CHICAGO—Choosing a treatment for antiphospholipid syndrome (APS) involves an array of factors, from the antibodies present to their titers to other risk factors, said Lisa Sammaritano, MD, during a guided tour of APS treatment at the 2019 ACR State-of-the-Art Clinical Symposium, held April 5–7. Dr. Sammaritano, associate attending physician at the Hospital for Special Surgery,…
The Microbiome: A Predictor of Autoimmune Response?
CHICAGO—The world of rheumatology is beginning to harness the promise of the microbiome, with evidence showing components of the gut may help predict response to medication and may be manipulated to improve how well a treatment works, said Jose Scher, MD, at the 2019 ACR State-of-the-Art Clinical Symposium, held April 5–7. “We can truly exploit…
Expert Says Vaccines Are Largely Safe for Rheumatology Patients
CHICAGO—Rheumatologists often come to Brian Schwartz, MD, associate professor of medicine and vice chief for clinical affairs in the Division of Infectious Diseases, University of California, San Francisco, with a concern: A patient on immunosuppression has a family member who needs a live vaccine, but the patient may be vulnerable to the vaccine’s effects. Should…
The Type I Interferon Pathway’s Influence in Connective Tissue Disease
Type I interferon appears to play a role in disease susceptibility and pathogenesis in several classic connective tissue diseases, at least in some patients. Below, I present evidence supporting this connection, explore potential missing links in pathogenesis and discuss biological treatments that target the pathway. The Type I Interferon Pathway Interferons are a class of…
The Prevalence, Incidence, Mortality & Costs of RA-Related ILD
Interstitial lung disease (ILD) can be associated with rheumatoid arthritis (RA) with significant morbidity and mortality. An article in The Journal of Rheumatology focused on calculating the prevalence, incidence, mortality and costs to the healthcare system of RA-related ILD (RA-ILD).1 “RA is the most common of connective tissue diseases encountered by rheumatologists—affecting about 1% of…
Study Shows Lupus Clinics Outperform General Rheumatology Clinics
Are outcomes better in a specialized lupus clinic compared with care provided in a general rheumatology setting? New research from Rush University, Chicago, studies this important care management question and finds the specialized clinic does indeed produce better outcomes.1 A big part of the difference may be due to the added experience specialty clinic clinicians…
Mouse Research Suggests the Microbiome Is Related to Lupus
Research in type I interferon (IFN) driven mouse models of systemic lupus erythematosus (SLE) suggests the microbiome may play a role in the development of autoimmunity. Additionally, changes in diet may induce protective effects in the gut.1 “Microbes in the gut worsen a lupus model related to the interferon pathway,” says Martin A. Kriegel, MD,…
ACR Volunteer Leaders Visit Capitol Hill, Lobby for 5 Issues
WASHINGTON, D.C.—Dozens of rheumatology leaders met with more than 100 politicos on Capitol Hill in mid-May as part of the ACR’s annual Advocacy Leadership Conference. Armed with research and advocacy training concerning a handful of important issues, rheumatologists, rheumatology interprofessional team members, government affairs specialists and others met with federal lawmakers, legislative aides and correspondents….
Case Report: An Adult-Onset Still’s Disease Mimic
A 53-year-old man was hospitalized for pericarditis, abdominal lymphadenopathy of unknown origin and non-bloody diarrhea. He was admitted for four days, and then he was discharged home without incident. Two months after his initial presentation, he was readmitted for the evaluation of several new issues, including symmetric arthralgias, hypovolemia with associated electrolyte abnormalities and concurrent…
Lyme Arthritis: Presentation, Diagnosis & Treatment
A 52-year-old man living in greater Boston with a history of hypertension presented at our rheumatology clinic with bilateral knee pain and swelling. He had been in his usual state of health until four months earlier when he developed right knee pain and swelling without an incipient trauma, which did not improve with non-steroidal anti-inflammatory…
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