Our patient was a 33-year-old, 5’2″ Asian woman with a past medical history of systemic lupus erythematosus (SLE). The diagnosis was based on serologies positive for anti-nuclear antibodies (ANAs), as well as antibodies to Sm, RNP and SSA. Her illness included neuropsychiatric and cutaneous involvement. She also had a diagnosis of Hashimoto’s thyroiditis. She presented…
Ethan Craig was not pleased. As a reader of this column, you know that Dr. Craig is an assistant professor of clinical medicine in the Division of Rheumatology at the University of Pennsylvania and an associate editor of The Rheumatologist. On this particular morning, however, he was the father of a 5-year-old who woke up…
Camelot allegedly existed once upon a time in South Wales. The name was evoked again in the 1960s, but perhaps it is also applicable to the character of rheumatology in the halcyon days of the 1970s and 80s. That’s not to belittle the world we now live in, with so many treatment options for our…
Scleroderma renal crisis is a true medical emergency in rheumatology, one that requires prompt diagnosis and treatment. Here, we review the historic introduction of the angiotensin-converting enzyme inhibitors in this context, and highlight management and key questions moving forward. Background Awareness of renal disease in scleroderma dates back many years. The revered physician William Osler…
The ARP’s revised Fundamentals of Rheumatology Course (FRC) will soon be released on the ACR website. The course was revamped by interdisciplinary rheumatology professionals emphasizing an inter-professional approach to patient care. It is intended to reach a broad audience, including nurses, occupational therapists, pharmacists, physical therapists, psychologists and social workers to name a few. However,…
The use of an interleukin (IL) 17A inhibitor resulted in gut microbial dysbiosis and features of subclinical intestinal inflammation in a subgroup of psoriatic arthritis (PsA) and spondyloarthritis (SpA) patients, according to a multidisciplinary, collaborative study across several institutions published in Arthritis & Rheumatology.1 Understanding the downstream effects of these perturbations is an important step…
A team of healthcare practitioners and researchers, spearheaded by the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the ACR, has developed updated evidence-based clinical practice guidelines for the prevention, diagnosis and treatment of Lyme disease. The 2020 guidelines cover a wide variety of Lyme disease manifestations, including Lyme arthritis. Linda…
On Friday, Nov. 20, 2020, the U.S. Department of Health and Human Services (HHS) published a Notice through the Federal Register announcing the withdrawal of guidance documents that established the Unapproved Drugs Initiative. This Notice brings to an end a 14-year-old program that has been blamed for significantly contributing to the rising cost of some…
The Medical University of South Carolina (MUSC), Charleston, has established a $1 million endowed chair to support world-class autoimmune research and scholarship. The Silver chair is a tribute to the distinguished career and contributions of former Rheumatology & Immunology Division Director Richard M. Silver, MD, MACR, distinguished university professor and active division member. The inaugural holder…
COVID-19 is responsible for many things, including placing public attention on clinical trials and the worldwide race to approve a vaccine. The words rushed to market usually strike fear in the minds and hearts of clinical research coordinators. Many have seen investigational products with aggressive timelines withdrawn mid-study or during late-stage trials. This year, we…
Hydralazine has been in use as a treatment for hypertension, most notably in heart failure patients, since 1951.1 The drug is a known cause of autoimmune disease, most specifically hydralazine-induced lupus. Hydralazine-induced lupus occurs in 7–13% of those taking the medication.2-4 It often presents with constitutional symptoms, arthritis/arthralgias, cutaneous lesions, serositis, myalgias and/or hepatomegaly. Features…
Renal arteriosclerosis is common in lupus patients with nephritis and occurs two decades earlier than it does in people without lupus nephritis (LN), report investigators in a study that examined the prevalence of renal arteriosclerosis in LN patients compared with healthy controls.1 The finding suggests that renal arteriosclerosis could be used as a biomarker for…
Two experts discussed ongoing difficulties in diagnosing autoinflammatory disease, & promising new studies that point to possible genetic roots of autoinflammatory disease.
In the late-breaking abstract session at ACR Convergence 2020, drug research for a variety of indications is reviewed.
Three experts discuss the ins and outs of using magnetic resonance imaging to diagnose axial spondyloarthritis, particularly in individuals who lack clear clinical symptoms indicative of disease.
Recent breakthroughs in stem cell-based treatments for arthritis may help delay joint replacement for some patients. Farshid Guilak, PhD, described the methods for creating bioartificial cartilage, its implications for inflammation, disease flare and more.
Experts discussed the latest knowledge on B cell disease processes, and what it might mean for future B cell depletion therapies.
Speakers at ACR Convergence 2020 offered a range of tips to navigate the competitive environment of research funding, emphasizing the importance of collaboration, diversifying funding sources and staying determined in the face of disappointment.
NIH investigators describe key features and genetic causes of Mendelian interferonopathies, & treatment approaches that may indicate the efficacy of IFN inhibition.
Experts discussed the heavy toll the pandemic has taken on patients and clinicians, with many patients in need of mental health support and others in need of rehabilitation.
Drug-induced lupus erythematosus and ANCA-associated vasculitis (AAV) are both autoimmune conditions associated with the use of hydralazine, a commonly prescribed drug for hypertension and congestive heart failure. Although the pathogenesis is unknown, it is believed that hydralazine alters neutrophil and lymphocyte function and promotes exposure of antigens, leading to the development of anti-neutrophil antibodies (ANCA)…
In a controlled, large-cohort, longitudinal study from Canada, Atiquazzaman et al. found that use of non-steroidal anti-inflammatory drugs (NSAIDs) substantially contributes to increased cardiovascular disease risk among people with osteoarthritis (OA).1 This is the first study to evaluate the mediating role that NSAIDs play in the association between OA and cardiovascular disease (CVD), and the…
To say it has been an interesting (the science and the memes), tumultuous (the politics) and heartbreaking (the pandemic and social injustice) year is an understatement. There have been moments of grace and inspiration that we hope have kept everyone going. As we look to 2021, we take lessons from our experiences in 2020. Washington,…
Between April and December 2020, many eligible healthcare providers received or applied for payments from the $175 billion Coronavirus Aid, Relief and Economic Security (CARES) Act Provider Relief Fund (PRF) through the U.S. Department of Health & Human Services (HHS). On Dec.27, 2020, the Consolidated Appropriations Act, 2021 (the Appropriations Act) was signed into law,…
Every Christmas Eve, Angus Worthing, MD, FACP, FACR, his wife, Margaret, and two young children, engage in a sing-off over the phone, competing against a professional quartet comprising his best friend, Doug, Doug’s sister and their parents. Dr. Worthing, a partner at Arthritis & Rheumatism Associates in Washington, D.C., demonstrated his musical talent as a…
Results from two recent phase 3 clinical trials show risankizumab significantly improved the skin and joint symptoms of patients with psoriatic arthritis compared with placebo.
Hydroxychloroquine may not increase the risk of cardiotoxicity in RA patients, according to findings presented during ACR Convergence 2020.