Difficult-to-treat rheumatoid arthritis (RA) is defined as the failure of two or more classes of biologic or targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) to control active or progressive disease in patients with RA. Between 5 and 20% of patients with RA have difficult-to-treat RA.
Mental Health in Rheumatology
Regaining a sense of control, limiting responsibilities and engaging in mindfulness can help rheumatologists manage their mental health needs. Rheumatologists should also address the mental health concerns raised by their patients. Here are insights from a psychiatrist/rheumatologist.
Interferons in Systemic Lupus Erythematosus
Current knowledge of receptor-ligand interactions, cell signaling, and transcriptional regulation derive from studies of type I interferon. The design of novel therapeutics is informed by the advances in investigation of type I interferon, with the potential for important impacts on patient management.
When to Check Drug Levels & Why
Checking blood levels of commonly used disease-modifying anti-rheumatic drugs (DMARDs) has gained widespread attention in the rheumatology community, even resulting in a recent guidance document from EULAR for biologics.1 Although a highly useful tool, drug level measurement in rheumatology is not without challenges; many of our drugs violate the basic principles of pharmacology that we…
ACR Image Competition 2023 Results, Part 4
For the 2023 Image Competition, the ACR sought images representing a diverse range of patients with idiopathic inflammatory myopathies (IIMs) or IIM mimics. Unilateral Heliotrope Rash in Anti-MDA-5 Antibody Dermatomyositis These images depict a 36-year-old patient with arthralgias, dyspnea and a unilateral heliotrope rash (image A). A unilateral heliotrope rash is a distinctive, but rare,…
SMILE, an Online Lupus Tool, Can Aid Shared Decision Making
Patients with systemic lupus erythematosus (SLE) often face many concerns, fears and uncertainties that render “treatment decision making very difficult,” says Jasvinder Singh, MD, MPH, professor of medicine and epidemiology at the University of Alabama at Birmingham. Often these patients, who tend to be women from minority groups, “do not have access to easily understandable…
Reflecting on B Cell-Depleting Therapies & COVID-19
In the early days of the COVID-19 pandemic, confusion and concern for immunosuppressed patients grew among rheumatologists and patients alike. Research has helped bridge the knowledge gap, and treatment options for COVID-19 have helped ease concerns.
Can Repeat Injections Improve Knee OA Pain?
Promising Results from a Phase 3 Study SAN DIEGO—An investigational liposomal formulation of dexamethasone sodium phosphate (TLC599) for intra-articular injection is being studied to treat patients with knee osteoarthritis (OA). George Spencer-Green, MD, MS, chief medical officer of Taiwan Liposome Company (TLC), Cambridge, Mass., presented recent data on this agent in a late-breaking abstract session…
Neuropsychiatric Lupus Research Benefits from Functional MRI & Insights into Microglia
Experts described the latest breakthroughs related to lupus and the brain, including the use of functional magnetic resonance imaging (fMRI) to gain insights into brain fog. Research into the role of microglia in neuropsychiatric lupus is also described.
FDA Issues Boxed Warning for Denosumab & Approves a Generic NSAID
In January, the U.S. Food & Drug Administration approved indomethacin in an oral suspension, a generic version of Indocin Oral Suspension. The agency also issued a boxed warning and updated label for denosumab, warning of the risks of severe hypocalcemia in patients with chronic kidney disease.
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