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The Rheumatologist: January 2023

To Treat or Not to Treat? The Great Debate on Treatment of Subclinical Rheumatoid Arthritis

Jason Liebowitz, MD, FACR  |  December 6, 2022

PHILADELPHIA—One of the great advancements in the field of rheumatology in recent years has been the increased understanding of various stages of disease in rheumatoid arthritis (RA), including what is termed subclinical rheumatoid arthritis. However, questions remain regarding whether to treat patients with subclinical disease and whether treatment of these patients has implications in preventing…

Janusian Thinking in Rheumatology

Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS  |  January 17, 2023

Happy New Year, readers of The Rheumatologist! As the incoming editor, I want to welcome you back in this new year and hope that you’ll stick around, month after month, as we journey together through 2023. As the year progresses, you may notice some departures from what we have previously done, but I also wish…

Patients Fight Against Dark Days & Find Ways to Cope

Thomas R. Collins  |  December 2, 2022

PHILADELPHIA—Amy Gietzen started feeling the pain when she was 19. Her forearms, elbows, wrists and fingers were constantly swollen and sensitive. Six months later, she saw a doctor and was diagnosed with systemic diffuse scleroderma—a particularly hard-to-manage rheumatic disease with wide-ranging effects. Ms. Gietzen, who spoke at ACR Convergence 2022 and is a public speaker,…

Psoriatic Arthritis: Advances in Therapeutics, Imaging & More Presented at ACR Convergence 2022

Walter P. Maksymowych, MB ChB, FACP, FRCP(C)  |  December 1, 2022

PHILADELPHIA—Selecting my top 10 picks for abstracts in psoriatic arthritis (PsA) at the ACR Convergence 2022 meeting was not easy because there was a great deal to review and learn from the 139 abstracts submitted to the meeting. I focused first and foremost on advances in therapeutics that encompassed both new and approved therapeutics, novel…

Lost and found

A Look Back at the First Use of Cortisone in Rheumatoid Arthritis

Ruth Jessen Hickman, MD  |  January 17, 2023

In 1949, the first description of patients with rheumatoid arthritis (RA) given cortisone sent shockwaves through the medical community, quickly capturing the public imagination as well. The paradigm-shifting report paved the way for the use of cortisone and related drugs in RA and many other medical conditions.1 The following is a discussion of some of…

ACR Image Competition 2022 Results, Part 2

Jonathan T. Cheah, MBBS  |  January 17, 2023

Tumoral Calcinosis in Systemic Sclerosis Plain radiograph and computed tomography images depict calcinosis in the region of the right shoulder, left elbow and cervical spine of a 71-year-old woman with a 20-year history of systemic sclerosis. Manifestations include high-titer anti-Scl-70 antibody, diffuse skin involvement, Raynaud’s syndrome, acro-osteolysis, gastroesophageal reflux disease, interstitial lung disease and complete…

Rheumatology Medications with Limited Safety Data: How Do We Use Them in Pregnant Patients?

Samantha C. Shapiro, MD  |  December 6, 2022

How does a rheumatologist treat a pregnant woman when many medications are not approved for pregnancy or safety data are limited?

Contraception, Abortion & Rheumatic Disease after Dobbs

Samantha C. Shapiro, MD  |  December 12, 2022

PHILADELPHIA—As rheumatologists, we care for patients who may or may not want to become pregnant. We aren’t obstetricians or gynecologists, but several of the drugs we prescribe for active rheumatic disease can negatively affect pregnancy outcomes. It’s imperative we understand how to effectively counsel our patients with rheumatic disease on the risks and benefits of…

Highlights from the ACR Review Course 2022

Samantha C. Shapiro, MD  |  December 6, 2022

PHILADELPHIA—At ACR Convergence 2022, the much-anticipated ACR Review Course featured talks from eight experts. Topics reflected the heterogeneity of our field and included Sjögren’s disease, spondyloarthritis (SpA), osteoarthritis (OA), paraneoplastic rheumatic syndromes, metabolic bone disease, statin myopathy, Raynaud’s phenomenon and autoinflammatory syndrome. Here, I share highlights from this comprehensive, six-hour session. Sjögren’s Disease Sara S….

Dr. Michelle Petri: A Guiding Light for Patients with Lupus

Jason Liebowitz, MD, FACR  |  January 17, 2023

Systemic lupus erythematosus (SLE) affects a substantial number of patients worldwide, with an estimated prevalence in North America of 241 per 100,000 people.1 The morbidity and mortality associated with the condition can be significant, and thus research on this disease continues to be of utmost importance. The story of one of the world’s leading experts…

FDA Approves Ustekinumab for Children with PsA

Michele B. Kaufman, PharmD, BCGP  |  November 7, 2022

After examining study data from pediatric patients with both psoriasis and psoriatic arthritis (PsA), the FDA approved ustekinumab as a treatment for patients aged 6–17 years old with PsA.

TNF Inhibitors Associated with Neurological Adverse Events

Michele B. Kaufman, PharmD, BCGP  |  November 7, 2022

A study examined the association between TNF inhibitors and neurological demyelinating adverse events in patients with rheumatoid arthritis and spondyloarthritis using cohort data from five Nordic countries. Researchers showed that patients with SpA were more likely to experience adverse events than patients with RA.

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