Medication-related osteonecrosis of the jaw (MRONJ) is a condition that manifests as exposed, necrotic and non-healing jaw bone in patients who have been treated with bisphosphonates, denosumab, chemotherapeutic agents, anti-angiogenic drugs, tyrosine kinase inhibitors, thalidomide and steroids.1-4 These medications are administered via intravenous, subcutaneous and oral routes to manage osteopenia; osteoporosis; hypercalcemia of malignancy; bone…
Just YouTube it. As a rheumatologist who sees many patients with granulomatosis with polyangiitis (GPA), I have spent a significant portion of my life talking to people about neti pots. Originally, the neti pot was part of the Ayurvedic tradition. Neti pots were used to flush the sinuses with water, milk and ghee, or to…
An ACR COVID-19 Vaccine task force examined vaccine data and literature to evaluate COVID-19 vaccine safety, efficacy and interaction with medications for patients with rheumatic and musculoskeletal diseases, and to craft a living guidance document for members.
It is with great sadness that we report the passing of a giant of international rheumatology, Professor Shunle Chen. He was a friend, colleague, collaborator, visionary leader and inspiration to many rheumatologists in China and the world. Moreover, despite his international stature, he was a warm friend and nurturing mentor to all those who had…
The occurrence of opportunistic infections is an established complication in patients diagnosed with systemic lupus erythematosus (SLE). The foremost challenge in such circumstances is differentiating between an exacerbation or progression of SLE, and the effects of the infection itself.1 Toxoplasma gondii is a ubiquitous parasite that often causes an asymptomatic infection in healthy, immunocompetent adults….
At the helm of the Collaborative Initiatives Special Committee (COIN), Rosalind Ramsey-Goldman, MD, DrPH, will oversee projects to tackle disparities within rheumatologic care, improve the inclusiveness of ACR initiatives, advance professional development in rheumatology topics and more.
In this study, Fatima et al. analyzed how well the Health Assessment Questionnaire (HAQ) disability index predicts future all-cause mortality in patients with early RA (i.e., with a symptom duration of less than one year). A total of 1,724 patients with early RA were included. The researchers found that a higher HAQ score and Disease Activity Score at one year were significantly associated with all-cause mortality.
From understanding terminology, to collecting relevant data, to shaping a culture of awareness and inclusivity, clinicians can take many steps to improve the healthcare experience and outcomes for LGBTQ+ patients.
ACR CONVERGENCE 2020—With the inevitable decline in organ function that comes with age, and the likelihood that older patients (i.e., generally defined as older than 60 or 70, depending on the study) are on more than one medication due to multiple comorbidities, therapeutic drug treatment for older patients requires persistent vigilance and know-how, two experts…
ACR CONVERGENCE 2020—Myalgic encephalomyelitis/chronic fatigue syndrome, postural orthostatic tachycardia syndrome (POTS) and mast cell activation syndrome were the topics of the day in the ever-popular Curbside Consults session in November 2020. POTS An anxious woman with a chronic headache and constant myofascial pain in the neck and upper back, assorted gastrointestinal symptoms, chronic severe fatigue,…
ACR CONVERGENCE 2020—Sjögren’s syndrome requires care from several specialists, and presenters at the Sjögren’s Syndrome: Dental and Ocular Perspectives session shared diagnostic and treatment pearls from their respective specialties. Rebecca Manno, MD, MHS, of the Comprehensive Arthritis and Rheumatology Center of the U.S. Virgin Islands moderated the session. Oral Health Dry mouth is famously associated…
ACR CONVERGENCE 2020—Research has shown time and again the benefits and low risk of physical activity for people with rheumatic diseases, but only a third or less of patients meet guidelines for this activity, Patricia Katz, PhD, professor of medicine and health policy at the University of California, San Francisco, said in the ARP Distinguished…
Experts at ACR Convergence 2020 addressed how diet & the body’s microbiome affect chronic diseases.
Experts discuss the diagnosis and treatment of myositis-related cardiovascular disease.
ACR CONVERGENCE 2020—In recent years, a pathophysiological role for the interleukin (IL) 17/IL-23 axis in the development of psoriasis, enthesitis and inflammatory arthritis has been investigated in both rodent and human models. Clinical trials have demonstrated differential benefits for skin disease and joint disease in patients with psoriatic arthritis, axial spondyloarthritis (axSpA) and ankylosing spondylitis…
ACR CONVERGENCE 2020—In a year like no other, the 2020 virtual ACR Convergence was a meeting like no other. Nonetheless, the meeting introduced a healthy mix of clinical insights and take-home pearls, according to panelists in the meeting’s closing session, Bright Future: Discovery & Growth. In this session, panelists discussed some of the biggest news…
Rheumatologists are in the unique position of diagnosing and treating rare auto-inflammatory and autoimmune diseases. Although systemic lupus erythematosus (SLE) often has textbook presentations, it is a heterogeneous condition with a wide variety of disease manifestations. In 2019, the European League Against Rheumatism and the ACR introduced new classification criteria to help diagnose this condition.1…
A 24-year-old woman presented to our rheumatology office in 2017 with a blotchy purple rash on her arms and legs. She reported no history of miscarriage or blood clots. The rash pattern was concerning for livedo reticularis or livedo racemosa, and she was noted to have an anti-nuclear antibody (ANA) titer of 1:160 with a…
We report on a 77-year-old patient who was diagnosed with giant cell arteritis (GCA) on histopathology of the submandibular gland and eventually went on to develop classic signs and symptoms of GCA. This observation highlights neck swelling as a rare initial presentation of GCA. Case Presentation A 77-year-old previously healthy man presented to his primary…
Rheumatologists play a critical role in healthcare delivery, especially with an aging U.S. population. Despite this, a workforce shortage exists—one that is projected to worsen.1,2 The ACR CareerConnection service is free to job seekers searching for opportunities in the field of rheumatology.3 This study examines currently available rheumatology employment opportunities across the U.S. The ACR…
Younger individuals (<50 years) have a stronger genetic component in their fibromyalgia score than older individuals (>60 years), according to a study published in Arthritis & Rheumatology.1 Studies that suggest a strong familial component to fibromyalgia have often focused on individuals with primary fibromyalgia who did not have another accompanying disorder, the study authors report….
Dermatomyositis (DM) is an idiopathic inflammatory myopathy involving proximal muscle weakness and skin rash. An associated increased risk of malignancy is well established.1 The most frequent malignancies are related to the ovary, endometrium, lung, gastrointestinal tract, prostate, breast and lymphatics.2 On rare occasions, DM has been reported with certain types of non-Hodgkin’s lymphoma, specifically cutaneous…
Research from Ellingwood et al. examines how often patients diagnosed with early RA experience episodic joint inflammation and describes characteristics that may result in RA development.
In phase 3 clinical trial, upadacitnib proved superior to placebo and adalimumab in improving the signs and symptoms of RA in patients on stable background methotrexate.
Despite revolutionary advances in pharmacologic treatments for many rheumatic conditions in recent years, some patients still fail to reach a desired state of living with their disease, notes R. Swamy Venuturupalli, MD, FACR, a clinician and researcher in rheumatology, as well as the founder and director of Attune Health, a Beverly Hills, Calif.-based company that…
NEW YORK (Reuters Health)—Denosumab showed biological efficacy against osteolysis after total hip replacement in a proof-of-concept trial. “Denosumab is already a well-established licensed drug for the indications of osteoporosis and metastatic bone lesions in cancer, and has been shown to be effective in reducing erosions in inflammatory arthritis,” Dr. Mark J.M. Wilkinson of the University…
New state legislatures face many continuing issues, including budget shortfalls, vaccine distribution problems and strained healthcare infrastructure. However, opportunities exist for significant policy wins for rheumatology, particularly on the issues of step therapy reform, telemedicine and copay accumulators.
Leigh Callahan, PhD, Now President Elect of United States Bone & Joint Initiative After 20 years of involvement with the U.S. Bone and Joint Initiative (USBJI), Leigh F. Callahan, PhD, Mary Link Briggs Distinguished Professor of Medicine, associate director, Thurston Arthritis Research Center, and director, Osteoarthritis Action Alliance at the University of North Carolina at…
Updated 12/20/2022 to add a video link to the episode. Fire truck. Those are among the favorite words of Jay Mehta, MD, a pediatric rheumatologist and rheumatology fellowship director at Children’s Hospital of Philadelphia. When he was in high school, Jay appeared on the TV game show, Wheel of Fortune, during My Favorite Teacher week….
In a post-marketing safety study, tofacitinib did not prove non-inferior to tumor necrosis factor inhibitors when evaluated for its long-term effects on heart disease, malignancies and serious infections in RA patients.
Sapart et al. suggest a combination of methotrexate and biologic disease-modifying anti-rheumatic drugs as induction therapy for patients with early RA may lead to long-term remission.