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Institute for Clinical Economic Review Final Report on RA Treatments

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On April 7, 2017, the Institute for Clinical and Economic Review (ICER) published its final report, titled, Targeted Immune Modulators for Rheumatoid Arthritis: Effectiveness & Value.1 The stated objective of the report was to assess the comparative clinical effectiveness of the targeted immune modulators (TIMs) used to treat patients with moderate to severe active rheumatoid…

Rheumatology Case Report: Bullous Lesions in Patient with Lupus

Mitali Sen, MD, Corrado Minimo, MD, & Ruchika Patel, MD  |  

Systemic lupus erythematosus (SLE) is a heterogeneous disease associated with multiple acute or chronic cutaneous manifestations, including the relatively rare category of bullous lupus. The development of vesiculo-bullous lesions may be associated with a high morbidity, hence they warrant an urgent investigation, including a skin biopsy to identify the diagnosis and initiate prompt treatment. With…

Fellows Forum Case Report: Neuromyelitis Optica

Atul Kapila, MD, Tayseer Haroun, MBBS, & Jayanth Doss, MD  |  

Case Presentation The patient was a 42-year-old African American female diagnosed with systemic lupus erythematosus (SLE) based on the findings of polyarthritis, malar and discoid rash, fatigue, positive double-stranded DNA (dsDNA) ribonucleoprotein and Smith antibodies, and low serum complement levels. Her SLE had been well controlled on hydroxychloroquine 400 mg daily, oral methotrexate 25 mg…

Recommendations for Sjögren’s Syndrome: How to Address Biologics & Musculoskeletal Pain

Arthritis Care & Research  |  

The clinical practice guidelines for managing Sjögren’s syndrome, developed by the Sjögren’s Syndrome Foundation with the ACR, were designed to improve quality and consistency of care. In total, 19 recommendations were agreed on, which include managing the rheumatic and systemic aspects of the disease. Recommendations include a decision tree for the use of DMARDs for inflammatory musculoskeletal pain, use of self-care measures and exercise to reduce fatigue, and the use of rituximab in selected clinical settings for oral and ocular dryness…

Research Offers Insight into Diagnosis, Treatment of Small-Vessel Vasculitis

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WASHINGTON, D.C.—Experts speaking at the 2016 ACR/ARHP Annual Meeting session, Update on Small-Vessel Vasculitis, offered insight into the latest approaches to the diagnosis and treatment of diseases involving the inflammation of blood vessels. “Vasculitis is an immune-mediated process. White blood cells invade the vessel wall, causing inflammation throughout the vessel wall,” said Jason M. Springer,…

How to Diagnose Antisynthetase Syndrome

How to Diagnose Antisynthetase Syndrome

Quretul Quresh, MD, & Stephen Lindsey, MD  |  

Antisynthetase syndrome (AS) is strongly associated with the presence of antibodies to aminoacyl-transfer RNA (tRNA) synthetases (ARSs) that are implicated in the pathogenesis of myositis and interstitial lung disease (ILD). Antibodies against eight antisynthetases have been identified and are detected in 16–26% of patients with idiopathic inflammatory myopathies (IIM).1 Serum assays for five of these…

As Biosimilars Hit, EU Pharma Warns against Blanket Prescribing

Reuters Staff  |  

LONDON (Reuters)—European drugmakers, faced with increasing competition from cut-price copies of complex biotech drugs, cautioned doctors on Thursday to take care when switching patients from an established product to biosimilar version. The complex nature of biological medicines, which are made inside living cells, means copies can never be exactly the same as the original. But…

Peripheral Helper Cells May Provide Clue to RA Pathology

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Research has identified a subset of T cells, peripheral helper (TPH) cells, which may promote pathological B cell responses and antibody production in patients with seropositive RA. TPH cells also express chemokine receptors, enabling them to infiltrate inflamed parts of the body and stimulate B cells to produce antibodies…

Tips for Handling Less Common Rheumatoid Arthritis-Related Disorders

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WASHINGTON, D.C.—As treatments for rheumatoid arthritis (RA) improve, some related conditions that used to be common in patients with RA are not seen very often anymore, but they still exist and physicians need to know how to identify them. Speaking to attendees at the ACR/ARHP Annual Meeting talk titled Rheumatoid Arthritis—A Case-Based Approach to Selected…