A new study examined the independent effects of excess weight and obesity on achieving sustained remission in rheumatoid arthritis (RA) patients. Researchers found that within three years of RA diagnosis, overweight and obese patients were significantly less likely to achieve sustained remission than patients with healthy body mass indices (BMIs). Higher BMIs were also associated with persistent disease activity…
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4 Rheumatoid Arthritis Therapy Principles, & New Drug Info
CHICAGO—Amid what she called a “dizzying array of choices” for rheumatoid arthritis (RA)—from anti-TNF and anti-IL6-receptor therapies to B cell depletion to new biosimilar options—disease treatment should still revolve around several basic concepts, an expert said at the ACR State-of-the-Art Clinical Symposium in April. Joan Bathon, MD, chief of rheumatology at Columbia University in New…

The Impact of Pharma Info vs. Neutral Info on Patients’ Drug Decisions
Patients who reviewed an industry-sponsored booklet about a commonly used rheumatoid arthritis drug were twice as likely to choose the proposed therapy as were patients who reviewed similar decision-aid material presented in a neutral manner, according to a recent study. Richard Martin, MD, MA, professor of medicine, rheumatology, at Michigan State University College of Human…

The Latest on Eosinophilic Granulomatosis with Polyangiitis
The past five years have been busier than usual for the Churg-Strauss syndrome. It was renamed eosinophilic granulomatosis with polyangiitis (EGPA).1 Longitudinal cohorts totaling 484 patients—approximately as many as all previous series combined—were described.2,3 A proposal was advanced to remove and rename a subset in which vasculitis may not be present.4 And shortly after the…

The Demise of the Inpatient Rheumatology Unit
Through much of the 20th century, dedicated rheumatic disease units were found in hospitals across the U.S. and countries around the world. In the latter part of the century, this began to change, with hospitals moving toward the consult model of care for rheumatic patients. This change reflects larger shifts in the medical world toward…

Learn to Spot Neuropathic Arthropathy Mimicking RA
Rheumatoid arthritis (RA) is characterized by polyarthritis, especially involving hands and wrists. Without treatment, RA usually evolves to articular deformities. Unfortunately, although rheumatoid deformities are characteristic, they are not pathognomonic, and we should be aware of possible mimics.1 Neuropathic arthropathy (NA), similar to other diseases, such as hemochromatosis, psoriatic arthritis, calcium pyrophosphate deposition disease, Jaccoud…
Obesity in Women & Smoking in Men Strongly Predict Lack of Remission in Early RA
NEW YORK (Reuters Health)—Obesity in women and current smoking in men appear to be the strongest predictors of lack of remission in early rheumatoid arthritis (RA) within one year, according to new research presented June 13 at EULAR 2018, the annual meeting of the European League Against Rheumatism, in Amsterdam.1 Even though early identification and…

Why & How to Pursue Shared Decision Making with Your Patients
Over the past several decades, the medical community has been moving toward a model of shared decision making. In addition to its ethical advantages, shared decision making potentially yields such benefits as improved medical adherence and better health outcomes. With the proliferation of treatment options and changes in the larger culture, shared decision making is…

Flare Risk Increases When Medication Is Stopped Prior to Arthroplasty
After total hip or knee arthroplasty, flares are common in patients with rheumatoid arthritis (RA), according to a recently published study.1 Higher disease activity at baseline appears to be linked to flares, but use of such medications as biologics and methotrexate did not independently predict flaring. “Contrary to the notion that patients with established RA…

Case Illustrates the Difficulty Diagnosing Granulomatosis with Polyangiitis
Granulomatosis with polyangiitis (GPA) was first described in the British Medical Journal in 1897 by Scottish otolaryngologist Peter McBride.1 GPA is a relatively rare, systemic necrotizing vasculitis that can make diagnosis challenging. The incidence has been estimated anywhere between two and 12 cases per million.2 GPA mainly affects adults between the ages of 45 and…
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