New prescribing guidance has been issued by the FDA for immediate-release and extended-release/long-acting opioids for pain management. The agency also announced multiple label updates, which include changes to the Boxed Warnings.
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Case Report: A Patient Presents with Digital Ischemia & Gangrene
Defined by the presence of antiphospholipid antibodies (aPL) in individuals with clinical evidence of thrombosis or pregnancy morbidity, antiphospholipid syndrome (APS) is a systemic autoimmune thrombophilia. Clinical thrombosis, which should be confirmed by objective validated criteria (e.g., imaging studies or histopathology), can occur in the arterial, venous or small vessel vasculature and is not limited…
How to Discuss Anti-Inflammatory Diets & Supplements with Your Patients
My patients ask me almost daily what kind of diet they should be on, or if there are certain supplements they should try. And a growing amount of evidence shows lifestyle and dietary factors may contribute to disease risk and outcomes in rheumatic disease. Thus, rheumatologists and rheumatology professionals are being called upon by patients…
RA Disease Activity & Alcohol Consumption Habits
Past studies have suggested that patients with rheumatoid arthritis (RA) who consume a moderate amount of alcohol may experience lower disease activity and higher quality of life than non-drinkers. In this study, Alfredsson, et al. confirmed earlier studies’ claims that alcohol consumption reduces disease activity in a dose-dependent manner, and also indicated that patients who stopped drinking post-baseline experienced worsened disease activity, more pain and a lower quality of life.
Slow but Steady: 2023 State Legislative Progress
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.
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…
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