Recent research analyzed factors influencing the selection of the first-line biologic medications and the real-life factors that lead to switching from those medications to other biologics in treating rheumatoid arthritis (RA). The study compared the use of abatacept and tocilizumab with a tumor necrosis factor alpha inhibitor (TNFi).1,2 Participants were enrolled in the Lombardy Rheumatology…
Systemic autoimmune diseases are thought to result from immune dysregulation in genetically susceptible individuals who were exposed to environmental risk factors. Many studies have identified genetic risk factors for these diseases, but concordance rates among monozygotic twins are 25–40%, suggesting that nonheritable environmental factors play a more prominent role.1,2 Through carefully conducted epidemiologic and other…
Throughout their training and practice, physicians become adept at pattern recognition as a means to efficiently connect and synthesize seemingly disparate laboratory, physical exam, and radiologic and historical findings into a coherent theory for what likely ails the patient sitting in front of them. This inductive method of reasoning is necessary because, based on these…
Overcoding is a common term used when discussing fraud and abuse in reporting procedures and services not supported by the actual work performed. Alternatively, undercoding—or failing to report the full extent of services or procedures provided—is an equally unsound practice and a compliance risk. In the world of quality reporting, undercoding can have damaging effects…
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…
“It is not necessary to change. Survival is not mandatory.” —W. Edwards Deming For practices to survive, change is a requirement—not an option—in the rapidly evolving practice of rheumatology care. Pharmaceutical therapies are advancing quickly, opening the door for game-changing therapies in the treatment of chronic autoimmune disorders. With these advances comes a need for…
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…
“To err is human.” —Alexander Pope (1688–1744) The Wisest Minds in Medicine At some point during our careers, we have the privilege of meeting a physician so talented that everyone else pales in comparison. These are those gifted clinicians whose astonishing mastery of medicine makes everyone in their midst feel like inept, babbling fools. They…
Guselkumab Improves Active Psoriatic Arthritis New research has revealed that patients with active psoriatic arthritis (PsA) and ≥3% body area of plaque psoriasis benefit from treatment with a human monoclonal antibody known as guselkumab (GUS). GUS is specific for the p19 subunit of interleukin 23 (IL-23). Patients in the Phase 2 clinical trial experienced significant…
WASHINGTON, D.C.—Calling it an extremely challenging topic, Peter K. Gregersen, MD, professor and head, Robert S. Boas Center for Genomics and Human Genetics, Feinstein Institute, Manhasset, N.Y., said the current role of genetics in clinical practice is less about how to use genetic information to care for patients and more about how providers and patients…