New research exploring the effects of etanercept on cardiovascular disease in treatment-naive, early RA patients suggests a treatment advantage with etanercept, a TNF inhibitor and methotrexate over treatment with methotrexate and a conventional synthetic disease-modifying anti-rheumatic drug…
The Latest Data on Cancer Immunotherapy’s Interaction with Autoimmunity
CHICAGO—The body of literature on immunosuppressive drugs used to treat cancer and autoimmune diseases is growing, helping bring some clarity to their effects on the immune system and how well they work in patients. This has helped refine the questions that further research must answer, said an expert at the 2018 ACR/ARHP Annual Meeting. The…
Diagnosing & Managing Pulmonary & Kidney Manifestations in Lupus
CHICAGO—In systemic lupus erythematosus (SLE), most types of severe pulmonary manifestations are relatively rare, but it’s crucial they be caught because of the potentially dire consequences, said Richard Silver, MD, professor in the Rheumatology Division at the Medical University of South Carolina, Charleston, at the 2018 ACR/ARHP Annual Meeting. Pulmonary Manifestations Parenchymal disease—seen in the…
The Tortured Path to the Cortisone Discovery
CHICAGO—The path to the discovery of cortisone—a top-selling, important drug, with dozens of indications—was complicated by failure, false moves, desperation and obsession. The tale, recounted in the Philip Hench, MD, Memorial Lecture: Crossroads of History & Hope: Discovery & First Use of Cortisone for RA at the 2018 ACR/ARHP Annual Meeting in October, is an…
These 3 Tough Cases from the 2018 Thieves Market Underscore Need for Clinical Diligence
CHICAGO—In the Thieves Market session at the 2018 ACR/ARHP Annual Meeting, rheumatologists from around the country presented a slate of challenging cases that emphasized the importance of clinical persistence and attention to detail, and the need to consider diagnoses that might not be common or obvious. Three of them are summarized below. (Look for more…
What to Do with Erosive, Inflammatory Osteoarthritis
CHICAGO—Is erosive, inflammatory osteoarthritis (EOA) a separate condition from osteoarthritis (OA)? Roberta Ramonda, MD, PhD, a rheumatologist at the University of Padova, Italy, spoke at the 2018 ACR/ARHP Annual Meeting on the clinical presentation of EOA and how it differs from OA. EOA is characterized by a frequent aggressive clinical course and occurs most often…
Why & How Our Biologic Drug Discussion with Patients Should Evolve
As we turn the corner on the second decade of biologic use for rheumatic disorders, a reappraisal of approach in our communication with patients is due. In practice, the impact these agents have on patients’ lives justifies the friction rheumatologists face when connecting patients to them. You can understand why older rheumatologists who apprenticed on…
Cancer-Associated Myositis: A Case Report & Review of the Literature
Since it was first reported in 1916, a correlation between inflammatory myopathies and cancer has been noted in several studies. Population studies have confirmed this relationship, and the phrase cancer-associated myopathy has entered the vernacular. Over the past decade, research efforts have shifted toward revealing associations between autoantibodies and clinical phenotypes. One subset of auto-antigens…
Large-Vessel Involvement Is an Independent Risk Factor Predicting GCA Mortality
At diagnosis, temporal artery biopsy results and large-vessel involvement of patients with giant cell arteritis may be stronger predictors of mortality than cardiovascular risk factors…
Alterations in Macrophage Activation May Signal a Lupus Flare
New data suggest myeloid cells in SLE patients skew B and T cell activation status toward the M1 proinflammatory phenotype, thereby directing SLE flares and remission…
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