Despite the presence of a highly effective vaccine, measles (rubeola) is still an important problem worldwide, one that has reemerged in some areas of the world where it had previously been almost eradicated. Rheumatology patients may have questions about whether they are sufficiently protected. Here we discuss key considerations for rheumatologists in light of recent…
“And of course, I am not telling you to do it. That would be illegal.” As a general rule, I try not to instruct my patients to break the law. My business model depends on repeat customers, so placing a patient at risk of getting arrested—even if that risk is remote—doesn’t seem like a good…
It happens all the time. We can see it coming—that quizzical look or the hesitant nod after someone asks what we do for a living. We are so accustomed to the next question that we often provide the answer before someone even has a chance to ask it: “What’s a rheumatologist?” The ACR has long…
Over the past few years, biosimilars and other new drugs have been introduced to treat rheumatic illnesses. Some of the conditions we treat have numerous drug options, others have few or only off-label options. This series, “Rheumatology Drugs at a Glance,” provides streamlined information on the administration of biologic, biosimilar and small molecule inhibitor drugs…
Historically, the early approach for treating interstitial lung disease (ILD) due to systemic sclerosis (SSc) involved immunosuppressant therapy, primarily with cytotoxic agents.1 Glucocorticoids in combination with another immunosuppressant agent, such as oral azathioprine or cyclophosphamide, were often used to treat patients with severe, progressive SSc-ILD.2 However, direct evidence to support this therapeutic approach was lacking…
Congratulations! You’ve decided to become a rheumatologist and, in so doing, join the ranks of some of the most intelligent, empathic and dynamic physicians out there. But between your decision today and where you see yourself in three, five or 10 years, many more decisions must be made. Arguably, the most important is the decision…
“Congratulations! You have matched!” With Match Day in the rearview mirror and residency nearing an end, incoming fellows prepare for the next road trip on their journey to becoming a rheumatologist. Residency molds new graduates into competent physicians by providing an overview of general medicine and teaching them the clinical and professional skills necessary to…
Rheumatology is a field rife with uncertainty. With regard to both diagnosis and treatment, we live in a world of rare diseases that are difficult to study. As a result, we are often left without an answer to our diagnostic dilemmas and without clarity when deciding the best treatment options for our patients. For rheumatologists…
Psoriatic arthritis (PsA), scleroderma and lupus often require management input from both rheumatologists and dermatologists. Usually patients see the two specialists separately. Combining both in a single rheumatology/dermatology clinic appointment can improve outcomes and increase both provider and patient satisfaction. “Physicians talk about tearing down silos of care, where each specialist focuses on their part…
Although the true cause of systemic sclerosis (SSc), or scleroderma, remains unknown, researchers have made progress in detecting the autoimmune disease’s early presence. Beyond the physiological signs of Raynaud’s phenomenon, a capillaroscopy can detect alterations in microcirculation and lab tests can confirm the presence of telltale autoantibodies, such as anti-topoisomerase 1, anti-centromere and anti-RNA polymerase…
Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome or allergic granulomatosis and angiitis, is a rare small- and medium-vessel vasculitis. This disease was first described by American pathologists Jacob Churg and Lotte Strauss in 1951.1 Although the vasculitis is often not apparent in the initial phases of the disease, EGPA can affect any…
New in 2019, pediatric rheumatologists will be able to network in a community lounge, as well as attend the cutting-edge educational sessions specific to the field. Here’s a sneak peek…
Autoinflammatory diseases are genetically diverse, but clinically similar, conditions distinct from autoimmune illnesses, such as systemic lupus erythematosus or rheumatoid arthritis. Clinically, they are defined by recurrent episodes of inflammation that follow a characteristic pattern each time they occur. Some have a set length of time during which fever, peritonitis or arthritis manifest. Others are…
In September 2018, the U.S. Food & Drug Administration (FDA) granted fast-track status to FCX‑013, a gene therapy product developed to treat moderate to severe localized scleroderma (morphea). Previously, the treatment received an orphan drug designation for localized scleroderma, as well as a rare pediatric disease designation. Phase 1 and 2 studies will assess safety…
Many, if not all, rheumatologists seek to grow as clinicians so they can provide consistently exceptional care to patients and serve as role models for colleagues and trainees. In this series, Lessons from a Master Clinician, we compile insights from clinicians who have achieved a level of distinction in the field of rheumatology. Gail Kerr,…
Methotrexate (MTX) remains the predominant medication used by rheumatologists to treat rheumatoid arthritis (RA). Doses of 7.5–25 mg per week with daily folic acid are generally prescribed. Despite its common use, MTX must be prescribed cautiously given the potential adverse effects when taken incorrectly or without folic acid supplementation. Cases of MTX-induced cutaneous ulceration have…
Patients with chronic kidney disease (CKD) often experience joint pain due to various etiologies, including crystalline arthropathies, renal osteodystrophy, amyloid arthropathy, erosive osteoarthritis, avascular necrosis and even erosive spondylarthrosis.1 Below, we present a case of crystalline arthropathy in a patient with chronic kidney disease, mistaken for gout. The Case A 29-year-old man was admitted to…
In an international clinical trial, adding the drug belimumab to standard maintenance therapy for patients in remission with vasculitis did not lower the relapse rate. The double-blind, placebo-controlled study evaluated the safety and efficacy of belimumab as adjunctive therapy to maintain remission in anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Results of the multi-center, industry-sponsored…
Toll-like receptors play an important role in host defense. TLR-7 recognizes viral ssRNA, but also plays a role in the development of systemic lupus erythematosus (SLE). Genetic ablation of a similar receptor, TLR-9, results in opposite effects, with severe disease and kidney involvement. The mechanism of how this works remains unknown. Anna-Marie Fairhurst, PhD, from…
Prestigious Carol Nachman Prize for Research in Rheumatology Awarded to Ellen Gravallese On May 10, Ellen M. Gravallese, MD, the Myles J. McDonough Chair in Rheumatology and chief of the Division of Rheumatology at University of Massachusetts Medical School, Worcester, was awarded the prestigious Carol Nachman Prize for lifetime achievement in rheumatology research in Wiesbaden,…
Roughly 20 years ago, Gary S. Firestein, MD, was surfing at Cloudbreak, a sheltered reef nearly three miles south of Namotu Island in Fiji. With waves soaring as high as 20 feet, it’s either a surfer’s dream or nightmare, and ranked among the 10 most challenging waves anywhere on the planet. At the time, Dr….
RA patients who achieve low disease activity on tofacitinib and methotrexate combination therapy can safely cease methotrexate use, according to recent research…
Results from a one-year study suggest subcutaneous CT-P13, which is biosimilar to infliximab, is as safe and effective for RA patients as intravenous (IV) CT-P13 and IV infliximab…
Medical students and residents are choosing careers in rheumatology, thanks in part to the annual Choose Rheumatology Experience hosted by the Rheumatology Research Foundation during the ACR/ARP Annual Meeting. The Choose Rheumatology Experience is a special half-day program designed to help future physicians and rheumatology professionals navigate the Annual Meeting. Cultivating interest in rheumatology is…
As the number of COVID-19 cases continues to rise in the U.S., the fast spread of the virus is causing gaps in practice staffing, and patient influx will likely increase, leaving systems needing more providers. The use of locum tenens physicians can help practice fill gaps at your organization caused by COVID-19. Below we offer…
It is with great pleasure that the ARP congratulates the 2019 recipients of the Mentored Nurse Practitioner/Physician Assistant Award for Workforce Expansion. The purpose of the NP/PA Award is to increase the supply of rheumatology healthcare providers to better meet the needs of people with rheumatic diseases across the U.S., particularly in geographically underserved areas….
From insights into mentoring and statistics to integrating virtual reality into a patient’s rehab—the educational sessions offered during the ACR/ARP Annual Meeting will be practical, yet innovative and inspiring…