Autoinflammatory diseases are genetically diverse, but clinically similar, conditions distinct from autoimmune illnesses, such as systemic lupus erythematosus or rheumatoid arthritis. Clinically, they are defined by recurrent episodes of inflammation that follow a characteristic pattern each time they occur. Some have a set length of time during which fever, peritonitis or arthritis manifest. Others are…
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Rheumatology Drugs at a Glance, Part 3: Rheumatoid Arthritis
Over the past few years, biosimilars and other new drugs have been introduced to treat rheumatic illnesses. Some of the conditions we treat have numerous drug options, others have few or only off-label options. This series, “Rheumatology Drugs at a Glance,” provides streamlined information on the administration of biologic, biosimilar and small molecule inhibitor drugs…
Common Characteristics in RA Patients Who Don’t Respond to Biologics
At least 6% of patients who used biologic disease-modifying anti-rheumatic drugs (bDMARDs) suffered refractory disease, according to a recent study based on data from the British Society for Rheumatology Biologics Registry for Rheumatoid Arthritis.1 This observational study evaluated the extent of biologic refractory rheumatoid arthritis (RA). The study defined biologic refractory disease as occurring in…
What to Do with Erosive, Inflammatory Osteoarthritis
CHICAGO—Is erosive, inflammatory osteoarthritis (EOA) a separate condition from osteoarthritis (OA)? Roberta Ramonda, MD, PhD, a rheumatologist at the University of Padova, Italy, spoke at the 2018 ACR/ARHP Annual Meeting on the clinical presentation of EOA and how it differs from OA. EOA is characterized by a frequent aggressive clinical course and occurs most often…
The ACR Has Introduced a New Reproductive Health Guideline Draft
CHICAGO—Reproductive health can be a concern for patients with rheumatic diseases, and practitioners in both disciplines often work closely together. The Reproductive Health in Rheumatic and Musculoskeletal Diseases Guideline, a draft of new clinical recommendations developed by an ACR-convened group for pregnant women, post-menopausal women, lactating women, and women and men trying to conceive or…
Pediatric Rheumatologist Dr. Lynn Punaro Loves a Good Mystery
When Marilynn “Lynn” Punaro, MD, MACR, isn’t working with medical students, seeing patients in the clinic, participating in translational research or performing leadership duties, she’s enjoying a good book—especially a good mystery. This shouldn’t be a surprise. It was mystery that led Dr. Punaro to a career in pediatric rheumatology more than 30 years ago,…
Canakinumab Treatment Effective for Familial Mediterranean Fever
Canakinumab may be a useful first-line treatment for renal transplant recipients with familial Mediterranean fever (FMF), according to recent research. Immunosuppressive drugs can interact with colchicine, the standard first-line treatment for FMF, and increase the incidence of side effects, such as diarrhea and myopathy…
The Latest Autoinflammatory Discoveries & Tips
SAN DIEGO—Since the identification of the autoinflammatory disease, familial Mediterranean fever (FMF), researchers have identified an alphabet soup of other autoinflammatory diseases with genetic underpinnings, from PAPA (pyogenic arthritis with pyoderma gangrenosum and acne) to NIAID (NLRP1-associated autoinflammation with arthritis and dyskeratosis) to TRAPS (TNF receptor-associated periodic syndrome). The torrent of discoveries, brought about largely…
How to Recognize, Diagnose Periodic Fever Syndromes in Adults
A number of autoinflammatory syndromes that result from genetic mutations have been described recently. The vast majority occur in children. However, three periodic fever syndromes are important for rheumatologists who treat adults to know about. The goal of this review is to provide a concise description of each condition, and to help the clinician understand…
Rheumatology Case Report: Monoarticular Arthritis in Pregnancy
Limited data exist on the clinical presentation of Muckle–Wells syndrome (MWS) during pregnancy. The purpose of this case report is to highlight the diagnosis of MWS in a pregnant woman. Many rheumatic diseases affect women of childbearing age, and their management during pregnancy can be challenging. Case A 33-year-old, 18-weeks’ pregnant woman was hospitalized for…
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