A recent prospective, observational cohort study of potential clinical biomarkers for progression to interstitial lung disease (ILD) in patients with early systemic sclerosis (SSc) found that higher levels of CCL2 circulating in their plasma predicted both faster ILD progression and poorer survival rates than in those with lower levels.1 CCL2, also known as monocyte chemoattractant…
What factors drive inflammation and progressive disease in ankylosing spondylitis (AS)? The answers have long eluded rheumatologists. Although 90% of patients with AS test positive for the HLA-B27 gene, pieces remain missing in our understanding of this chronic, inflammatory disease, which often leads to pain, spinal fusion and, in about half of patients, gut involvement,…
Necrotizing autoimmune myopathy (NAM) is a relatively recently discovered subgroup of inflammatory myopathies. NAM is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation.1 One subgroup of NAM is 3-hydroxy-3-methylglutaryl-CoA reductase antibody (HMGCR Ab)-related immune-mediated necrotizing myopathy (IMNM), which occurs (rarely) after statin exposure, with a rough incidence of two per…
Mysterious Ways The juxtaposition of the old and the new was readily evident that busy Wednesday morning. My first patient, a 94-year-old gentleman, Hal, arrived with a precise request. His rheumatologist for the past 40 years had just retired, and he was searching for a doctor with expertise in the use of gold sodium aurothioglucose,…
RISE now has three means of reporting through the Merit-Based Incentive Payment System (MIPS): individual, group and the recently added virtual groups. According to the CMS, virtual groups allow individual MIPS-eligible clinicians or groups consisting of not more than 10 MIPS-eligible clinicians to join together and report as if they were a single entity. The…
Medicare’s Merit-Based Incentive Payment System (MIPS) has been on a gradual incline toward requiring full participation by eligible providers. During its transition stage, reporting for the first year (2017) allowed providers the option to report as partial, full, minimum or not at all, with varying degrees of penalties and incentives across all three reporting components:…
New research has examined the effect of obesity on inflammatory markers, specifically C-reactive protein (CRP) level and erythrocyte sedimentation rate, in patients with rheumatoid arthritis (RA). Researchers found higher BMIs were associated with higher CRP levels in women both with and without RA, suggesting the phenomenon is related to adiposity and not an indication of disease activity. For men with RA, low BMI was associated with higher CRP levels, which proved to be RA-specific but not a direct causal effect of adiposity…
In a Year in Review session at the 2017 ACR/ARHP Annual Meeting, Daniel Solomon, MD, MPH, highlighted the latest and most intriguing aspects of clinical research on rheumatic diseases from 2017. His discussion touched on medical therapy, genetics, the effects of bariatric surgery and diet, cancer risk and more…
Tubulointerstitial nephritis and uveitis (TINU) syndrome, also known as Dobrin syndrome, is a rare oculo-renal inflammatory disease. It was first described in 1975 by American physician Robert Dobrin, MD.1 It manifests as acute interstitial nephritis and bilateral uveitis. In addition, patients often experience nonspecific systemic findings, such as fever, weight loss, malaise, myalgia and arthralgia. TINU…
Medications for serious or life-threatening conditions may receive accelerated approval from the U.S. Food and Drug Administration (FDA) by showing an effect on surrogate measures that are reasonably likely to predict a treatment’s clinical benefit. Post-approval confirmatory drug trials are then required to determine whether or not these effects translate into clinical improvements. In recent…