Glucocorticoids are widely prescribed by rheumatologists, and the effects of daily and cumulative doses of these drugs on bone mineral density (BMD) are important elements of a draft clinical guideline document presented on Nov. 13 at the 2016 ACR/ARHP Annual Meeting in Washington, D.C. Leaders of the ACR guideline project discussed their recommendations at the…
A recent study found that although patients with giant cell arteritis respond positively to long-term tocilizumab treatment, relapse may occur after discontinuing the medication…
A 38-year-old female patient returns to the practice for the second of three hyaluronate sodium injections of the left knee. The patient states the pain is somewhat better after her last injection. Her weight is 165 lbs., her height is 5 feet 6 inches, and her blood pressure is 120/81. After discussing the risks of…
“Obesity is an inflammatory state, so it is in the landscape of the rheumatologist,” says Christopher Ritchlin, MD, MPH. And the more attention rheumatologists pay to obesity, the better…
NEW YORK (Reuters Health)—Low-molecular-weight heparin failed to prevent symptomatic venous thromboemboli in people receiving knee arthroscopy or a lower leg cast, according to a pair of studies conducted in the Netherlands. The treatment is controversial because there is little clear evidence that heparin wards off clots in such instances. The research team, led by Dr. Raymond…
Serum uric acid (UA) is an important factor in the causal pathway for gout. It has also been implicated as a potential risk factor and/or mediator of cardiovascular disease outcomes and mortality in a large number of observational studies. Although many of the clinical trials targeting serum UA reduction have focused on pharmacologic interventions, diet…
The decision to continue or discontinue immunomodulatory medications during pregnancy is a difficult one for both patients and physicians. On the one hand, when left untreated, rheumatic conditions can cause harm to an unborn child, as well as to the pregnant mother. On the other hand, medications can be harmful to a developing fetus. In…
A large medical specialty society for ophthalmologists recently updated its recommendations for the screening of chloroquine (CQ) and hydroxychloroquine (HCQ) retinopathy.1 The recommendations from the American Academy of Ophthalmology (AAO) affect patients who may use CQ or HCQ for rheumatoid arthritis or systemic lupus erythematosus (SLE), as well as some inflammatory and dermatologic conditions. The…
Which came first? The infectious microorganism or a host’s immune resistance against it? Through the millennia, a raging battle has pitted the hordes of infectious agents surrounding us against, arguably, the most complex biologic structure ever created, the finely tuned human immune system. The stakes are high for both sides. For the infectious agent, an…
Both due to its efficacy and favorable side effect profile when compared with alternative drugs for rheumatologic conditions, hydroxychloroquine is an important agent in rheumatologists’ armamentarium. However, one barrier to hydroxychloroquine use can be its effects on the eye (also see “Revised Retinopathy Screening Guidelines,”). Ocular side effects of hydroxychloroquine can include impact on the…