“Do you seriously want me to stand on my tiptoes?” my gruff 68-year-old patient at the VA Rheumatology Clinic asked, incredulous. “I came with a walker. I think you very well know, doc, that if I get on my tippy-toes, then I’m going to fall flat on my face.” He had a point, one that…
Past President Marlin Shields Reflects on the ARHP’s 50-Year History
As the Association of Rheumatology Health Professionals (ARHP) continues to celebrate its 50th anniversary, The Rheumatologist recently spent time with Charter Member and Past President Marlin N. Shields, RPT, discussing the history of the ARHP and the changes he has seen in rheumatology. One topic that was, and remains, near and dear to him is…
Rheumatology Research Foundation Expands Studies in Rheumatic Diseases Through Career Support
For the past 30 years, the Rheumatology Research Foundation has been an invaluable resource for investigators looking to further their careers and expand essential research into rheumatic diseases. Among the Foundation’s many award recipients is Robert Plenge, MD, PhD. In 2008, Dr. Plenge received a grant from the Foundation to pursue finding a genetic basis…
Dr. St.Clair Reflects on Progress in Rheumatology
As a practicing rheumatologist, I have experienced the increasing payer and government involvement shaping our evolving healthcare system. New payment models, changes in health insurance coverage, the federal mandate for the adoption of electronic health records and the implementation of ICD-10 are recent changes that have rocked our world. Our patients are also paying the…
Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings
Despite a generation of advances in molecular biology, a huge gap exists between the Sjögren’s syndrome (SS) patient’s description of their symptoms and the objective findings. Current issues include: Many SS patients are misclassified as either rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), even within rheumatology clinics. Frequently, the sickest SS patients with extraglandular…
When Sense Disorders Signal Immune System Interactions
I sometimes find myself mired in sticky clinical circumstances. I am facing a distraught patient who is seeking my opinion about a condition that, according to some, may not truly belong in the rheumatologist’s bailiwick. Case example: hearing loss. The Steroid Test Sudden sensorineural hearing loss (SSNHL) and its relative, autoimmune inner ear disease (AIED),…
Rheumatology Drug Updates on Brentuximab Vedotin, Tofacitinib Citrate
Brentuximab Vedotin Enters Phase 2 Trials Brentuximab vedotin (Adcetris), an antibody-drug conjugate (ADC) directed at CD30, is currently entering Phase 2 clinical trials for treating systemic lupus erythematosus (SLE).1 The ADC encompasses an anti-CD30 monoclonal antibody, which is attached by a protease-cleavable linker to a microtubule-disrupting agent, known as monomethyl auristatin E (MMAE). The ADC…
U.S. Drug Benefit Managers Clamp Down on Specialty Pharmacies
NEW YORK/LOS ANGELES (Reuters)—In recent days, the largest U.S. managers of private prescription drug benefits have cut off at least eight pharmacies that work closely with drugmakers, intensifying scrutiny of a system that helps inflate drug prices, officials at the benefit managers told Reuters. The terminations come from payers who together manage drug benefits for…
Bronchial Tissue Immune Activation Seen in Early Rheumatoid Arthritis
NEW YORK (Reuters Health)—Patients with untreated early rheumatoid arthritis (RA) show signs of immune activation and local inflammation in their bronchial tissues, researchers from Sweden report. Previous studies have shown that patients with RA have shared citrullinated epitopes in the lungs and joints, as well as anticitrullinated protein antibodies (ACPA) in bronchoalveolar lavage (BAL), suggesting…
Does Methotrexate Increase Skin Cancer Risk?
A recent study connects the use of immunosuppressant and biologic agents to an increased risk of nonmelanoma skin cancer in patients being treated for RA and IBD…
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