Rheumatoid arthritis (RA) can be defined as a chronic autoimmune systemic inflammatory condition characterized by symmetrical polyarthritis. Typically, patients present with pain, stiffness and warmth of the affected joints. The condition can result in extra-articular features, adding to disability, and may eventually lead to premature death, especially if not treated early and appropriately.1,2 Over the…
How to Choose the Best Course of Treatment to Manage Rheumatoid Arthritis
Diagnosing rheumatoid arthritis (RA) early in the disease process is ideal, because treatments are more likely to be effective and less damage will occur. Guidelines from the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) state that using newer biologic medications, in addition to more aggressive dosing of traditional medications, is…
Living with RA: Study Examines the Value of Patient Involvement in Creating Clinical Practice Guidelines
“The lived experience with RA is itself a valuable form of expertise,” writes Dr. Liana Fraenkel, MD, MPH, and her colleagues in their latest research. To examine the value of this expertise and how it can be incorporated into clinical practice guidelines, researchers developed 18 questions for which two panels—one physician dominated and one comprising entirely patients—would develop recommendations. For a majority of these questions, the patient panel made the same recommendations as the physician panel, with similar recommendation strengths…
ACPA-Positive & ACPA-Negative Patients with RA: The Difference Begins in the Lungs
A new study from Stockholm, Sweden, strengthens the link between the lungs and anti-citrullinated protein antibody (ACPA)–positive RA. After analyzing the bronchial tissue of untreated patients with early RA, researchers found the patients’ lungs had signs of immune cell accumulation and activation…
The Microbiome’s Role in Inflammatory Arthritis
Despite the relative novelty of the human microbiome as an area of study, a substantial body of evidence has accumulated addressing its potential involvement in the pathogenesis of rheumatic disease. This review article explores the available data in animal and human studies, focusing on the role of the intestinal microbiome in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and the spondyloarthritidies (SpA)…
Original Sin—Researchers Look for Infectious Triggers of Rheumatic Disease & the Best Options to Block the Process
SAN FRANCISCO—Two hundred years ago, physicians knew nothing about what caused various forms of arthritis. Today, we have more clues about what may trigger rheumatic diseases, but still can’t pinpoint the culprits that set scores of inflammatory conditions in motion. Researchers discussed some of the background and recent findings that point to what immunologists call…
More Evidence Biomarkers Predict RA Relapse with DMARD Taper
NEW YORK (Reuters Health)—For rheumatoid arthritis (RA) patients in stable remission, a panel of inflammatory markers in blood can help predict the odds of relapse when disease-modifying anti-rheumatic drug (DMARD) therapy is tapered, say researchers from Germany. The multibiomarker disease activity (MBDA) score, when combined with anticitrullinated protein antibody (ACPA) testing, can predict relapse in…
Case Report: Sternoclavicular Erosions in a Patient with Uncontrolled RA
Sternoclavicular joint involvement has rarely been reported in the context of active rheumatoid arthritis (RA).1 Traditionally, rheumatologists use serial radiographs of hands and feet to diagnose, monitor for progression or evaluate the response to treatment. The sternoclavicular (SC) joint is not a typical joint assessed for RA. However, the fact that it is a diarthrodial…
Air Pollution: Is There an Association with Rheumatic Disease?
Interactions between an individual’s genetic background and their exposure to environmental factors are thought to result in a cascade of immune reactions, ultimately leading to the development of autoimmune diseases such as rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE) and juvenile dermatomyositis.1,2 For example, an environmental factor that conclusively affects susceptibility…
Patient-Centered Care Model for RA Flares Could Improve Self-Management of Symptoms
A recent trend to incorporate patient-reported outcomes (PROs) in clinical research, and ultimately clinical practice, is a response to the need to better measure and treat what patients truly care about, and adapt to the changing healthcare environment, which increasingly includes patient satisfaction as a key metric for overall quality of care, a metric tied…
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