WASHINGTON, D.C.—Experts speaking at the 2016 ACR/ARHP Annual Meeting session, Update on Small-Vessel Vasculitis, offered insight into the latest approaches to the diagnosis and treatment of diseases involving the inflammation of blood vessels. “Vasculitis is an immune-mediated process. White blood cells invade the vessel wall, causing inflammation throughout the vessel wall,” said Jason M. Springer,…
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Gout Treatments Effective If Patients Maintain Lifelong Adherence to Therapies
Although gout is one of the most effectively treated of all rheumatic diseases, it is among the worst-managed diseases long term, as shown by many studies. “Treatments are excellent, yet are dramatically under-utilized,” says Theodore Fields, MD, FACP, rheumatologist, Hospital for Special Surgery (HSS), New York. “This is because some gout patients feel better between…
Tacrolimus Use for Lupus Nephritis Raises Debate over Role in North American Population
The following summary regarding use of tacrolimus (TAC) in lupus nephritis highlights a number of debatable points. Although the role of TAC in lupus nephritis remains unproved for North American populations, it might be an excellent option in some clinical situations. These situations include lupus flare during pregnancy and also for lupus nephritis when the…
Why Rheumatologists Should Ask Patients About Drug Use
SAN FRANCISCO—“We’ve known for a long time that prescription medications and illicit drugs can both mimic and actually induce the autoimmune syndromes treated by rheumatologists,” Jonathan Graf, MD, professor of medicine at the University of California–San Francisco in the Division of Rheumatology at Zuckerberg San Francisco General Hospital (SFGH), said at the California Rheumatology Alliance…
When Rheumatologists Are a Patient’s Second or Third Choice for Medical Opinion
Outside Exam Room No. 5, the chart rack was empty, so I assumed my new consult was late. Just in case, I looked back over my shoulder as I passed by the partially open door and glimpsed the lower half of a woman holding a three-ringed binder on her lap. I squinted and took a…
Treatment Challenges, Uncertainty Abound with IgA Vasculitis
CHICAGO—Diagnosing and treating IgA vasculitis—leukocytoclastic vasculitis involving deposits of IgA1 deposits on the walls of small vessels—is rife with uncertainties, outright unknowns and treatment challenges, an expert on the disease said at the ACR’s 2016 State-of-the-Art Clinical Symposium. Alexandra Villa-Forte, MD, MPH, staff physician at Cleveland Clinic’s Center for Vasculitis Care and Research, said IgA…
Prepare Now to Survive MACRA
The year 2015 brought an end to the much-maligned Sustainable Growth Rate (SGR), sometimes known as the “doc fix.” The SGR established limits on Medicare reimbursement for physicians, and each year, physicians and those lobbying on their behalf were forced to stave off drastic cuts to their payments. “The SGR was Congress’s attempt to control…
Early Consults, Timely Patient Histories Aid Rheumatologists Treating Patients in the ICU
CHICAGO—When it comes to treating patients with rheumatic diseases who are in the intensive care unit (ICU), there are so many complications and considerations that few rules exist as a guide. But Paul Dellaripa, MD, associate professor at Harvard Medical School, said at the ACR’s State-of-the-Art Clinical Symposium that there are basic steps a rheumatologist…
Monitoring Doctors Cuts Opioid Prescriptions
(Reuters Health)—Doctors in states that track painkiller prescriptions were nearly one-third less likely to offer patients dangerously addicting opioids, a new study found. The launch of drug-monitoring programs in 24 states led to an immediate 30 percent drop in prescriptions for Schedule II opioids, the most addictive, in patients with pain complaints, the study showed….
Opinion: Adhering to Standards of Care Helps Manage Risk
Medicare and other third-party payers have started predicating reimbursement on adherence to standards of care. Post hoc chart reviews have resulted in substantial take-backs for failure to adhere to those values in cardiology, pulmonology and expanding to other areas. Outpatient medicine is also being subjected to such scrutiny. The question of standards and who sets…
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