ACR guidelines include recommendations for the management of patients with particular conditions or diseases. Guidelines are developed using a systematic process and are based on available evidence and the clinical experience and expertise of rheumatologists and other interested stakeholders. In the January issue of Arthritis & Rheumatology, Arthritis Care & Research and the Journal of…
Zoster Reactivation Risk in Patients Treated with Cyclophosphamide
Varicella-zoster-virus (VZV) reactivation, which can cause patients to develop herpes zoster (i.e., shingles), occurs more frequently in patients with systemic vasculitis and systemic lupus erythematosus (SLE) who have received intravenous cyclophosphamide than in otherwise healthy adults, according to a retrospective study published in The Journal of Rheumatology by researchers in France.1 The study also shows…
When Immunodeficiency & Autoimmunity Coexist
When a patient has both primary immune deficiency and autoimmune disease, the combination can lead to life-threatening complications. Here are some insights into the challenges of diagnosing and treating this rare subset of patients…
Study Finds Chronic Fatigue Clues in Overactive Immune Response
LONDON (Reuters)—Scientists exploring what may trigger chronic fatigue syndrome (CFS) have found clues in the way some people’s immune systems respond to interferon alpha.1 The researchers used the drug to create a model of the disease in people without CFS but with hepatitis C. Many patients who receive interferon alpha experience extreme fatigue during treatment,…
The Streets of Heaven: Remembering Nadia Morgan, MBBS
Editor’s notes: A memorial service for Nadia is being planned for Jan. 16, 2019, from 4:30-6:00 p.m. at Johns Hopkins Bayview Asthma and Allergy Center, Richard A. Grossi Auditorium, 5301 Hopkins Bayview Circle, Baltimore. To honor her life and the impact she made on the Division of Rheumatology, Johns Hopkins is establishing the Dr. Nadia D….
Case Report: A Behçet’s Patient Develops Cerebral Venous Sinus Thrombi
A 39-year-old woman presented at the emergency department with three weeks of progressive, constant and pulsatile right-sided headache. She said her headache was worse in the morning and when she would bend forward. She reported associated nausea and vomiting. On initial assessment, she did not have any focal neurological deficits. Her medical history was significant for…
Initial Sjögren’s Manifestations Can Go Beyond Dry Eyes & Mouth
Primary Sjögren’s syndrome is a systemic autoimmune condition noted for findings of xerostomia, keratoconjunctivitis sicca and focal lymphocyte infiltrate in salivary glands.1 In the initial publications regarding keratoconjunctivitis sicca, Henrik Sjögren, a Swedish ophthalmologist, described a group of 19 women with dry eyes, some of whom had other organ dryness and inflammatory infiltrates.2,3 The syndrome…
AAV Remission Study: Does Rituximab or Azathioprine Work Best?
Researchers sought to identify predictors of patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) who took rituximab for maintenance had a better sustained remission rate through 60 months than those taking azathioprine, according to the latest results from the maintenance of remission using rituximab in systemic ANCA-associated vasculitis (MAINRITSAN) trial, a prospective, randomized trial…
Rituximab Maintenance Study: Is Fixed-Schedule or Tailored Dosing Best?
Rheumatologists prescribe rituximab for induction and maintenance treatment for anti-neutrophil cytoplasm antibody (ANCA) associated vasculitides (AAV). Maintenance treatment typically employs fixed-schedule dosing, but in the recent maintenance of remission using rituximab in systemic ANCA-associated vasculitis II (MAINRITSAN2) trial, researchers from the French Vasculitis Study Group examined whether individually tailored maintenance dosing might work better. “The…
VA Study Tracks Biologics Usage, Finds Dramatic Patient-Age Difference
Patients under the care of the U.S. Veterans Affairs who were older, non-white and had more comorbidities were less frequently given biologic initiation therapy to treat their rheumatoid arthritis (RA), according to a recent study. Researchers sought to identify predictors of greater use of biologic therapies, as well as factors associated with persistent use of…
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