GCA, GPA, myositis, new research—rheumatology care keeps clinicians on their toes & requires them to stay up to date…


GCA, GPA, myositis, new research—rheumatology care keeps clinicians on their toes & requires them to stay up to date…

Last year, the FDA was busy with new biologic and other drug approvals, new and expanded drug indications, and important safety updates relevant to rheumatology…

Robin Paudel, MD, Prerna Dogra, MD, & Richard S. Morehead, MD |
A 59-year-old woman with rheumatoid arthritis (RA) presented to our pulmonary clinic for progressively worsening dyspnea of five years’ duration. She described progressively worsening dyspnea after a few minutes of walking on level ground. In addition, she noted worsening pain and morning stiffness of the wrists, knees and metacarpophalangeal (MCP) joints, with subcutaneous nodules. She…

A study published in Arthritis & Rheumatology highlights how the presence of autoantibodies to peptidylarginine deiminase (PAD) may eventually be used to influence treatment decisions in the management of rheumatoid arthritis (RA), sharpening our understanding of disease subtypes.1 Although follow-up prospective studies are needed, these findings underline some intriguing areas for future investigations in immunobiology….

Mithu Maheswaranathan, MD, & Lisa Criscione-Schreiber, MD, MEd |
The idiopathic inflammatory myopathies (IIM) encompass eight categories: 1) dermatomyositis (DM) in adults, 2) juvenile dermatomyositis, 3) amyopathic DM, 4) cancer-associated DM, 5) polymyositis, 6) immune-mediated necrotizing myopathy, 7) inclusion body myositis, and 8) overlap myositis.1 These categories help classify the myopathies based on clinical and histologic features. The incidence of IIM is estimated at…
Based on a request by the ACR Insurance Subcommittee, off-label use of mycophenolate for scleroderma has been added to a Medicare-approved compendium.

Michael Putman, MD |
The U.S. Food & Drug Administration (FDA) approved nintedanib for systemic sclerosis associated interstitial lung disease (SSc-ILD) on Sept. 6 after a randomized, controlled trial (SENSCIS) demonstrated significant benefit against placebo.1 At a cost of $96,000 per year, treatment reduced the adjusted annual rate of change in forced vital capacity (FVC) from –93.3 mL in…

Scott Rodriguez, MD, Kenton Powell, MD, & Daniel Albert, MD |
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…

Katherine Yates, MD, Erin H. Penn, MD, & Minna J. Kohler, MD |
Patients with chronic kidney disease (CKD) often experience joint pain due to various etiologies, including crystalline arthropathies, renal osteodystrophy, amyloid arthropathy, erosive osteoarthritis, avascular necrosis and even erosive spondylarthrosis.1 Below, we present a case of crystalline arthropathy in a patient with chronic kidney disease, mistaken for gout. The Case A 29-year-old man was admitted to…

Bryn Nelson, PhD |
Although the true cause of systemic sclerosis (SSc), or scleroderma, remains unknown, researchers have made progress in detecting the autoimmune disease’s early presence. Beyond the physiological signs of Raynaud’s phenomenon, a capillaroscopy can detect alterations in microcirculation and lab tests can confirm the presence of telltale autoantibodies, such as anti-topoisomerase 1, anti-centromere and anti-RNA polymerase…