Pegloticase is a new alternative therapy for patients with severe, refractory gout unresponsive to other urate-lowering agents. The goal of this therapy is to reduce disease burden, tophi size and frequency of flares and to improve quality of life when other treatments have failed. Persistent lowering of plasma uric acid (PUA) to less than 6…
Ethical issues that arise in the average rheumatology practice and in clinical research are often straightforward. The AMA Code of Medical Ethics and the Office Practice and Procedures Manual offer useful information.1 In research, the Protocol and Investigators Agreement spells out who you can enroll and how the trial must be conducted. But still—even when…
When Abby Paterson, PhD, started her doctoral work in product design and technology at Loughborough University in the United Kingdom in 2009, she says 3D printing was little known by clinicians or the general public. Now, the technology is seemingly everywhere. For Dr. Paterson, the advancing science has led to a promising project focused on…
Rheumatoid arthritis (RA) is rarely associated with renal manifestations, but secondary amyloidosis due to chronic inflammation is reported to be the etiology of renal dysfunction in many cases of RA.1,2 The discovery of biologic therapy, with TNF-alpha inhibitors in particular, made a huge difference in the disease course and prognosis of RA patients. However, TNF-alpha…
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…
Never underestimate the power of dreams and the influence of the human spirit. … The potential for greatness lives within each of us. —Wilma Rudolph, U.S. Olympic sprinter & winner of three gold medals From Spinnaker to Wheelchair It can be an unnerving experience when the patient you are about to see is young and…
Foot osteoarthritis (OA) of the first metatarsophalangeal (MTP) joint is thought to have biomechanical factors, but its treatments have not been comprehensively tested in clinical trials. In the first study to explore the efficacy of mechanical interventions, researchers compared the effectiveness of foot orthoses and rocker-sole footwear in reducing pain. Both interventions were effective, but the foot orthoses group wore the intervention for significantly more hours than the footwear group…
A recent small-scale study showed that patients who received platelet-rich plasma therapy for tendon healing experienced clinically important improvements in pain and disability compared with placebo. Additionally, MRI showed that some participants had improvement in the pathoanatomy of the rotator cuff six months after treatment…
SAN FRANCISCO—A broadening of the medical community’s horizons in how pain is regarded and treated in older adults, including those with osteoarthritis and other rheumatic diseases, is sorely needed, a researcher said at the 2015 ACR/ARHP Annual Meeting. Incidence Studies show that a large percentage of older adults each year see physicians for such issues…
The boy who could not walk: S.L. is a previously healthy 10-year-old boy who has not walked for three months. Physical examination reveals swollen wrists, knees, ankles and several toes. There is reduced hip range of motion and flexion contractures of both knees. He can stand with assistance, but is unable to take a single…