For patients with rheumatoid arthritis (RA) who respond to subcutaneous tocilizumab, discontinuing methotrexate may be an option and offer an alternative to patients who cannot tolerate or prefer not to take methotrexate. “This is one of the first studies showing that methotrexate may be discontinued in a cohort of patients with a biologic agent without…
Palindromic rheumatism (PR) was first described in 1944 as “unique in its nature of recurrent, transient episodes of excruciatingly painful inflammation of articular and periarticular tissues, followed by periods without symptoms.”1 Unfortunately, it is becoming evident this entity is more frequent than we thought.2 PR is easily ignored or misdiagnosed due to its character (i.e.,…
Immune checkpoint inhibitors (ICIs) are increasingly used to treat a variety of malignancies, leading to better cancer treatment outcomes and patient survival. However, the emergence of autoimmunity has been a major adverse event resulting from ICI use. Below, we describe a patient who experienced a flare of preexisting psoriasis and new-onset severe psoriatic arthritis after…
Systemic lupus erythematosus (SLE) is a heterogeneous, autoimmune, inflammatory, connective tissue disease affecting multiple organs. Neither central nervous system nor peripheral nervous systems are spared. The neurologic system is involved in a wide range of 10–80% of patients with SLE. Peripheral neuropathy, such as Guillain-Barré syndrome (GBS) and its variants, can occur in neurologic complications…
Uveitis is an inflammation of the uvea, which comprises the iris, ciliary body and choroid. Uveitis can lead to ocular damage and complete visual loss. Noninfectious etiologies for uveitis are the most common in the U.S.1 The estimated incidence of uveitis ranges from 25–52 per 100,000 in adults and five per 100,000 in children. The…
NEW YORK (Reuters Health)—Heredity plays a substantially larger role than diet in determining serum urate levels, according to new findings in BMJ. Nearly 25% of the variation in serum urate is attributable to common genetic variants, while dietary pattern explained less than 1%, Dr. Tanya J. Major of the University of Otago in Dunedin, New…
AMSTERDAM—Just how seldom prednisone is successful at inducing remission in giant cell arteritis (GCA), despite such a long history of use for the disease, is one of the many lessons to emerge from the data in the GiACTA trial, said the principal investigator of the trial, which is the largest ever in GCA and is…
As a first-year internal medicine resident, I find myself consulting rheumatologists for just about every mystery patient in our hospital. Like many residents, I was initially intimidated by the complexity of this elusive field. At first glance, diagnosis and management seem completely inaccessible to a first-year resident. But several rheumatology consults later, I can confidently…
Save the date for the 2018 ACR/ARHP Annual Meeting, Oct. 19–24 in Chicago. Connect with your colleagues for an unmatched educational experience featuring exceptional sessions by leading rheumatology experts. The ACR/ARHP Annual Meeting is your gateway to global rheumatology education. With more than 450 sessions—including The Great Debate—the meeting provides boundless opportunities for professional development,…
Multiple studies show that hydroxychloroquine (HCQ) has many benefits in systemic lupus erythematosus (SLE), including cardiovascular benefits, such as reducing coronary artery and thrombosis risks. HCQ can prevent disease flares, including in renal and central nervous system lupus, and is the only drug shown to prolong survival in lupus. However, guidelines released in 2016 by…