Singer Jimmy Dean reportedly once said, “I can’t change the direction of the wind, but I can adjust my sails to always reach my destination.” The COVID-19 pandemic has required us as rheumatologists to adjust our sails multiple times. We have had to rethink many of the ways in which we interact with our worried…
The uncertainty is certain Let us draw up the curtain Unmask this serial killer’s intention. Attack of its clones gone viral Made distancing societal Disrupting every human convention. Humble hydroxychloroquine Now forced into the scene Telehealth bridges our care. Drive-thru testing PPE and sanitizing Social media fills the air. But let’s not be deceived This…
In 2019, the ACR created a Global Strategy Task Force to establish and oversee a cohesive approach to expanding its global impact in education, training and research through increased engagement with international partners. Just as the task force met in February 2020, the world was plunged into the COVID-19 pandemic. The concept of global collaboration…
No data exist for prescribing hydroxychloroquine for post-exposure prophylaxis, and we should not prescribe it for this indication.
In a matter of weeks, the COVID‑19 crisis has totally upended clinical medicine and the practice of rheumatology. Our old ways of seeing patients in person, precepting fellows in clinic or on the consult service, and leading in-person interactive teaching rounds are gone for now and possibly for good. But how can we replace these…
Under the onslaught of developing information on COVID-19, one health system found a way to streamline communication using a secure tool it already had access to.
Two rheumatologists offer advice on patient management during the COVID-19 pandemic.
In March 2020, an elderly married couple living on Long Island, N.Y., presented to our emergency department with symptoms suspicious for COVID-19 infection. The wife, a-76-year-old woman, presented with complaints of subjective fevers, minimal dry cough and headaches of one-week duration. She denied having any chills, rhinorrhea, diarrhea, abdominal pain or shortness of breath. Two…
The new landscape for rheumatologists includes telemedicine, kids out of school and infection-prevention protocols. During the current pandemic, the practice of medicine, research and daily lives are changing to keep providers and patients safe…
Telerheumatology—which refers to the application of electronic communication technology to clinical encounters from a distance between rheumatologists and their patients—has the potential to extend a workforce projected to experience significant shortfalls, making it more accessible to more patients. Multiple barriers that stood in the way of taking full advantage of this promise are now down—at…
Even before I started my rheumatology fellowship, I knew it would be a demanding career, diagnosing complex diseases with only a few management options in seriously ill patients. What I didn’t appreciate as much before is how badly we are needed across the country. According to the 2018 outcomes report from the National Resident Matching…
Two new studies delving into the relative safety of biologic drugs prescribed for rheumatoid arthritis (RA) have concluded that real-world applications of abatacept and tumor necrosis factor inhibitors (TNFi’s) are comparable to more conventional therapies in their associated risk of serious infections. Triple Therapy One study, in Arthritis Care & Research, found the risk of…
Surrounded by his immediate family, Luis R. Espinoza, MD, died on March 29 after a prolonged illness.
Clinically amyotrophic dermatomyositis (CADM), a subset of dermatomyositis (DM), is a rare autoimmune disease characterized by typical DM cutaneous findings (e.g., heliotrope rash, Gottron papules, Gottron sign) without evidence of myositis.1 The incidence of DM and CADM is approximately 9.63 per 1 million people and 2.08 per 1 million people, respectively.2 The association with development…
SNOWMASS VILLAGE, COLO.—Janus kinase inhibitors—or Jakinibs—are a relatively new class of disease-modifying anti-rheumatic drugs (DMARDs) that perform well and have a safety profile comparable to biologics. This group of drugs was the subject of The New Frontier: Comparative Safety of JAK Inhibitors, a presentation given at the ACR Winter Symposium by Kevin L. Winthrop, MD,…
SNOWMASS VILLAGE, COLO.—The study of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) is ongoing, and research results should help improve treatment for this patient population. Key trials and therapeutic options were discussed at the 2020 ACR Winter Symposium during the session, Update on the Treatment of ANCA-Associated Vasculitis, by Peter A. Merkel, MD, MPH, chief of…
SNOWMASS VILLAGE, COLO.—Current trends in rheumatoid arthritis (RA) therapy are the increased use of newer medication categories, such as Janus kinase (JAK) inhibitors (Jakinibs) and biologics, and the rising costs of treatment. Unchanged is the consistent use of methotrexate as an effective therapy. These topics and more were discussed at the ACR Winter Symposium during…
SNOWMASS VILLAGE, COLO.—The science underlying the neurobiology of chronic pain isn’t something rheumatologists often think about. However, pain is an important reason why patients see a rheumatologist. At the 2020 ACR Winter Symposium in January, Leslie Crofford, MD, gave two presentations addressing pain experienced by rheumatology patients, including a session on the fundamental mechanisms of…
SNOWMASS VILLAGE, COLO.—A major workforce shortage, a population of patients taking immunosuppressants where safety concerns and the patient experience are critical, and an increasing focus on remote patient monitoring and telehealth are driving a discussion regarding the role digital wearables play in rheumatologic care. “We need to be more thoughtful and efficient in taking care…
SNOWMASS VILLAGE, COLO.—Choosing the right treatment at the right time is the brass ring all rheumatologists hope for. Precision medicine provides the ability to leverage clinical, biomarker and omics data to predict and personalize future treatment for rheumatoid arthritis (RA). “New data and new methods to analyze the data are helping us better predict patterns…
As state rheumatology societies go, the Nebraska Rheumatology Society (NRS) is one of the new kids on the block. Established two years ago, the NRS hopes to involve all 27 rheumatologists across the state. Marcus Snow, MD, a rheumatologist at the University of Nebraska Medical Center (UNMC), Omaha, says the state’s rheumatologists are spread across…
Ageism is defined as stereotyping, prejudice or discrimination against individuals on the basis of their age. According to the American Medical Association (AMA), 43% of all physicians and surgeons are 55 or older. Specialists are, on average, older than primary care doctors. In addition, around 30% of the current U.S. population is older than 55,…
In 2001, Victoria Seligman, MD, MPH, was vacationing in Vietnam. While traveling by train, she met a student from Yale University who was working on the school’s Cambodian Genocide Program, which documents the atrocities that occurred in Cambodia between 1975 and 1979 under the Khmer Rouge regime. Approximately 1.7 million people—representing 21% of the population—were slaughtered….
The FDA is considering an application for subcutaneous tanezumab, a monoclonal antibody, as a treatment for moderate to severe osteoarthritis…
The FDA has approved two pain medications: meloxicam in an injection and over-the-counter diclofenac sodium topical gel 1%…
Note: This article was updated July 21 to add recommendations on restarting biologics following COVID-19. On April 29, the ACR released Guidance for the Management of Adult Patients with Rheumatic Disease During the COVID‐19 Pandemic and later updated the guidance for publication in Arthritis & Rheumatology. The recommendations address various treatment options and provide general…