This legislative season has seen key pharmacy benefit manager reforms but slow movement on other issues, such as copay accumulators and utilization management. The ACR is also monitoring emerging topics, such as biomarker testing and post-public health emergency telehealth reforms.
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Case Report: Migratory Polyarthritis as the Presenting Symptom of GPA
Granulomatosis with polyangiitis (GPA) is a primary, necrotizing granulomatous vasculitis, involving small- to medium-sized arteries, that causes systemic disease. Almost any organ can be affected, but the most affected systems are the upper airways, lungs, kidneys, eyes and peripheral nerves. Migratory polyarthritis is reported in approximately 25% of patients with anti-neutrophil cytoplasmic antibody (ANCA) associated…
Integration of Complementary & Conventional Care for Patients with Musculoskeletal Disorders
Studies related to acupuncture and tai chi show some benefits for patients with musculoskeletal disorders, such as fibromyalgia and osteoarthritis. When patients ask about these integrative health approaches, rheumatologists should recommend they use qualified, experienced practitioners.
Psoriatic Arthritis Drugs at a Glance, 2023
Biosimilars have become a therapeutic turning point for many patients who are living with rheumatic illnesses. Psoriatic arthritis (PsA) is a complex, multi-faceted chronic inflammatory musculoskeletal and skin disease where the treatment has changed considerably over the past few years. Psoriatic arthritis has an impact on about 30% of people with psoriasis.1 In 2019, the…
The Only Rheumatologist on the Island
“What are you up to this weekend?” “Flying to Guam.” “What? Why?” “I promised an entire island I’d be their doctor.” In fall 2021, Jonathon Thorp, MD, phoned a friend. A passionate internist, he was bound and determined to bring a rheumatologist to Guam. Unlike most primary care providers (PCPs), he was willing to prescribe…
Research Update: Using Vagus Nerve Stimulation for Rheumatic Disease
Over the past decade, a number of pilot studies have provided proof of concept for the use of vagus nerve stimulation (VNS) to treat rheumatic conditions. The studies represent an expansion of this treatment approach into rheumatology, building on years of scientific inquiry into the mechanisms of VNS on disease states that led to preclinical…
Insights from a Neuro-Rheumatology Clinic
Neuro-rheumatology is a fast-growing field. Better testing and imaging have increased recognition of once-infrequent diagnoses, such as neuro-sarcoidosis and amyloid beta-related angiitis. Concurrently, the rapid expansion of immunotherapy options to treat cancer and their untoward neurological side effects have increased the frequency of referrals to both neurologists and rheumatologists. Identifying and treating neurologic manifestations of…
Case Report: GPA or IgG4-Related Disease in an 11-Year-Old Girl?
Granulomatosis with polyangiitis (GPA) is a type of anti-neutrophil cytoplasmic antibody (ANCA) associated small vessel vasculitis that typically affects the kidneys, lungs and sinuses.1 Due to an overlap in signs and symptoms, GPA may initially be difficult to distinguish from IgG4-related disease, another condition that can affect multiple tissues and has variable presentations. Further complicating…
Appreciative Rheumatology: Positivity Beyond Serologies
Spam, spam, advertisement, spam … wait wait, what’s this? A small envelope, addressed from Maine. I wonder what this is about? Usually, when I get an envelope this size, it’s a letter from someone trying to sell me something or complain about something I have no control over. So imagine my surprise when I found…
Diet May Help Reduce Inflammation in RA
In a small study, an anti-inflammatory diet helped reduce pain and swelling in a subset of people with rheumatoid arthritis (RA). Diet changes are complementary to standard treatment. Diet-related research can be challenging, but many patients with RA are motivated to try healthy changes.
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