Methotrexate (MTX) remains the predominant medication used by rheumatologists to treat rheumatoid arthritis (RA). Doses of 7.5–25 mg per week with daily folic acid are generally prescribed. Despite its common use, MTX must be prescribed cautiously given the potential adverse effects when taken incorrectly or without folic acid supplementation. Cases of MTX-induced cutaneous ulceration have…
Psoriatic arthritis (PsA), scleroderma and lupus often require management input from both rheumatologists and dermatologists. Usually patients see the two specialists separately. Combining both in a single rheumatology/dermatology clinic appointment can improve outcomes and increase both provider and patient satisfaction. “Physicians talk about tearing down silos of care, where each specialist focuses on their part…
Secukinumab therapy proved safe and effective for psoriatic arthritis patients with multiple co-morbidities and long treatment histories, according to recent research…
An analysis of follow-up data from the DESIR cohort showed patients with recent onset axial spondyloarthritis who experienced peripheral arthritis had worse symptoms and quality of life long term. In the study, peripheral arthritis was also associated with negative HLAB27, non-smoking and the presence of other peripheral disease manifestations…
CHICAGO—The world of rheumatology is beginning to harness the promise of the microbiome, with evidence showing components of the gut may help predict response to medication and may be manipulated to improve how well a treatment works, said Jose Scher, MD, at the 2019 ACR State-of-the-Art Clinical Symposium, held April 5–7. “We can truly exploit…
Type I interferon appears to play a role in disease susceptibility and pathogenesis in several classic connective tissue diseases, at least in some patients. Below, I present evidence supporting this connection, explore potential missing links in pathogenesis and discuss biological treatments that target the pathway. The Type I Interferon Pathway Interferons are a class of…
A 53-year-old man was hospitalized for pericarditis, abdominal lymphadenopathy of unknown origin and non-bloody diarrhea. He was admitted for four days, and then he was discharged home without incident. Two months after his initial presentation, he was readmitted for the evaluation of several new issues, including symmetric arthralgias, hypovolemia with associated electrolyte abnormalities and concurrent…
In a study of bDMARD-naive patients with active PsA and skin disease, ixekizumab proved more efficacious than adalimumab…
SAN FRANCISCO—The 13th International Congress on Systemic Lupus Erythematosus (SLE), held April 5–8, highlighted continuing advances in the fight against lupus, a chronic, inflammatory, autoimmune disease affecting multiple organ systems. The rheumatologist’s ability to control this incurable and life-threatening condition is limited both by its heterogeneous presentation and by the lack of successful treatment options,…
New research by Jose Scher, MD, discussed during the 2019 ACR State-of-the-Art Clinical Symposium, demonstrated how clinicians may be able to modify aspects of the microbiome to predict and boost a patient’s treatment response…