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The Rheumatologist: December 2021

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Kawasaki Guideline Urges Treatment Intensification for Some Patients

Ruth Jessen Hickman, MD  |  December 16, 2021

A soon-to-be published guideline from the ACR and the Vasculitis Foundation on Kawasaki disease underscores the importance of early diagnosis and intensified treatment for people with this serious condition.1 Intravenous immunoglobulin (IVIG) remains the treatment mainstay, and prompt, aggressive treatment may be able to reduce the risk of serious complications in some patients. The guideline…

The Transformative Power of Tragedy

Philip Seo, MD, MHS  |  December 16, 2021

On Sept. 11, 2001, I was at work. I had accepted a position as an assistant chief of service (ACS) for the Department of Medicine, which is Hopkins-speak for a hybrid position that involves all the administrative duties of a chief resident, plus the responsibility of an attending. For a year, I admitted patients to…

Meet New ACR President Kenneth G. Saag, MD, MSc

Leslie Mertz, PhD  |  November 9, 2021

Kenneth G. Saag, MD, MSc, is a nationally recognized expert & researcher in the epidemiology of gout, osteoporosis & rheumatoid arthritis. Dr. Saag brings a penchant for problem solving & a strong belief in the power of collaboration to his newest role in the College as the 85th ACR president.

Speak Out Rheumatology: Telerheumatology for Improving Accessibility

Anmol Dhillon, MD  |  December 1, 2021

An early adopter gives her take on telerheumatology.

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Rheumatic Complications from Immune Checkpoint Inhibitors

Nilasha Ghosh, MD, MS, & Anne R. Bass, MD  |  December 16, 2021

Immune checkpoint inhibitors (ICIs), such as anti-programmed cell-death 1/programmed death-ligand 1 (anti-PD-1/PD-L1) or anti-CTL-associated protein (anti-CTLA-4), have dramatically changed the treatment of advanced cancers over the past decade. ICIs block T cell inhibition, thus increasing the anti-tumor immune response. ICIs are used not only for metastatic cancer, but also as adjuvant treatment for some stage…

Opening Session of ACR Convergence 2021 Takes on Burnout, Pandemic Challenges & Moving Toward a New Normal

Vanessa Caceres  |  November 10, 2021

Keynote speaker Seema Yasmin, MD, brought her unique perspective to moving past the pandemic to improve provider mental health, address vaccine hesitancy and prepare for future health crises.

‘Battle for Health Justice’: Dr. Alakija Addresses Global Rheumatology Inequities

Ruth Jessen Hickman, MD  |  November 10, 2021

On Nov. 3, the inaugural, virtual Global Rheumatology Summit brought together specialists from all over the world to share critical expertise on global health issues related to rheumatology.

Gout Research at a Glance: ‘My picks for the top research in gout presented at ACR Convergence 2021’

Lisa Stamp, MBChB, PhD  |  November 10, 2021

Dr. Lisa Stamp helps filter the noise to get to the key insights from the research abstracts on gout presented at ACR Convergence 2021.

From Contraception to Breastfeeding: Experts Address Reproductive Health & Medication Management

Mithu Maheswaranathan, MD  |  November 11, 2021

ACR CONVERGENCE 2021—Rheumatologists are often left in a challenging space when managing medications for patients with rheumatic diseases in relation to contraception, pregnancy and breastfeeding, especially with many novel immunosuppressants and often a dearth of pregnancy safety data. On Nov. 6 during ACR Convergence 2021, leading reproductive health experts came together to speak on this…

Basic Science: New Insights into Inflammation in OA, VEXAS, COVID-19 & More

Samantha C. Shapiro, MD  |  November 10, 2021

Michael B. Brenner, MD, addresses exciting advances in basic science in rheumatology, including insights into inflammation in osteoarthritis, the adult-onset autoinflammatory syndrome VEXAS and more.

The 2021 ACR Awards of Distinction & Distinguished Fellows

Patrice Fusillo  |  December 16, 2021

During ACR Convergence 2021 in early November, the ACR honored a group of individuals who have made significant contributions to rheumatology research, education and patient care, announcing the recipients of the ACR’s 2021 Awards of Distinction, as well as the group of Distinguished Fellows. recognized for their contributions. Three pediatric rheumatologists and one pediatric fellow…

HCQ/CQ May Increase the Risk of Cardiovascular Events

Arthritis & Rheumatology  |  December 1, 2021

A special article in the December issue of Arthritis & Rheumatology summarizes the current understanding of the cardiac toxicity of HCQ and CQ.

Case Report: GPA Presenting as Neuropathy

Ann George, MD, Azin Azarfar, MD, Shazia Bég, MD, & Maria Farooq, MD  |  December 16, 2021

Granulomatosis with polyangiitis (GPA), is a type of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) that affects small- to medium-sized vessels.1 It can occur equally in both men and women, with a reported mean age at onset of 55 years.2 The classical presentation of GPA includes upper respiratory tract (i.e., chronic sinusitis, serous otitis and…

New Booklet Offers Tips for Diagnosing Lupus, Images of Presentation on Skin of Color & More Insights

Renée Bacher  |  December 16, 2021

For decades, rheumatologist Cindy Flower, MD, accumulated images of systemic lupus erythematosus (SLE) in her patients, as well as clinical vignettes to use in teaching at Queen Elizabeth Hospital in Bridgetown, Barbados. For decades, she has wanted to do something wide-reaching with these materials, sharing information from her practice and her mentor, the late Prof….

Vax Hesitancy? Myths & Facts for Patients

Susan Bernstein  |  December 16, 2021

Although more than 189,300,000 eligible Americans are fully vaccinated against SARS-CoV-2 as of Oct. 18, 2021, vaccine hesitancy persists.1 The U.S. Centers for Disease Control and Prevention (CDC), citing data from the U.S. Census Bureau’s Household Pulse Survey collected between May 26 and June 7, 2021, reports that in some U.S. counties—particularly in the Southeast…

Vasculitis Guidelines in Focus, Part 4: Polyarteritis Nodosa

Michael Putman, MD  |  September 22, 2021

Jason Springer, MD, MS, served as one of the lead authors of the ACR/VF guidelines for polyarteritis nodosa (PAN), and talks about the recommendations specific to PAN here.

A positron emission tomography (PET) scan shows a 3 cm, hypermetabolic mass adjacent to the stomach.

Case Report: Elevated Inflammatory Markers & a Hypermetabolic Mass

Lisa L. Korn, MD, PhD, Mina L. Xu, MD, & Cristina Brunet, MD  |  December 16, 2021

Consulting rheumatologists often assess patients with atypical clinical presentations for the possibility of an underlying rheumatic disease. Inflammatory syndromes that are not clearly rheumatic in nature can be particularly challenging to diagnose. Here, we share the case of a young woman with a long-standing undiagnosed illness and highly elevated inflammatory markers, and describe the evaluation…

North Carolina Rheumatology Association Looks to the Future

Linda Childers  |  November 4, 2021

With more than 100 members, including rheumatologists, physician assistants and nurse practitioners, the NCRA is a dynamic, member-owned organization.

New Healthcare Price Transparency Requirements Are Complicated & Vary by State

Emily A. Johnson, JD  |  December 16, 2021

Healthcare law is ever changing, particularly with regard to price transparency. Key healthcare leaders and stakeholders have long argued for more stringent price transparency regulations in an effort to increase patient awareness regarding the cost of a hospital item or service prior to receiving the service. Such information is anticipated to enable patients to take…

Considerations for Prescribing Avacopan for ANCA-Associated Vasculitis

Michele B. Kaufman, PharmD, BCGP  |  October 27, 2021

In early October, the FDA approved avacopan to treat anti-neutrophil cytoplasmic antibody associated vasculitis. Here are insights into the treatment’s risks and considerations.

FDA Approves First Interchangeable Biosimilar to Adalimumab, Plus a Combination Drug Approved

Michele B. Kaufman, PharmD, BCGP  |  November 17, 2021

Cyltezo (adalimumab-adbm) may be interchanged for Humira (adalimumab) for all indications, according to an October decison by the FDA. The FDA has also approved a new combination of celecoxib and tramadol for pain management.

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