“Treat to target regardless of disease activity level” tops the list of recommendations for both early and established RA in the 2015 Guideline for the Treatment of Rheumatoid Arthritis. The guideline addresses six major topics, including DMARDs, glucocorticoids and biologics, and includes 74 recommendations. These recommendations are not prescriptive, and the treatment decisions should be made by physicians and patients together…

Rheumatology Research Foundation Scholarships Help Students Attend ACR/ARHP Annual Meeting
Seven students pursuing rheumatology-related careers will head to San Francisco in November on a Student and Resident ACR/ARHP Annual Meeting Scholarship—awards that are open to students and residents from states that are underserved by rheumatology professionals. The Rheumatology Research Foundation has awarded the students $750–1,500 toward travel expenses and registration for the ACR/ARHP Annual Meeting,…

Rheumatology Research Foundation Expands Studies in Rheumatic Diseases Through Career Support
For the past 30 years, the Rheumatology Research Foundation has been an invaluable resource for investigators looking to further their careers and expand essential research into rheumatic diseases. Among the Foundation’s many award recipients is Robert Plenge, MD, PhD. In 2008, Dr. Plenge received a grant from the Foundation to pursue finding a genetic basis…

Dr. St.Clair Reflects on Progress in Rheumatology
As a practicing rheumatologist, I have experienced the increasing payer and government involvement shaping our evolving healthcare system. New payment models, changes in health insurance coverage, the federal mandate for the adoption of electronic health records and the implementation of ICD-10 are recent changes that have rocked our world. Our patients are also paying the…

Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings
Despite a generation of advances in molecular biology, a huge gap exists between the Sjögren’s syndrome (SS) patient’s description of their symptoms and the objective findings. Current issues include: Many SS patients are misclassified as either rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), even within rheumatology clinics. Frequently, the sickest SS patients with extraglandular…

Research in Temporal Arteritis Suggests Link with Infection, Autoimmune Disease
Temporal arteritis was first described by Sir Jonathan Hutchinson in 1890 in an elderly retired gentleman’s servant who developed red, painful streaks on his temples and was found to have bilaterally swollen temporal arteries with feeble pulses.1 Sir Hutchinson disputed the suggestion that the red streaks were caused by the man’s hat and, instead, called…
Online Tool Helps RA Patients Make Informed Decisions
Should you escalate care to a biologic? Many RA patients find this decision difficult and may need extra support and education to come to an informed decision. A recent study on this issue tested the value of a Web-based interactive decision support tool, which was developed with patient and physician input. After eight weeks, patients using the tool showed a measurable increase in the objective and subjective knowledge needed for making an informed decision compared with standard care…
Low-Grade Inflammation in Symptomatic Knee OA
Although osteoarthritis (OA) was formerly considered a non-inflammatory joint disease, it’s now well-appreciated that inflammatory mediators, such as PGE2 and IL-1β, are produced by osteoarthritic joint tissues and can be used to identify patients with symptomatic knee OA. A peripheral blood leukocyte inflammatory transcriptome identifies a subset of symptomatic knee OA patients at higher risk for radiographic progression and may reflect persistent low-grade joint inflammation…

Interdisciplinary Collaboration at Wash U Advances Understanding of Immunology, Rheumatology
In June 2014, 10 members of a church group returned to St. Louis from Haiti, where they had contracted chikungunya virus (CHIKV), a mosquito-transmitted alphavirus previously unknown in the Western hemisphere that produces inflammatory arthritis symptoms. Because CHIKV-related arthritis mimics seronegative RA, a group of clinicians, immunologists, virologists and geneticists at the Washington University in…

FDA Issues Stronger Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Warning
The U.S. Food and Drug Administration (FDA) has toughened the existing warnings for nonsteroidal anti-inflammatory drugs (NSAIDs) due to their stroke and myocardial infarction (MI) risk increase.1 Due to a continual review of these products, FDA is requiring label updates for all prescription NSAIDs. Over-the-counter (OTC) NSAIDs already list the increased risk of MI and…
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