Rheumatoid arthritis (RA) is a systemic autoimmune disease that affects approximately 1% of the adult population, and involvement of extra-articular tissue occurs in approximately 40% of patients over their lifetimes.1 RA-associated pericardial disease is an uncommon complication, and surgery is the only definitive therapy—according to current literature. In this report, we present the case of…
Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or programmed cell death protein 1 (PD-1) axes have revolutionized therapy and improved survival in advanced cancers. However, these immune system modulators also lead to immune-related adverse events (IRAEs).1,2 In clinical trials, IRAEs mainly involved the gastrointestinal tract, skin, endocrine glands, liver and lung,…
ATLANTA—At the 2019 ACR/ARP Annual Meeting in November, the ACR and the ARP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. This month, The Rheumatologist speaks with the winners of the ARP Merit Awards about their individual contributions to advancing rheumatology. You’ll also find a…
As Ellen M. Gravallese, MD, begins the ACR presidency, her goals include workforce expansion, improved access to care and support for members in all areas of practice.
A recent study in The Journal of Rheumatology sheds light on the importance of preconceptional cardiovascular health in women with systemic lupus erythematosus. Although many questions remain, improved cardiovascular health measures seem to positively affect pregnancy outcomes, suggesting a potential role for preconception cardiovascular interventions.1 Women with lupus now have healthier pregnancies than in the…
Scleroderma renal crisis (SRC) is a life-threatening complication of systemic sclerosis. SRC occurs in 2–15% of patients with diffuse sclerosis and usually within the first five years from the time of diagnosis. Risk factors for SRC include, but are not limited to, early diagnosis, corticosteroid or cyclosporine use, and the presence of anti-RNA polymerase III…
When I first met Ms. Miller (name changed), quite frankly, I couldn’t wait to get out of the room. I’m sure she couldn’t either. A woman in her 40s with systemic lupus erythematosus, poorly controlled asthma and fibromyalgia, she seemed to have every conceivable symptom. And, worse than that, due to a long history of…
Apremilast was first marketed in March 2014 for the treatment of adults with psoriatic arthritis (PsA). An immunomodulating drug, which is a small molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine monophosphate (cAMP), apremilast is administered orally. By inhibiting PDE4, intracellular cAMP levels are increased. Although the exact mechanism of action is not…
Sir William Osler, widely regarded as one of the greatest physicians of the 20th century, once said, “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.”1 This sentiment is particularly true in the field of rheumatology, in which understanding the…
A 32-year-old male patient with rheumatoid arthritis affecting multiple joints without rheumatoid factor returns to the office for a follow-up visit with the nurse practitioner (NP). The patient states his overall pain has improved since his previous visit, although he rates the severity of his right shoulder and right wrist pain at a 5 on…