Scenario 1: Direct Billing A 70-year-old female patient with rheumatoid arthritis in multiple joints and positive rheumatoid factor returns to the practice for her fourth infusion of infliximab with the nurse practitioner (NP). She reports no fevers, cough, dyspnea or concurrent illness. She rates the severity of her joint pain at 6 on a 10-point…
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FDA Rheumatology Update: New Drug Approvals, Plus Expanded Drug Indications & Safety Concerns
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…
Remembering Etanercept & the Advent of the Biologic Era
As a veteran rheumatologist, I remember the clinical trials of etanercept’s (Enbrel’s) efficacy. And when the drug was first approved in 1998, I participated in those clinical trials and realized the effectiveness was astonishing. It was easy to tell which patients were treated with etanercept vs. those who received placebo, even though both groups were…
Canada & E.U. Approve Upadacitinib for RA
Upadacitinib will soon be available to treat patients with moderate to severe rheumatoid arthritis in Canada and the E.U…
The Care & Treatment of Myositis: Creatinine Kinase Level Isn’t Gospel & Other Recommendations
During a session at the 2019 ACR/ARP Annual Meeting, Lisa Christopher-Stine, MD, MPH, provided valuable recommendations and practical insights into the care and treatment of myositis patients…
New Insights into the Management of Giant Cell Arteritis
A systematic literature review identified novel evidence on the treatment and management of GCA that was incorporated into the most recent EULAR recommendations on the management of large vessel vasculitis. Investigators confirmed the efficacy of prompt initiation of glucocorticoids and found fast-track approaches to diagnosis lowered the risk of ischemic complications…
Tips for Exploring Tough Topics with Teens with Rheumatic Disease
ATLANTA—Managing teenage patients may present challenges for pediatric rheumatologists and rheumatology professionals not only because of their often complex, rare conditions, but because teenagers are, well, teenagers. Teens may experiment with sexual intercourse, alcohol use, tobacco or vaping e-cigarettes to fit in with their peers, even if these habits have serious health consequences, according to…
Case Report: Obliterative Bronchiolitis in Rheumatoid Arthritis
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…
Sjögren’s Syndrome in Kids: Diagnostic Challenges & Treatment Options
A 14-year-old girl is referred to your office for fatigue and arthralgias. While you’re obtaining her past medical history, she divulges that she has had four episodes of bilateral parotitis, each lasting two weeks. An otolaryngologist evaluated her. She lacked sicca symptoms, had a normal complete blood count (CBC), normal inflammatory markers and a negative…
PAD4 Antibodies May Help Predict Treatment Response in Rheumatoid Arthritis
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….
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