NEW YORK (Reuters Health)—Risankizumab, an inhibitor of interleukin (IL) 23, provides some relief for patients with active psoriatic arthritis (PsA) whose symptoms have responded poorly to standard treatments, according to 24-week results of a phase-3 trial. “Despite the range of available therapies for psoriatic arthritis, efficacious, well-tolerated therapeutic options are needed to treat the diverse…
Lab Study Suggests Zinc May Worsen Rheumatoid Arthritis
NEW YORK (Reuters Health)—Zinc supplementation may exacerbate rheumatoid arthritis (RA), new laboratory data suggest. In monocytes from patients with RA, researchers found high concentrations of intracellular zinc, which regulates immune responses by affecting signaling pathways, according to a report in Science Signaling.1 They also found increased expression of Zip8, a zinc-specific importer, in peripheral and…
Study: Pegloticase & Methotrexate Co-Treatment Helps Uncontrolled Gout
A larger proportion of patients with gout had a therapeutic response at six months when treated with methotrexate and pegloticase than with pegloticase alone, according to results from the multi-center, open-label MIRROR (methotrexate to increase response rates in patients with uncontrolled gout receiving KRYSTEXXA) study, recently published in the Journal of Rheumatology.1 The MIRROR study…
COVID-19 Vaccination in Patients with Rheumatic Disease
In January A&R, Simon et al. report a study to assess humoral and cellular immune responses after infection with, or vaccination against, SARS-CoV-2 in patients with B cell depletion and controls who are B cell competent, finding that B cell depletion completely blocks humoral but not T cell SARS-CoV-2 vaccination response. In the same issue, Connolly et al. evaluated disease flare and post-vaccination reactions in patients with rheumatic and musculoskeletal diseases following messenger RNA (mRNA) vaccination.
Case Report: Elevated Inflammatory Markers & a Hypermetabolic Mass
Consulting rheumatologists often assess patients with atypical clinical presentations for the possibility of an underlying rheumatic disease. Inflammatory syndromes that are not clearly rheumatic in nature can be particularly challenging to diagnose. Here, we share the case of a young woman with a long-standing undiagnosed illness and highly elevated inflammatory markers, and describe the evaluation…
New Booklet Offers Tips for Diagnosing Lupus, Images of Presentation on Skin of Color & More Insights
For decades, rheumatologist Cindy Flower, MD, accumulated images of systemic lupus erythematosus (SLE) in her patients, as well as clinical vignettes to use in teaching at Queen Elizabeth Hospital in Bridgetown, Barbados. For decades, she has wanted to do something wide-reaching with these materials, sharing information from her practice and her mentor, the late Prof….
Case Report: GPA Presenting as Neuropathy
Granulomatosis with polyangiitis (GPA), is a type of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) that affects small- to medium-sized vessels.1 It can occur equally in both men and women, with a reported mean age at onset of 55 years.2 The classical presentation of GPA includes upper respiratory tract (i.e., chronic sinusitis, serous otitis and…
Rheumatic Complications from Immune Checkpoint Inhibitors
Immune checkpoint inhibitors (ICIs), such as anti-programmed cell-death 1/programmed death-ligand 1 (anti-PD-1/PD-L1) or anti-CTL-associated protein (anti-CTLA-4), have dramatically changed the treatment of advanced cancers over the past decade. ICIs block T cell inhibition, thus increasing the anti-tumor immune response. ICIs are used not only for metastatic cancer, but also as adjuvant treatment for some stage…
Kawasaki Guideline Urges Treatment Intensification for Some Patients
A soon-to-be published guideline from the ACR and the Vasculitis Foundation on Kawasaki disease underscores the importance of early diagnosis and intensified treatment for people with this serious condition.1 Intravenous immunoglobulin (IVIG) remains the treatment mainstay, and prompt, aggressive treatment may be able to reduce the risk of serious complications in some patients. The guideline…
At Least 1 Year on Bisphosphonates Needed for Fracture Prevention
(Reuters Health)—It takes 12.4 months of bisphosphonate therapy to prevent one nonvertebral fracture per 100 postmenopausal women with osteoporosis, a meta-analysis of randomized clinical trials suggests.1 Researchers examined data on 10 randomized clinical trials with a total of 23,384 women who had an osteoporosis diagnosis based on either existing vertebral fractures or a bone mineral…
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