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…
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Diagnosis, Treatment Updates for Lyme Arthritis
CHICAGO—A clustering of cases in Lyme, Conn., in 1975 led to the discovery of Lyme disease. Allen C. Steere, MD, professor of medicine at Harvard Medical School in Boston, investigated that outbreak, and he shared his knowledge of Lyme disease with rheumatologists gathered at the ACR’s State-of-the-Art Clinical Symposium in April. He explained that Lyme arthritis…
How Global Geographic Disparities Affect Healthcare Outcomes
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…
A Stiff Man: A Case Study in Ankylosing Spondylitis
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…
Adenosine Treatment Promotes Cartilage Homeostasis
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…
News Updates for Diclofenac Sodium, Denosumab & Sarilumab
In drug news, a generic 2% diclofenac sodium solution is now available, denosumab is promising to treat osteoporosis, and the FDA has approved sarilumab to treat adults with RA…
Rheumatologists Treating Patients with HIV Face Treatment, Diagnostic Challenges
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…
Centrexion’s Chili-Based Painkiller Offers Relief for 6 Months—Study
(Reuters)—A synthetic version of a medicine traditionally extracted from chili plant relieved knee pain among osteoarthritis patients for up to six months, data showed, bringing Centrexion Therapeutics a step closer to developing a safe and effective analgesic. The drug, designed to be injected at the site of pain, is being developed by the privately-held company…
Rheumatologist Dr. Sandra Pagnussat Recalls Journey from Patient to Physician
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….
The Immune Checkpoint Inhibitors Unleashed to Fight Cancer
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…
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