Scleroderma renal crisis (SRC) is a life-threatening complication of systemic sclerosis. SRC occurs in 2–15% of patients with diffuse sclerosis and usually within the first five years from the time of diagnosis. Risk factors for SRC include, but are not limited to, early diagnosis, corticosteroid or cyclosporine use, and the presence of anti-RNA polymerase III…
Case Report: A Patient on Apremilast Develops Streptococcus Salivarius
Apremilast was first marketed in March 2014 for the treatment of adults with psoriatic arthritis (PsA). An immunomodulating drug, which is a small molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine monophosphate (cAMP), apremilast is administered orally. By inhibiting PDE4, intracellular cAMP levels are increased. Although the exact mechanism of action is not…
Case Report: Cardiac Tamponade in a Rheumatoid Arthritis Patient
Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disease. Although RA develops its central pathology within the synovium of diarthrodial joints, many non-articular organs can be involved, particularly in patients with severe joint disease.1 Although most patients are asymptomatic, cardiac involvement is relatively common and includes rheumatic heart nodules, pericarditis (30–50%), pericardial effusion and…
Clinical Insights into Gout Management: Rheumatology Drugs at a Glance Pt. 4
Three clinical experts on gout offer their insights into common management errors, clinical pearls, new safety data from the FDA and the role of biologic therapies in the management of gout.
New Options for Treatment-Resistant RA
Two JAK inhibitors, one recently approved by the FDA, have shown improvements in patients with active RA for whom other therapies have proved ineffective…
Mortality from Anti-neutrophil Cytoplasmic Autoantibody-Associated Vasculitis Falling Slightly
NEW YORK (Reuters Health)—Mortality rates in patients with antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) decreased from 1999 to 2017, according to records from the Centers for Disease Control and Prevention (CDC). “The mortality attributed to several rare diseases [e.g., hypersensitivity pneumonitis] has increased in recent years,” Alexander W. Steinberg, MD, from Saint Joseph Hospital, Denver, tells…
Transbronchial Lung Cryobiopsy a Valid Diagnostic Option in Interstitial Lung Disease
NEW YORK (Reuters Health)—Transbronchial lung cryobiopsy (TBLC) and surgical lung biopsy (SLB) had a high level of agreement for diagnosing interstitial lung disease in the first comparative study. “These data suggest that TBLC, when done by an experienced proceduralist, is a valid first-line minimally invasive diagnostic tool for patients with interstitial lung disease deemed to…
More Than Skin Deep: Insights into Clinical Challenges in Psoriatic Arthritis
Accurately classifying patients with psoriatic arthritis (PsA) can be difficult, especially patients with monoarticular/oligoarticular and polyarticular forms of PsA. A session at the 2019 European Congress of Rheumatology provided insight into the assessment and treatment of PsA subtypes…
Lupus Flares Pose Greatest Risk for Adverse Pregnancy Outcomes in Women with SLE
According to new research, women with SLE are at the highest risk for adverse pregnancy outcomes during a lupus flare. The data may enable clinicians to use risk stratification and tailored monitoring to counsel SLE patients who are pregnant or considering pregnancy. Researchers also found that maternal age, lupus nephritis and antiphospholipid antibodies may affect pregnancy outcomes…
Gut Instinct: Ankylosing Spondylitis & the Microbiome
CHICAGO—At the 2019 ACR State-of-the-Art Clinical Symposium, an annual gathering featuring talks by key opinion leaders on the most salient topics for practicing rheumatologists and healthcare providers, Jose U. Scher, MD, director of the Microbiome Center for Rheumatology and Autoimmunity at NYU Langone Medical Center, New York City, was the featured speaker. In his remarks,…
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