Elderly patients have unique requirements with regard to treatment for pain, rheumatic disease and other ailments. Collaboration between rheumatologists, geriatricians and primary care physicians is essential to avoid unnecessary interventions and improve care for this patient population…
CHICAGO—Leonard H. Calabrese, DO, professor of medicine at Cleveland Clinic in Ohio, presented on emerging concepts of viral infections and rheumatic disease at the ACR’s State-of-the-Art Clinical Symposium in April. “We are at a pivotal point in rheumatology in understanding the relationship between viruses and rheumatic disease,” began Dr. Calabrese. “It’s a very exciting time.” Dr. Calabrese…
First Appearances I watched the old man, his back painfully bent, shuffle toward the scale. A blocky rigidity draped over him. His feet seemed stuck to the floor. His head hung heavily over his chest. Observing him from the end of the hallway, instead of a face, I saw only a mound of shaggy, matted…
NEW YORK (Reuters Health)—In patients with rheumatoid arthritis (RA), disease-activity-guided dose reduction of a tumor necrosis factor inhibitor (TNFi) is safe and effective in the long-term and leads to a large reduction in TNFi use, according to three-year data from the DRESS study. Implementation of this strategy would “vastly improve the cost-effective use of TNFi,” conclude Dr….
When she was in elementary school, Sandra Pagnussat, MD, began experiencing unrelenting pain and stiffness, first in her pinky and then in her other fingers. Her pediatrician diagnosed her with polyarticular juvenile idiopathic arthritis (JIA). In high school, Sandra decided to pursue a career in medicine and began taking advanced placement classes in biology and chemistry….
Most SLE clinical trials continue standard background medications being taken by patients at entry, based on assumptions that this minimizes the risk of serious flares and that immunologic interference is minimal. These assumptions are not evidence based, but eliminating polypharmacy in trials studying patients with active lupus remains controversial. These researchers tested the withdrawal of immunosuppressants to make SLE trial results more interpretable…
Often, young adults (18–23 years old) with rheumatic illness demonstrate poor adherence to treatment regimens, lack advocacy skills and have inadequate knowledge about diagnosis and treatment.1 Patients presenting at a transition clinic are typically comfortable with having their parents continue to be centrally involved with their care, but this is a time in life when…
A 53-year-old female presented to the clinic for severe polyarticular joint pain and was found to have a seronegative inflammatory arthritis. Six months before, she had completed 10 months of treatment for stage IV metastatic melanoma with the immune checkpoint inhibitors, nivolumab and ipilimumab, achieving complete remission of her cancer. She said that throughout her…
NEW YORK (Reuters Health)—Temporarily withholding methotrexate (MTX) can improve the efficacy of seasonal influenza vaccination in patients with rheumatoid arthritis (RA), according to a new randomized clinical trial. Response was strongest in patients who discontinued MTX for two weeks before and two weeks after receiving the flu shot, Dr. Eun Bong Lee of Seoul National…
Collaboration among all providers—surgeon, rheumatologist, physical therapist, etc.—is essential for patients with a rheumatic disease who are about to undergo total joint arthroplasty to reach their goals, including reduced pain and improved mobility…