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Collaborative Guideline Addresses the Perioperative Use of Antirheumatic Drug Therapy

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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…

Progress Made During HOD Annual Meeting

Gary L. Bryant, MD, FACR, FACP  |  

The AMA House of Delegates (HOD) met in Chicago for its annual meeting June 9–14. More than 530 HOD members were present, with several hundred AMA and association staff and guests. As I am sure you have noted from past issues of ACR@Work, the ACR is in its five-year membership review. The ACR must be…

Anti-CarP May Play Special Role in RA-Associated Mortality

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Researchers may have established a relationship between a new RA autoantibody, anti-carbamylated protein (anti-CarP) antibodies, and increased mortality risk. The recent study showed that anti-CarP was the only autoantibody associated with mortality, specifically respiratory system cause of death…

Soccer, Wrestling among Sports Tied to Risk of Knee Arthritis

Will Boggs MD  |  

(Reuters Health)—Participation in some sports, including soccer, wrestling and elite-level long-distance running, may increase the risk of knee osteoarthritis, researchers say. “While the typical athlete is not at a greater risk of knee osteoarthritis, it was interesting to see that certain athletes may be more likely to have knee osteoarthritis later in life, specifically, elite…

Rheumatology Drug Updates: Uncertain Future for Romosozumab, Plus FDA Approves Tocilizumab for GCA

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Romosozumab’s Future Is Uncertain Romosozumab, which has the possible U.S. brand name Evenity, is awaiting approval from the FDA.1 The treatment is an investigational, injectable biologic for treating osteoporosis. It increases bone formation and bone density, reducing a patient’s risk of fractures. The manufacturer no longer expects the FDA to approve the drug this year…

Drug Tapering: Studies Point to Success in Some Patients

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Highlights from the 2017 EULAR Congress MADRID—Scores on the Health Assessment Questionnaire for Rheumatoid Arthritis (HAQ) and C-reactive protein (CRP) levels were independent predictors of whether patients could be tapered successfully from a TNF inhibitor after having reached remission of their RA, according to findings presented in a session at the Annual European Congress of…

Rheumatology Coding Corner Question: Established Patient Office Visit with Acute Gout

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A 66-year-old female patient returns to the office complaining of swelling and a burning pain in her right first toe. She rates the pain level at a 9 out of 10. She currently takes an over-the-counter non-steroidal anti-inflammatory drug (NSAID), but it has done little to alleviate the pain. This is her second episode this…

Amyloidosis Is Often Underdiagnosed, Undertreated

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CHICAGO—Caryn A. Libbey, MD, clinical associate professor of medicine at Boston University School of Medicine, described the evolving in our understanding of amyloid at the ACR’s State-of-the-Art Clinical Symposium in April. Amyloidosis is a rare disease that is often underdiagnosed and undertreated. “Even though this disease has been around for 150 years, I still consider it…

Rheumatologist Dr. Santosh Bhusal Shares Insights in Move from Fellowship to Practice

Santosh Bhusal, MD, with Terence W. Starz, MD, on behalf of the ARHP Practice Committee  |  

“I was hoping for good news, but now I am worried,” was the response of a 29-year-old patient when I suggested an oncology referral. He was four months into treatment of dermatomyositis and had experienced significant improvement of his muscle strength, CPK levels and interstitial pneumonitis, but a follow-up CT scan showed that his spleen…