In several U.S. states, Blue Cross/Blue Shield and other insurers have dropped or are considering dropping coverage of hyaluronic acid injection—or viscosupplementation—for patients with knee osteoarthritis. The decision appears to be based on guidelines published by the American Academy of Orthopaedic Surgeons in 2013, which at that time specified that research had not found hyaluronic…
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Treatment Tips for Pulmonary Arterial Hypertension & ILD
CHICAGO—About 30 years ago, pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) began to outpace renal crisis as the main causes of death in scleroderma (SSc). But treating these lung complications has proved vexing for clinicians. There is no easy way to predict who will develop PAH. There is no telltale antibody and no…

Improve Your Recognition & Treatment of Osteoporosis
BALTIMORE—Rheumatologists may not think about osteoporosis on a daily basis, but they should, said Dr. Karl Insogna, the Ensign Professor of Medicine at Yale University School of Medicine and director of the Yale Bone Center in New Haven, Conn., in his recent lecture at the Maryland Society for the Rheumatic Diseases. With approximately 75 million…

Phase 3 Trial Results: Blisibimod for Lupus Shows Possible Efficacy
A phase 3 clinical trial in which researchers treated lupus patients with blisibimod, a biologic treatment that inhibits B cell activating factor (BAFF), did not meet its primary endpoint, but did demonstrate evidence of possible efficacy. Researcher Joan T. Merrill, MD, a member of the Oklahoma Medical Research Foundation (OMRF) and OMRF professor of medicine…

Epratuzumab May Work for SLE Subgroups
A recent analysis of the monoclonal antibody epratuzumab finds new evidence for its effectiveness in a subset of systemic lupus erythematosus (SLE) patients who have a concurrent diagnosis of Sjögren’s syndrome, a progressive autoimmune disease that affects exocrine glands and is characterized by dry eyes and mouth.1 Sjögren’s can be primary, meaning independent of other…

Case Report: Ehlers-Danlos Syndrome Mimicking Vasculitis
A 43-year-old man with a past medical history of type 2 diabetes mellitus, bilateral inguinal hernia repair as a child and prior cholecystectomy woke from sleep with sudden-onset periumbilical abdominal pain. He was admitted to another hospital, but required transfer to our surgical intensive care unit after a recurrent episode of severe abdominal pain, during…

Eosinophilia & Hypereosinophilia Diagnosis & Treatment Tips
CHICAGO—High eosinophil counts that can’t be explained should concern rheumatologists and spark attempts to identify what’s happening, an expert said at the ACR State-of-the-Art Clinical Symposium in April. “Eosinophil counts over 1,500 (per microliter) should provoke worry,” said Bruce Bochner, MD, professor of medicine in allergy and immunology at Northwestern University Feinberg School of Medicine…

Hydroxychloroquine Risk-Benefit Discussion, & a Handy Dosage App
CHICAGO—As good an option as hydroxychloroquine (HCQ) is for many patients with rheumatic diseases, such as rheumatoid arthritis and especially lupus, safety must be an important consideration, an expert said at this April’s ACR State-of-the-Art Clinical Symposium. The use of the antimalarial has become a controversial subject, with clinicians trying to balance the drug’s disease-modifying…

Researchers Seek to Predict & Prevent Rheumatoid Arthritis
Preventing adverse outcomes in individuals who have rheumatic diseases is a daily goal for rheumatologists. For example, rheumatologists prescribe medications and perform screening to prevent erosions in rheumatoid arthritis (RA), renal failure in systemic lupus erythematosus and flares across all diseases. Many of these actions are classified as secondary or tertiary prevention, because individuals have…

Researchers Compare Nonsurgical Knee OA Treatments
According to new research, knee OA patients reported greater pain relief from intra-articular corticosteroids, but naproxen was more effective at improving function…
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