SAN DIEGO—Should patients with rheumatic diseases switch from a biologic to its biosimilar? At the 2017 ACR/ARHP Annual Meeting’s Great Debate, held Nov. 5, two rheumatologists argued whether to switch or stay put based on safety, efficacy and potential cost savings. First to the podium to make the case for switching, Jonathan Kay, MD, tweaked…
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Autoreactive Germinal Centers: A Single Autoreactive B Cell Clone Can Drive Autoimmunity
A study in mice provides insight into the maturation of the self-reactive B cell response, contextualizing the epitope spreading observed in autoimmune disease. Researchers found that clonal expansion of wild type B cells in autoreactive germinal centers appeared to be at the heart of epitope spreading and the consequent autoimmune response…
Reassuring Data on Cancer Risk with Contemporary RA Drugs
NEW YORK (Reuters Health)—A large Swedish study1 provides reassuring data on the risk of cancer in patients with rheumatoid arthritis (RA) treated with tumor necrosis factor (TNF) inhibitors or with tocilizumab, abatacept or rituximab. Overall, the risk of malignant neoplasms did not differ between patients treated with a first anti-TNF drug; a second anti-TNF drug; tocilizumab,…
Rheumatoid Arthritis Treatments Show Mixed Results
MADRID—The anti-IL6 “nanobody,” vobarilizumab, produced mixed results when used with methotrexate (MTX) and compared with MTX and placebo, according to results of a 24-week, double-blind Phase 2b study of patients with rheumatoid arthritis (RA), which were presented in an abstract session at the Annual European Congress of Rheumatology (EULAR). The drug missed its primary endpoint…
Hemoptysis in a Young Indian Male
A 22-year-old Indian male presented to the emergency department with hemoptysis. A month prior, he had presented to an urgent care center complaining of cough with occasional episodes of blood-tinged sputum in the morning. He was diagnosed with community-acquired pneumonia based on a chest X-ray without laboratory testing and was prescribed levofloxacin. A few days…
Fellows’ Forum Case Report: Progressive Multifocal Leukoencephalopathy and RA
Rheumatoid arthritis (RA) is a systemic autoimmune disease associated with erosive destruction of diarthrodial joints. Patients who are seropositive are more prone to developing extra-articular manifestations, such as rheumatoid lung, rheumatoid nodules and others. With the development of disease-modifying anti-rheumatic drugs (DMARDs), the incidence and severity of these extra-articular manifestations has declined. Below, we describe…
Autoantibodies in Autoimmune Myopathy
In recent years, scientists and clinicians have learned a great deal about autoantibodies occurring in idiopathic inflammatory myopathies (IIMs). These new discoveries have reshaped our understanding of distinct clinical phenotypes in IIMs. Scientists continue to learn more about how these autoantibodies shape pathophysiology, diagnosis, disease monitoring, prognosis and optimum treatment. Moving forward, these autoantibodies will…
Lymphoma Risk in RA Patients Remains Steady
Patients with a diagnosis of rheumatoid arthritis (RA) experience on average double the risk of developing malignant lymphoma when compared with the general population. With the major changes in RA treatment taking place over the past decade, has there been a reduction in the risk of lymphoma in this population? Researchers from the Karolinska Institute…
Fellows’ Forum Case Report: Hemophagocytic Lymphohistiocytosis
The patient was a 48-year-old woman who saw her primary care physician for a flu-like illness three months prior to admission. Her symptoms initially improved, but recurred one month later; she was treated symptomatically, and again symptoms resolved. Two months later, she presented to an outside facility’s emergency department with fever to 103ºF, with associated…
2 Biosimilars Make Their Way Toward the European Market
Two biosimilar treatments, Rixathon and Imraldi, are moving closer to market release in Europe for the treatment of rheumatic and other diseases…
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