ACR Convergence 2020—In May 2020, the ACR published its updated guideline for the management of gout.1 It followed on the heels of a 2017 gout guideline published by the American College of Physicians.2 Although the guidelines provide similar recommendations on the treatment of acute gout, they differ importantly in the use of uric acid-lowering therapy…
The number of medications with rheumatologic indications has increased in parallel with expanding complexities of medication approval and delivery. Simply starting a patient on a biologic medication or new disease-modifying anti-rheumatic drug (DMARD) can be time consuming and frustrating for physicians, nurses and their support staff. In addition to educating the patient and obtaining prior…
The search for knowledge has shaped Western culture and is based on Greek philosophy, especially Aristotelian metaphysics. During the Middle Ages, this knowledge was matured by dialectical scholasticism, culminating, in its later stages, in the amalgam between Islamic science and the neo-Aristotelianism of St. Thomas Aquinas.1 In this way, the foundations of the future scientific…
The ACR position statement on access to care proposes the goal that “… all patients have timely access to expert rheumatology care … .”1 The reality is that new and established rheumatology patient wait times are often prolonged, causing delays in necessary diagnosis and treatment. The 2005 and 2015 ACR Workforce studies document intractable and…
June saw the passing of a beloved colleague, mentor and friend to many in the rheumatology community when J. Timothy Harrington, MD, died of pancreatic cancer in his hometown of Madison, Wis. Dr. Harrington trained at Massachusetts General Hospital, the National Institutes of Health National Cancer Institute and UT Southwestern Medical Center, and served on…
In May, the ACR released a new treatment guideline for the management of gout for simultaneous publication in Arthritis & Rheumatology and Arthritis Care & Research.1 Based on evidence from more than 130 published studies, the guideline makes a total of 42 recommendations—of which 16 are strong: It has 27 recommendations for urate-lowering therapy (ULT)…
Research into the disease-modifying effects of the novel cathepsin K inhibitor MIV-711 suggests it may be effective as a knee OA treatment. In OA patients using the treatment, the study documented statistically significant reductions in bone and cartilage progression…
A recent study compared three clinical criteria for rheumatoid arthritis (RA) in patients using certolizumab, assessing the predictability of treatment non-response. Researchers found Clinical Disease Activity Index measurement at three months may predict patient outcomes at 12 months…
Even before I started my rheumatology fellowship, I knew it would be a demanding career, diagnosing complex diseases with only a few management options in seriously ill patients. What I didn’t appreciate as much before is how badly we are needed across the country. According to the 2018 outcomes report from the National Resident Matching…
The Johns Hopkins Lupus Center, Baltimore, has described its experience using hydroxychloroquine (HCQ) levels.1 Forty-four percent of its patients had levels below 500 ng/mL (partial nonadherence); 13% were severely nonadherent (<200 ng/mL). They were shown their results and educated on HCQ adherence. Adherence then improved to 80%; those with lower HCQ levels had higher disease…