Janus kinase 1 and 2 inhibitors (jakinibs) have been approved for the treatment of rheumatoid arthritis, psoriatic arthritis and, most recently, juvenile idiopathic arthritis. They have also shown promise in the treatment of interferon (IFN) mediated diseases. The Janus kinase and signal transducer and activator of transcription (JAK/STAT) pathway is the principal signaling pathway for…
In the early 1900s, the treatment for rheumatic and musculoskeletal disease (RMD) was primarily targeted at symptomatic relief and included analgesics, physical therapy, splinting and bed rest. With the discovery of methotrexate and its impact on rheumatoid arthritis (RA) management, a much-needed evolution of medications targeting disease activity began. Over the past 30 years, several…
PRSYM—At its heart, the practice of medicine in all forms is specifically centered on delivering compassionate, thoughtful and evidence-based clinical care. In the world of pediatric rheumatology, a range of issues, such as chronic pain, reproductive health and transitioning to adult providers, are of utmost importance to patients and physicians alike. These topics were addressed…
NEW YORK (Reuters Health)—A six-month assessment of children with pediatric inflammatory multisystem syndrome temporally associated with COVID-19 disease (PIMS-TS) show generally favorable outcomes, but also a range of lingering issues. Cardiac, gastrointestinal, renal, hematology and otolaryngology problems largely resolved at six months, but muscular fatigue and emotional lability were common. Long-term, serious end-organ damage occurred…
Many practitioners can relate to the epiphany of Roy Basch, MD, the lead character in Samuel Shem’s satirical novel The House of God.1 During his first on-call shift as a medicine intern, long work hours combined with jaded advice from his senior resident leave Dr. Basch feeling disenchanted with the medical profession until he cares…
Laura Coates, MBChB, MRCP, PhD, described & compared the intricacies of different outcome measures, as well as implications for clinical practice & trials, for patients with psoriatic arthritis.
Common variable immunodeficiency (CVID) is a common primary immunodeficiency disease, with an estimated incidence of one per 25,000–50,000 individuals.1 The classic presentation includes frequent bacterial infections, secondary to dysfunctional B cell differentiation, impaired immunoglobulin production and diminished antibody response. The clinical presentation may be heterogenous and may include granulomatous disease as an uncommon manifestation. Granulomatous…
Dermatomyositis is an uncommon autoimmune condition involving skeletal muscle characterized by subacute onset of progressive weakness, intramuscular inflammatory infiltrates and the presence of myositis-specific autoantibodies.1 Immune-mediated myopathies may exert some pathogenic effects on the muscle tissue by targeting the microvasculature.1 Capillary inflammation, fragility and loss may contribute to heightened bleeding events in these patients. Here,…
As we emerge from the grips of a global pandemic, we are taking this opportunity to pause and reflect on the ARP and what our division brings to the care of our patients. I found the words of Amanda Gordon’s inaugural reading of her poem, “The Hill We Climb,” inspirational and instructive for our past,…
Clinicians can help their patients tap into personal resilience, and such characteristics as grit, gratitude and grace, to manage their chronic pain, says Afton L. Hassett, PsyD.