Editor’s note: The new Pillar Talk column is developed by the ARHP Executive Committee in an effort to share information about ongoing activities related to our four pillars: Education, Practice, Research and Advocacy. The ARHP Practice Committee is committed to addressing the current needs and evolving practice opportunities for health professionals working in rheumatology. A…
Research has shed light on the genetic mutations that link GDF5 with arthritis and height. An ancient regulatory variant in GROW1 has been repeatedly selected in humans in northern environments, explaining the high frequency of a GDF5 haplotype that increases arthritis susceptibility…
A new guideline developed by the ACR and the American Association of Hip and Knee Surgeons addresses the perioperative use of antirheumatic drug therapy. Specifically, it provides recommendations on the use of traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib and glucocorticoids in adults with RA; SpA, including ankylosing spondylitis and psoriatic arthritis; JIA; or SLE undergoing elective THA or TKA. The guideline provides recommendations regarding when to continue, when to withhold and when to restart these medications, and the optimal perioperative dosing of glucocorticoids…
Your home & your health: Does geography impact medicine? Does it matter whether a region is surrounded by large bodies of water, encircled by towering mountain peaks or that its residents share a common ancestry? Consider Switzerland, a nation with a highly developed economy replete with advanced technological and medical infrastructure. Despite these advantages, less…
First Appearances I watched the old man, his back painfully bent, shuffle toward the scale. A blocky rigidity draped over him. His feet seemed stuck to the floor. His head hung heavily over his chest. Observing him from the end of the hallway, instead of a face, I saw only a mound of shaggy, matted…
A recent study in mice examined the role of adenosine A2A receptors in joint health. Researchers specifically found that as extracellular levels of adenosine fall, individuals may become at risk for osteoarthritis…
Rheumatologists treating HIV patients in 2017 must think through many important factors as this population ages. As we continue to learn, rheumatologists must consider important drug–drug interactions, relatively uncommon rheumatological presentations of HIV, as well as specific diagnostic challenges. Working closely with infectious disease specialists is the best way to achieve optimum care for this…
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….
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…
Ipilimumab (Yervoy) is a monoclonal antibody directed against cytotoxic T-lymphocyte antigen 4 (CTLA-4). It was the first drug to demonstrate a survival benefit in advanced melanoma and was approved by the FDA in 2011.1 By blocking the CTLA-4 receptor, ipilimumab enhances the immune response against tumors via cytotoxic T lymphocyte activation and proliferation.2 However, immunopotentiating…