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Can Lupus Be Prevented? Research Reveals Clues to Who’s Most Likely to Transition to Classified Disease

Susan Bernstein | February 25, 2020

How does a patient transition from health to active SLE? This question is the crux of the research conducted by Judith A. James, MD, PhD, and colleagues…

Coding Corner Questions: Using NP/PA Services in Practice

From the College | February 13, 2020

Scenario 1: Direct Billing A 70-year-old female patient with rheumatoid arthritis in multiple joints and positive rheumatoid factor returns to the practice for her fourth infusion of infliximab with the nurse practitioner (NP). She reports no fevers, cough, dyspnea or concurrent illness. She rates the severity of her joint pain at 6 on a 10-point…

Should Hydroxychloroquine Level Testing Be Standard Care in Lupus?

Donald E. Thomas, MD, FACP, FACR, with Nathalie Costedoat-Chalumeau, MD, PhD, & Michelle Petri, MD, MPH, on behalf of the ARP Practice Committee | February 13, 2020

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…

Coverage & Reimbursement Challenges: Updates from the ACR Insurance Subcommittee Chair

Chris Phillips, MD | February 7, 2020

The ACR Insurance Subcommittee is working to address specialty pharmacy requirements for in-office treatments, elimination of consultation codes and other coverage and reimbursement challenges.

Update on the Management of Takayasu Arteritis

Lara C. Pullen, PhD | February 4, 2020

A rare form of large vessel vasculitis, Takayasu arteritis persents with no clear patterns, with patients experiencing vascular symptoms, as well as such systemic symptoms as fever and weight loss. A systematic literature review found evidence to guide rheumatologists in monitoring and treating their patients with Takayasu arteritis…

Tips for Exploring Tough Topics with Teens with Rheumatic Disease

Susan Bernstein | January 17, 2020

ATLANTA—Managing teenage patients may present challenges for pediatric rheumatologists and rheumatology professionals not only because of their often complex, rare conditions, but because teenagers are, well, teenagers. Teens may experiment with sexual intercourse, alcohol use, tobacco or vaping e-cigarettes to fit in with their peers, even if these habits have serious health consequences, according to…

Case Report: Obliterative Bronchiolitis in Rheumatoid Arthritis

Robin Paudel, MD, Prerna Dogra, MD, & Richard S. Morehead, MD | January 17, 2020

A 59-year-old woman with rheumatoid arthritis (RA) presented to our pulmonary clinic for progressively worsening dyspnea of five years’ duration. She described progressively worsening dyspnea after a few minutes of walking on level ground. In addition, she noted worsening pain and morning stiffness of the wrists, knees and metacarpophalangeal (MCP) joints, with subcutaneous nodules. She…

Sjögren’s Syndrome in Kids: Diagnostic Challenges & Treatment Options

Sara M. Stern, MD, Matthew L. Basiaga, DO, MSCE, & Scott M. Lieberman, MD, PhD | January 17, 2020

A 14-year-old girl is referred to your office for fatigue and arthralgias. While you’re obtaining her past medical history, she divulges that she has had four episodes of bilateral parotitis, each lasting two weeks. An otolaryngologist evaluated her. She lacked sicca symptoms, had a normal complete blood count (CBC), normal inflammatory markers and a negative…