the Slow Yes At the…

Researchers Explore Response to COVID-19 Vaccines in the Elderly

Ruth Jessen Hickman, MD  |  July 6, 2021

A delayed second dose of an mRNA vaccine may provide better protection against COVID-19 in elderly patients.

Healthcare Extenders Can Reduce Physician Burden & Improve Patient Access & Care

Kimberly Steinbarger, PT, MHS, DHSc, & Saba Mohiuddin, PharmD, BCACP  |  August 11, 2021

In the early 1900s, the treatment for rheumatic and musculoskeletal disease (RMD) was primarily targeted at symptomatic relief and included analgesics, physical therapy, splinting and bed rest. With the discovery of methotrexate and its impact on rheumatoid arthritis (RA) management, a much-needed evolution of medications targeting disease activity began. Over the past 30 years, several…

Vaccine Hesitancy: Wariness Is Rare, But There’s a Wider Worry About COVID Vaccines’ Efficacy in Some Populations

Susan Bernstein  |  July 6, 2021

Hesitancy about COVID-19 vaccination persists nationwide, although it varies among regions and sociodemographic groups.

Georgia Bonney

Prior Authorization Woes: Barriers to & Delays in Care, Administrative Hassles & Potential Solutions

Larry Beresford  |  August 6, 2021

As insurers phase out pandemic-related flexibilities, many are raising new obstacles to try to limit their financial exposure.

Outcome Assessments: Measuring Global Disease Activity in Patients with Psoriatic Arthritis

Jason Liebowitz, MD, FACR  |  June 23, 2021

Laura Coates, MBChB, MRCP, PhD, described & compared the intricacies of different outcome measures, as well as implications for clinical practice & trials, for patients with psoriatic arthritis.

Untangling the Diagnosis & Management of GCA

Jason Liebowitz, MD, FACR  |  June 28, 2021

Vision loss, implications of treatment and more—Sarah Mackie, BMBCh, PhD, MRCP, discussed the latest research on the evaluation and management of giant cell arteritis.

Grinding Away: An Overview of Progress in the Treatment & Management of Osteoarthritis

Jason Liebowitz, MD, FACR  |  June 28, 2021

Convex-walking shoes, dietary supplements, advancements in nerve growth factor inhibitors and more—Xavier Chevalier gave an overview and new insights into treatments for osteoarthritis.

Early & Long-Term Remission of Spondyloarthritis

Jason Liebowitz, MD, FACR  |  July 16, 2021

Filip Van den Bosch, MD, described his strategies for caring for patients with SpA and the possibility of achieving disease inactivity.

Food & Disease: How Diet May Affect Rheumatic & Musculoskeletal Diseases

Jason Liebowitz, MD, FACR  |  July 16, 2021

Patients’ questions about pro- and anti-inflammatory diets can be challenging to address. Dr. Elena Nikiphorou provided insight into the latest research regarding the role of diet in rheumatic and musculoskeletal diseases.

Achieving Excellence in Pediatric Rheumatology Clinical Care

Jason Liebowitz, MD, FACR  |  July 17, 2021

PRSYM—At its heart, the practice of medicine in all forms is specifically centered on delivering compassionate, thoughtful and evidence-based clinical care. In the world of pediatric rheumatology, a range of issues, such as chronic pain, reproductive health and transitioning to adult providers, are of utmost importance to patients and physicians alike. These topics were addressed…

The Many Facets of JIA: Insights from Bench to Bedside for the Clinical Care of Patients with JIA

Jason Liebowitz, MD, FACR  |  July 18, 2021

Experts provide insights into spondyloarthropathy, temporomandibular joint involvement and imaging for pediatric patients with JIA.

Manifestations of JIA: JIA-Associated Uveitis, sJIA & Lung Involvement in sJIA

Jason Liebowitz, MD, FACR  |  July 16, 2021

JIA can manifest in a variety of ways. Experts discuss the implications of uveitis, systemic disease and lung involvement in sJIA.

Treatment Factors to Consider in Patients with JIA

Jason Liebowitz, MD, FACR  |  July 18, 2021

Weighing treatment options and adjusting them to meet the needs of patients with JIA is a complicated process. Experts discussed factors influencing treatment options, optimizing treatment doses and possibilities for treatment withdrawal for these patients.

High Cost of Specialty Drugs Demands Action

Mary Beth Nierengarten  |  July 6, 2021

Amid rising drug costs and the growing influence of pharmacy benefit managers on patient care decisions, physicians are increasingly called upon to advocate for affordable, evidence-based treatments for their patients.

Health Canada Approves Upadacitinib to Treat Adults with PsA

Michele B. Kaufman, PharmD, BCGP  |  July 6, 2021

Based on data from two phase 3 clinical trials, Health Canada has approved the use of upadacitinib to treat adults with active psoriatic arthritis.

Guselkumab Promising to Slow Joint Damage in Patients with Psoriatic Arthritis

Michele B. Kaufman, PharmD, BCGP  |  June 29, 2021

In an efficacy and safety study of guselkumab, patients with active psoriatic arthritis taking guselkumab showed continued skin clearance and joint symptom relief, as well as statistically significant inhibition of joint damage, after two years.

Coming in September … Rheumatic Disease Awareness Month

From the College  |  August 11, 2021

In 2016, as part of the Simple Tasks campaign, the ACR established September as Rheumatic Disease Awareness Month (RDAM) to draw attention to the 100-plus conditions under the rheumatic disease umbrella. The goal of RDAM is not only to raise public awareness, but also to increase understanding about the symptoms, risk factors, treatment options, economic…

Make an Impact: Join Our Community of Donors

From the College  |  August 11, 2021

The Rheumatology Research Foundation is proud to announce the launch of RheumBuilders, a new community of monthly donors, and the relaunch of its Legacy Society, a community of donors who have included the Foundation in their wills or estate plans. These initiatives are designed to deepen the Foundation’s commitment to rheumatology research and patient care,…

Steven Echard Shares ACR Collaborative Plans at Florida Society Meeting

Vanessa Caceres  |  July 19, 2021

At the recent Florida Society of Rheumatology meeting, ACR executive vice president Steven Echard, IOM, CAE, emphasized the role of collaborations with state organizations in the ACR’s plans to modernize and expand its activities and offerings.

Coding Corner: Interprofessional Telephone/Internet/Electronic Health Record Assessment & Management

From the College  |  August 11, 2021

Example 1 A cardiologist contacts a rheumatologist concerning a lupus patient. The rheumatologist sees the patient four weeks later for a complete examination. A 20-minute call is initiated to review the findings and the patient’s chart with the cardiologist. After the call is completed, the rheumatologist completes a verbal and written report to the patient’s…

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