In recent years, scientists and clinicians have learned a great deal about autoantibodies occurring in idiopathic inflammatory myopathies (IIMs). These new discoveries have reshaped our understanding of distinct clinical phenotypes in IIMs. Scientists continue to learn more about how these autoantibodies shape pathophysiology, diagnosis, disease monitoring, prognosis and optimum treatment. Moving forward, these autoantibodies will…
Steady hands, nerves of steel: The endoscopic transphenoidal hypophysectomy is a delicate neurosurgical procedure. Using a three-dimensional microscope and a powerful magnetic resonance imaging machine to guide them, the surgeon must meticulously dissect the throat tissues, navigate through the palate and the sinuses to reach the base of the skull where the pea-sized master gland,…
Wider awareness and understanding of the more than 100 different rheumatic diseases is a vital element in our work as rheumatologists and rheumatology health professionals. Stimulating interest and engagement among lawmakers, patient groups and the public at large is essential to successful advocacy efforts, as well as the overall future of our specialty. This September,…
Rheumatoid arthritis (RA) is a systemic autoimmune disease associated with erosive destruction of diarthrodial joints. Patients who are seropositive are more prone to developing extra-articular manifestations, such as rheumatoid lung, rheumatoid nodules and others. With the development of disease-modifying anti-rheumatic drugs (DMARDs), the incidence and severity of these extra-articular manifestations has declined. Below, we describe…
A 22-year-old Indian male presented to the emergency department with hemoptysis. A month prior, he had presented to an urgent care center complaining of cough with occasional episodes of blood-tinged sputum in the morning. He was diagnosed with community-acquired pneumonia based on a chest X-ray without laboratory testing and was prescribed levofloxacin. A few days…
Treat-to-target is a widely used approach for rheumatoid arthritis, in which rheumatologists prescribe treatments to reach established benchmarks of disease activity.1 Is it time for a similar approach for fibromyalgia treatment, even though its pathogenesis, disease-activity measures and treatment algorithms are less well understood? Three fibromyalgia researchers present their case in a new paper, “Treat-to-Target…
A recent study, conducted by the Vasculitis Clinical Research Consortium and funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), examined whether the addition of abatacept, a drug that affects T cell activation, to standard prednisone treatment could reduce the risk of relapse in patients with giant cell arteritis (GCA).1 Although…
A two-year study among patients with knee osteoarthritis (OA) showed that steroid injections for knee pain were no more effective than saline injections and actually reduced cartilage volume more than placebo. The study, conducted at Tufts Medical Center in Boston, looked at progression of cartilage loss and change in knee pain after treatment with placebo…
It’s a bit ironic that when injured people are in pain—and their mobility is reduced—they are often expected to travel to a physical therapy clinic. For millions of people, such trips are a burden. In Australia, however, some patients are “letting movement come to them.” Novel research from The University of Melbourne shows that taking…
Patients with a diagnosis of rheumatoid arthritis (RA) experience on average double the risk of developing malignant lymphoma when compared with the general population. With the major changes in RA treatment taking place over the past decade, has there been a reduction in the risk of lymphoma in this population? Researchers from the Karolinska Institute…
MADRID—Tofacitinib (a JAK inhibitor) used with methotrexate (MTX) is not inferior to adalimumab (a TNF inhibitor) in rheumatoid arthritis (RA) patients who’ve had an inadequate response to MTX alone, according to results of a Phase 3B/4 trial presented in a session at the Annual European Congress of Rheumatology (EULAR). The findings came in a one-year…
MADRID—The anti-IL6 “nanobody,” vobarilizumab, produced mixed results when used with methotrexate (MTX) and compared with MTX and placebo, according to results of a 24-week, double-blind Phase 2b study of patients with rheumatoid arthritis (RA), which were presented in an abstract session at the Annual European Congress of Rheumatology (EULAR). The drug missed its primary endpoint…
MADRID—Researchers say that whole-body MRI could yield an earlier diagnosis of spondyloarthropathy (SpA) in patients with early inflammatory joint symptoms, according to findings presented in a poster session at the Annual European Congress of Rheumatology (EULAR). The approach could lead to earlier treatment and better outcomes, they say. Investigators at the University of Leeds recruited…
MADRID—Scores on the Health Assessment Questionnaire for Rheumatoid Arthritis (HAQ) and C-reactive protein (CRP) levels were independent predictors of whether patients could be tapered successfully from a TNF inhibitor after having reached remission of their RA, according to findings presented in a session at the Annual European Congress of Rheumatology. Researchers also developed a composite…
MADRID—Determining what is a best practice in rheumatology and then implementing improvements based on what you find can be fraught with complexity, an expert said during the 2017 Annual European Congress on Rheumatology (EULAR). Examples are emerging of benchmarking projects in which electronic registers are used to improve patient care, said William Dixon, MD, chair…
MADRID—Calcification in osteoarthritis (OA) involves a series of pathways and interactions that feed off each other in a process that bears some resemblance to the transformation of cartilage to bone that takes place in the embryonic stage of human development, a researcher said here at the 2017 Annual European Congress on Rheumatology (EULAR). “My hypothesis…
Abatacept Approved for Adult PsA On June 30, the U.S. Food and Drug Administration (FDA) approved abatacept (Orencia) to treat adults with active psoriatic arthritis (PsA).1 Abatacept is available as both an intravenous formulation and a subcutaneous injection.2 The approval was based on results of two randomized, double-blind, placebo-controlled trials, PsA-I and PsA-II, during which…
Editor’s note: The new Pillar Talk column is developed by the ARHP Executive Committee in an effort to share information about ongoing activities related to our four pillars: Education, Practice, Research and Advocacy. ARHP volunteers are actively involved in the ACR’s efforts to advocate for the care of our patients and the rheumatology professionals who…
In Part 1 of this series, we covered the vital role of medical decision making in determining the final level to bill for a patient encounter. Medical decision making is the key component in coding because it reflects the intensity of the provider’s cognitive labor. This implies that there’s an unseen component involved in the…
The Rheumatology Research Foundation hosted the 10th Annual Investigators’ Meeting in St. Louis, June 24–25. The meeting provides Foundation-funded investigators an opportunity to learn about recent findings and research projects, network, exchange ideas and collaborate on future projects. More than 30 rheumatology professionals were in attendance, with presentations from 21 investigators. James O’Dell, MD, professor…
Your gateway to global rheumatology education! Join us in San Diego for the 2017 ACR/ARHP Annual Meeting on Nov. 3–8. The advance registration deadline is Oct. 18. Register and get more information on all Annual Meeting sessions. High-Impact Learning Starts with Pre-Meeting Courses Pre-meeting courses, held Nov. 3–4 before the official start of the meeting,…
The Rheumatology Informatics System for Effectiveness (RISE) Registry is the ACR’s registry for quality improvement and reporting. Aggregated statistics and trends seen in the RISE Registry will be published monthly in The Rheumatologist. If you have questions about quality reporting, are interested in enrolling in RISE or would like to use data from RISE for…
What is RheumPAC? RheumPAC is the ACR’s nonpartisan political action committee (PAC) that works to elect and support pro-rheumatology candidates. It is the only PAC dedicated to the interests of the rheumatology profession. RheumPAC was created 10 years ago with the mission of educating, electing and supporting federal lawmakers who understand and can positively address…
A 67-year-old female patient from New York with a long history of fatigue, joint and muscle pain, rash and fevers is scheduled to see the rheumatologist in five days. She is referred to the rheumatologist by her primary care physician (PCP) for possible diagnosis of lupus erythematosus. The patient requested her medical records from her…
Take the Challenge. ICD-10 Codes R76.1—Raised antibody titer L20.8—Other atopic dermatitis R20.2—Paresthesia of skin R20.1—Hypoesthesia of skin CPT Codes 99358 and 99359 Rationale The Centers for Medicare & Medicaid Services (CMS) typically does not allow separate payment for physician services that do not require face-to-face time with a patient, but as of Jan. 1, 2017,…