The new EULAR/ACR classification criteria for SLE offer improved sensitivity and specificity, as well as more accurately reflect the current tests used to clinically diagnose SLE. A positive ANA test is obligatory…
On Boulders & Other Projects
The year is drawing to a close, and I have not been forced to release a statement that I am leaving The Rheumatologist “to spend more time with my family.” Once again, improbably, I have made it to the finish line. Given that, now seems to be a good time to reflect, and to give…
Ellen M. Gravallese, MD, Begins ACR Presidency
As Ellen M. Gravallese, MD, begins the ACR presidency, her goals include workforce expansion, improved access to care and support for members in all areas of practice.
Men, Women & Medical Differences in Axial Spondyloarthropathy
Historically, ankylosing spondylitis was considered mainly a male disease. But it has become evident this predominance is not as great as previously believed. Here we discuss recent developments in the area, including potential differences between the sexes in symptom and disease burden, immunological and genetic background, diagnostic delay, treatment response and ongoing research questions. Medical…
Remote Use of the Multidimensional Health Assessment Questionnaire (MDHAQ)
The patient medical history is far more prominent in clinical decisions for rheumatology than for many common chronic diseases in which a gold standard biomarker, such as blood pressure or serum glucose, is applicable to diagnosis and management of all individual patients.1 Components of a subjective patient history may be recorded as structured, quantitative, standard,…
FDA Approves Nintedanib for SSc-ILD, But Temper Your Expectations
The U.S. Food & Drug Administration (FDA) approved nintedanib for systemic sclerosis associated interstitial lung disease (SSc-ILD) on Sept. 6 after a randomized, controlled trial (SENSCIS) demonstrated significant benefit against placebo.1 At a cost of $96,000 per year, treatment reduced the adjusted annual rate of change in forced vital capacity (FVC) from –93.3 mL in…
Case Report: A 50-Year-Old Man Suffers Dye-Induced Arthritis
Hair dye products are commonly used by both men and women to enhance youth and beauty and to follow fashion trends. As reported in the medical literature, hair dyes and their ingredients are associated with allergic contact dermatitis. A possible association with joint inflammation has also been recognized. There is literature to support that para-phenylenediamine…
Meet the Incoming Arthritis & Rheumatology Editor in Chief, Dr. Daniel Solomon
Daniel Solomon, MD, MPH, has practiced rheumatology for more than 20 years, all while conducting translational and clinical research and teaching young clinicians. Soon, he will also step into the role of editor in chief of Arthritis & Rheumatology, as Richard J. Bucala, MD, PhD, ends his tenure. He will assume some duties during a…
How to Walk on Water & Climb Up Walls: 2019 ACR/ARP Annual Meeting gets an inspirational kickoff in Atlanta
ATLANTA—Did you know that Tasmanian wombats have cube-shaped poop or that no matter what size bladder someone has, they still pee in 20–30 seconds—even elephants? What do those factoids have to do with rheumatology? When keynote speaker David L. Hu, PhD, shared the information and how he discovered it, the stories incited laughter in the…
New Draft Gout Guideline Released
ATLANTA—The authors of the new draft ACR treatment guideline for the management of gout presented the draft guideline on Nov. 13 at the 2019 ACR/ARP Annual Meeting. Based on evidence from more than 130 published studies, there are 42 recommendations, of which 16 were strong, including 27 for urate-lowering therapy (ULT) management, 13 of which…
Collegiality—an ARP Mainstay
ATLANTA—In the late 1990s, at the Annual Meeting, a colleague asked Marian Hannan, DSc, MSc, who is now professor of medicine at Harvard Medical School, if she wanted to go to a tourist attraction and talk about professional pursuits during a break at the conference. The colleague ranked higher than she did, and she didn’t…
Year in Review: Rheumatic Disease Research in 2019
ATLANTA—Encouraging data on interleukin (IL) 23/IL-17 pathway drugs in psoriatic arthritis (PsA), JAK inhibitors in rheumatoid arthritis (RA) treatment and new evidence on physical activity and bone health in women were among the highlights of the 2019 ACR/ARP Annual Meeting’s Clinical Year in Review. Susan Manzi, MD, MPH, director of the Lupus Center for Excellence…
A Rash of Evidence: Evaluating & Treating Psoriatic Arthritis
ATLANTA—As many rheumatologists will recall, it was not too long ago that psoriatic arthritis was regarded somewhat like “rheumatoid arthritis with a rash,” with little attention paid to the ways in which the unique pathophysiology and manifestations of this entity make it distinct from other forms of inflammatory arthritis. At the 2019 ACR/ARP Annual Meeting…
Progress on Preventing Immune-Related Adverse Events
ATLANTA—One of the hottest topics in medicine is the emerging field of cancer immunotherapy. However, immune-related adverse events (irAEs) are associated with the therapy, and when things go wrong, they can go very, very wrong, said Ryan Sullivan, MD, during the 2019 ACR/ARP Annual Meeting in November. “The guiding principle of cancer immunotherapy is [that]…
1 Person Can Make a Difference: The Importance of Advocacy
Your voice matters: That was the shared theme of presentations by Angus Worthing, MD, FACR, FACP, William F. Harvey, MD, MSc, FACR, and Georgia Rep. Kim Schofield (D-Atlanta, Dist. 60) in the session, Raise Your Voice! Advocacy Update from Government Affairs at the 2019 ACR/ARP Annual Meeting on Monday, Nov. 11.
The 2019 ACR Award Winners & Distinguished Fellows
ATLANTA—Every year at its Annual Meeting, the ACR recognizes its members’ outstanding contributions to the field of rheumatology through an awards program. The ACR is proud to announce 20 award recipients for 2019, honored for their accomplishments as clinicians, instructors or researchers who have helped advance rheumatology, for their commitment to inspire others to enter…
Lessons from Master Clinicians: An Interview with Dr. Paul Plotz
Rheumatologists who are outstanding clinicians, provide consistently exceptional care to patients and serve as role models for colleagues and trainees are in the spotlight in our Lessons from a Master Clinician series. Here, we offer insights from clinicians who have achieved a level of distinction in the field of rheumatology. Paul Plotz, MD, is scientist…
Do Patients with Ankylosing Spondylitis in Remission Still Need TNF Inhibitors?
Patients with axial spondyloarthritis have a chronic, immune-mediated inflammatory disease that tends to localize to the sacroiliac joints and spine. Ankylosing spondylitis is, perhaps, the most representative of this group of diseases. Rheumatologists treat patients with axial spondyloarthritis with biologics, such as tumor necrosis factor inhibitors (TNFi’s), which can improve quality of life, activity and…
Ankylosing Spondylitis & Uveitis: An Ophthalmologist’s Perspective
It’s often said the eyes are the window to the soul, and in the case of ankylosing spondylitis and other spondyloarthropathies, one can also say the eyes are the window to systemic disease. Although uveitis occurs in approximately 2–5% of patients with inflammatory bowel disease, 6–9% of patients with psoriatic arthritis and 25% of patients…
Fall 2019’s Awards, Appointments & Announcements in Rheumatology
J. Michelle Kahlenberg Receives Presidential Early Career Award for Scientists & Engineers (PECASE) A physician scientist and associate professor of internal medicine in the Division of Rheumatology at the University of Michigan in Ann Arbor, J. Michelle Kahlenberg, MD, PhD, is a 2019 recipient of the prestigious PECASE award. Dr. Kahlenberg, who also holds the…
Legal Updates: Tips for Protecting Your Patients’ Health Information
In the daily shuffle of evaluating patients and focusing on the delivery of high-quality patient care, the importance of protecting patient information may get overlooked. Human error is just one possible way patient information can be compromised. Cybersecurity attacks are becoming more numerous and sophisticated every day, with the number of patient records compromised increasing….
Rheum After 5: Dr. Stacy Ardoin & Mr. Mom
In 2004, Stacy Ardoin, MD, MHS, became pregnant with twins during the second year of her fellowship at Duke University School of Medicine, Durham, N.C. Although she and her husband, Adrien, were thrilled by the news, the astronomical cost of day care for two infants was a specter. At the time, Adrien managed a bookstore…
Scottish Medicines Consortium Recommends Risankizumab; Plus Real-World Data on Secukinumab
The Scottish Medicines Consortium has released a detailed advice document recommending risankizumab for treating adults with psoriasis…
FDA Approves Rituximab for Children with GPA & MPA
Intravenous rituximab can now be used to treat pediatric patients with GPA and MPA as young as two years old…
Help Rheumatology Research Foundation Hit Its Year-End Goal: $100,000
The Rheumatology Research Foundation is the charitable arm of the ACR, advancing research and training to improve the health of people living with rheumatic disease. Thanks to the continued support of ACR and ARP members, the Foundation is the largest private funding source for rheumatology research and training programs in the U.S. In all, the…
An Interview with ACR Honoree Rep. Raul Ruiz on Step Therapy Reform
Rep. Raul Ruiz co-introduced the Safe Step Act in April and has helped educate members of Congress about how step therapy hurts patient outcomes and care.
Achieving Clinical Documentation Improvement in 2020
Although the Centers for Medicare & Medicaid Services (CMS) is simplifying documentation through its Patients over Paperwork initiative, clinical documentation improvement (CDI) did not go away. CDI is not about how to code in ICD-10-CM or the Current Procedural Terminology (CPT); instead, it is a huge part of the solution in maximizing the integrity of…
Coding Corner Questions: Rheumatology Word Search
Questions What type of drug is interchangeable with an FDA-approved biologic? What drug is used in conjunction with infliximab, unless the patient cannot tolerate it? What can be used as a key element in an evaluation and management (E/M) service, along with the history, exam and medical decision making? What drives the level of an…
Coding Corner Answers: Rheumatology Word Search
Take the challenge. Answers Biosimilars Methotrexate Time Presenting problem Ultrasound guidance International Classification of Diseases Current Procedural Terminology Trigger points Osteoporosis Osteoarthritis