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….
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Rheumatologist Dr. Sandra Pagnussat Recalls Journey from Patient to Physician
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….
The Biomarkers of Lupus Disease Study
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…

Tips for Managing Young Adult Rheumatology Patients
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…

The Immune Checkpoint Inhibitors Unleashed to Fight Cancer
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…
Four-Week Methotrexate Break Improves Flu Shot Response in RA Patients
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…

Strategies for Successful Joint Replacement Surgery
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…

How Gout Patients Can Stay on Target with the Go for Six Campaign
Gout patients need to lower their uric acid levels to 6.0 mg/dL or below and maintain that level. According to N. Lawrence Edwards, MD, MACP, MACR, an education campaign has been raising awareness of this fact and helping gout patients…

One Stop: Multi-Disciplinary Lupus Clinic Meets Patient Needs
Multi-disciplinary care may be a slowly growing trend. One clinic in Ohio is raising the bar for lupus patients, serving as a one-stop center for diagnostic testing, imaging services and physical therapy. The clinic is also able to conduct basic research to advance lupus treatment and tests…

A Moving Target: Cardiovascular Risk & Rheumatic Disease
For patients with rheumatic disease, general treatment guidelines for managing cardiovascular risk are suboptimal, says Katherine Liao, MD. A patient’s level of disease activity and inflammation affect their risk…
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