Search results for: Primary care

Methotrexate with Step-Down Glucocorticoid Remission Induction Works in Early RA

Reuters Staff | August 1, 2016

NEW YORK (Reuters Health)—Methotrexate with step-down glucocorticoid remission induction (COBRA Slim) is an effective, safe and feasible initial treatment strategy for patients with early rheumatoid arthritis (RA), researchers from Belgium report. Patients with early RA should be treated rapidly, intensively and to target, according to current guidelines, they note in a paper online July 18…

Ethics Forum: Unexpected Ethical Issues in Private Practice, Clinical Research

Donah Zack Crawford, MA, Jill Johnson, MD, Neal K. Moskowitz, MD, PhD, & James Udell, MD | July 14, 2016

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…

How HLA-B27 Research Landmarks, Advances Relate to Ankylosing Spondylitis Pathogenesis

Joerg Ermann, MD | July 13, 2016

The mechanistic link between human leukocyte antigen B27 (HLA-B27) and ankylosing spondylitis (AS) is one of the great enigmas in rheumatology. The introduction of biological therapies that target tumor necrosis factor (TNF) or the interleukin (IL) 23/IL-17A axis has had a major impact on the quality of life for many patients with AS, and one…

Rheumatology Drug Updates: Labeling for Fluoroquinolones; FDA to Review Benzhydrocodone/Acetaminophen Combination

Michele B. Kaufman, PharmD, BCGP | July 12, 2016

FDA Restricts Fluoroquinolone Use The U.S. Food and Drug Administration (FDA) has twice previously communicated safety information about systemic fluoroquinolones—in August 2013 and July 2008. The safety issues of this medication class described in its latest Drug Safety Communication were also discussed at a November 2015 FDA Advisory Committee meeting.1 The FDA is now advising…

RA Choice: A Tool to Improve Patient Literacy

Arthritis Care & Research | July 5, 2016

Doctor-patient communication is critical for successfully treating rheumatoid arthritis. But a majority of RA patients report suboptimal shared decision making, sometimes due to language barriers, lack of time, limited health literacy and other factors. A recent pilot study sought to improve patient understanding and communication by employing an adapted medication guide and decision aid during clinical visits. Use of the tool, RA Choice, resulted in an increase in patient knowledge, and a majority of clinicians found it helpful…

Diagnostic Tests, Tips for Gluten-Induced Celiac Disease

Thomas R. Collins | June 13, 2016

CHICAGO—Celiac disease—the gluten-induced illness that can be seen alongside rheumatic diseases—has been seen much more commonly over the past 20 years than it was previously, but the illness can come with questions that are not always straightforward, an expert said at the ACR’s State-of-the-Art Clinical Symposium. The disease, in which the small intestine becomes inflamed…

Researchers Calculate Comorbidity Burden for Patients with SLE

Arthritis Care & Research | June 7, 2016

A recent study from the U.K. calculated the incidence of comorbidity associated with systemic lupus erythematosus (SLE), specifically looking for cardiovascular disease, stroke, end-stage renal failure, cancer, osteoporosis and infection. Even after adjusting for age, sex and other variables, investigators found that people with SLE have an increased global burden of comorbidity compared with the general population. Additionally, the study found that men with SLE had higher rates of cardiovascular disease, stroke and cancer, while women with SLE had higher rates of infection and osteoporosis. Overall, younger people with SLE had the greatest relative risk compared with controls…

Rheumatology Coding Corner Answer: Documentation Improvement

From the College | May 13, 2016

Take the challenge. B—No. Although the documentation states the patient arrived at the clinic at 8:15 a.m. and left the clinic at 10:55 a.m., it does not document the actual start and stop times of the infusion. According to CPT, when reporting codes for which infusion time is a factor, use the actual time over…

Rheumatology Drug Updates: Infliximab Biosimilar Gets FDA Approval & More

Michele B. Kaufman, PharmD, BCGP | May 13, 2016

April 5, 2016, marks a revolutionary day in the treatment of autoimmune diseases: The U.S. Food and Drug Administration (FDA) approved an infliximab (Remicade) biosimilar, known as Inflectra (infliximab-dyyb). Infliximab-dyyb, which is administered by intravenous infusion, is the first biosimilar drug approved to treat rheumatic disease in the U.S.1 Infliximab-dyyb has received approval for almost…

Addressing the Rheumatology Workforce Shortage

Timothy Harrington, MD, Erin Arnold, MD, William Arnold, MD, David Sikes, MD, Gary Crump, MD, James Bower, MPA, & Drew Johnson, MS, MBA | May 13, 2016

In 2008, the American College of Rheumatology Workforce Study Advisory Group published a comprehensive rheumatology workforce analysis.1 It concluded: Based on assessment of supply and demand under current scenarios, the demand for rheumatologists is expected to exceed supply in the coming decades. Strategies for the profession to adapt to this changing health care landscape include…