A large medical specialty society for ophthalmologists recently updated its recommendations for the screening of chloroquine (CQ) and hydroxychloroquine (HCQ) retinopathy.1 The recommendations from the American Academy of Ophthalmology (AAO) affect patients who may use CQ or HCQ for rheumatoid arthritis or systemic lupus erythematosus (SLE), as well as some inflammatory and dermatologic conditions. The…
Two sets of guidelines—one on managing anti-rheumatic drugs perioperatively for patients undergoing total hip and knee replacements, and another that updates glucocorticoid-induced osteoporosis prevention and treatment strategies—will be featured in sessions at the 2016 ACR/ARHP Annual Meeting this month. The Sessions Sunday, Nov. 13, 2:30–3:30 p.m.: Glucocorticoid-Induced Osteoporosis Prevention and Treatment: A New ACR Clinical…
To speed the development of tocilizumab to treat giant cell arteritis (GCA), the FDA designated it as a breakthrough therapy earlier this month…
The following summary regarding use of tacrolimus (TAC) in lupus nephritis highlights a number of debatable points. Although the role of TAC in lupus nephritis remains unproved for North American populations, it might be an excellent option in some clinical situations. These situations include lupus flare during pregnancy and also for lupus nephritis when the…
A 55-year-old female patient returns to the office with complaints of gout pain. She is complaining of swelling and a burning pain in her left toe. She has been taking an over-the-counter NSAID to treat the pain, but this has done little to alleviate it. This is her second flare this year. The patient denies…
A recent analysis compared the care of patients with RA with that received by patients with gout, finding that hospitalization and costs for patients with gout have increased, but both are decreasing for patients with RA. Unlike RA, significant advances in treatment have not been made for gout, despite its increasing prevalence, and patients may land in the hospital unnecessarily…
A 50-year-old man with history of superficial bladder carcinoma presented to our rheumatology clinic for a three-year history of symmetric polyarthralgias. He had undergone multiple transurethral resection of bladder tumor procedures and bacillus Calmette–Guerin (BCG) treatments. Prior to receiving BCG, he was fully functional and employed. Days after receiving his second BCG treatment, he developed…
Outside Exam Room No. 5, the chart rack was empty, so I assumed my new consult was late. Just in case, I looked back over my shoulder as I passed by the partially open door and glimpsed the lower half of a woman holding a three-ringed binder on her lap. I squinted and took a…
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…
Although most systemic juvenile idiopathic arthritis patients don’t develop macrophage activation syndrome (MAS), the approximately 10% who do have this serious complication can experience widespread, massive inflammation, debilitating symptoms and even death. To improve understanding of MAS among physicians and advance efforts to develop effective therapies to treat it, a panel of 28 international pediatric…