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TNFi Exposure in Utero

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Vinet et al. evaluated the risk of serious infections in children of women with RA exposed to TNFi’s in the gestational period compared with unexposed offspring of women with RA, as well as with children from the general population. Although the research did not demonstrate a marked excess risk for serious infections, the authors could not exclude a differential risk according to specific TNFi, with infliximab potentially resulting in a threefold increase in the risk of serious infections compared with other TNFi’s. More studies are needed…

Immune Checkpoint Inhibitors & Immune-Related Adverse Events

Priya Chokshi, MD, Roberta Seidman, MD, Noah Levit, PhD, MD, & Steven E. Carsons, MD  |  

Immune checkpoint inhibitors (ICIs) are at the forefront of advances in cancer therapy and have shown promising results for progression-free survival. Checkpoint signaling pathways, such as cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1), normally regulate the immune response to promote self-tolerance and prevent tissue damage and inflammation. PD-1 is a…

Racial Disparities in Rheumatology: What Are We Doing About It?

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The data tell the story. Despite improvements in overall outcomes for common rheumatologic conditions, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), white patients fare better than minority patients, and sometimes substantially better. Even with new biologic therapies that have significantly altered the course of disease for patients with RA, outcomes for minorities…

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Advanced Practice Clinicians May Help Close the Workforce Gap

Paul H. Caldron, DO, PhD, FACP, FACR, MBA  |  

GLENDALE, ARIZ.—Arizona is a microcosm of America’s challenges in reconciling the rheumatology workforce to growing patient demand, as quantified in the ACR’s Workforce Study of 2015.1 So it was timely this year for the Phoenix Rheumatology Association to sponsor its 1st Annual Strategic Training for Rheumatology Advanced Practice Clinicians Symposium. (Note: Advanced practice clinicians [APCs]…

Delayed Care: Research Paints Complex Picture of Treatment Delays

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AMSTERDAM—A variety of factors lead to delays in patients seeking medical care for rheumatoid arthritis—from the nature of symptoms to coping tendencies—requiring more awareness from physicians when managing patients, researchers said at EULAR: the Annual European Congress of Rheumatology. Longer delays in treatment bring about more emotional distress to patients, missed chances to ease symptoms…

Promote Pregnancy Wellness: Data Can Help Guide Pregnancy Management in Lupus

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AMSTERDAM—Clinicians who are counseling women with systemic lupus erythematosus (SLE) have the benefit of an array of new insights into factors linked with increased risk of pregnancy loss, how SLE therapies affect pregnancy and data on outcomes of children born to mothers with SLE, an expert said in a session at EULAR: the Annual European…

Oklahoma Medicaid Tests New Tactic to Curb U.S. Drug Costs

Deena Beasley  |  

LOS ANGELES (Reuters)—A new front in the battle over the cost of expensive medicines in the United States is opening up in Oklahoma, the first state where the government’s Medicaid program is negotiating contracts for prescription drugs based on how well they work. In June, Oklahoma received approval from the U.S. Centers for Medicare and…

Studies Find More Evidence the Microbiome Affects Autoimmune Disease

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Evidence is accumulating that the microbiome may be an important part of the pathogenesis of many autoimmune diseases. Two recently published articles report on how translocation of the gut bacterium Enterococcus gallinarum drives autoimmunity in mice and humans, and on the role of other commensal bacteria in triggering immune responses—specifically to the autoantigen Ro60, which…