GLENDALE, ARIZ.—Arizona is a microcosm of America’s challenges in reconciling the rheumatology workforce to growing patient demand, as quantified in the ACR’s Workforce Study of 2015.1 So it was timely this year for the Phoenix Rheumatology Association to sponsor its 1st Annual Strategic Training for Rheumatology Advanced Practice Clinicians Symposium. (Note: Advanced practice clinicians [APCs]…
Honestly, I’m not sure why I bothered to listen. I was in my kitchen, early on a Saturday morning, with the radio keeping me company. It started with the news and the usual litany of tragedies, both major and minor, that comprise such programs. The news gradually faded into other programming, which I can no…
As rheumatology professionals, we focus on how to achieve better outcomes for our patients: lower disease activity, remission, milder symptoms and prevention of joint damage or serious complications, such as heart disease. Another outcome is just as important: good quality of life. What can we do to engage our current patients and those at risk…
Chikungunya is among a group of 16 diseases transmitted through mosquito, tick or flea bites that is of increasing public health concern in the U.S. Although few rheumatologists are likely to diagnose patients with the acute phase of the disease, they may encounter a handful of patients each year who complain of persistent, and often…
Save the date for the 2018 ACR/ARHP Annual Meeting, Oct. 19–24 in Chicago. Connect with your colleagues for an unmatched educational experience featuring exceptional sessions by leading rheumatology experts. The ACR/ARHP Annual Meeting is your gateway to global rheumatology education. With more than 450 sessions—including The Great Debate—the meeting provides boundless opportunities for professional development,…
Imagine telling a patient “You’re in remission!” and finding out it’s not true. The last thing you want to do is get it wrong clinically and put your patient on an emotional rollercoaster. With large vessel vasculitis (LVV) in particular, physicians struggle to be accurate, to determine if indeed the disease has gone away or…
As a first-year internal medicine resident, I find myself consulting rheumatologists for just about every mystery patient in our hospital. Like many residents, I was initially intimidated by the complexity of this elusive field. At first glance, diagnosis and management seem completely inaccessible to a first-year resident. But several rheumatology consults later, I can confidently…
The variability in serological testing for antinuclear antibodies (ANA) is under investigation after unexpected findings were reported from clinical trials of new agents to treat systemic lupus erythematosus (SLE). In “Assay Variation in the Detection of Antinuclear Antibodies in the Sera of Patients with Established SLE,” David S. Pisetsky, MD, PhD, and his colleagues demonstrate…
More than two decades ago, Charles King, MD, was completing his final year of residency in internal medicine, fairly confident he was headed for a career in gastroenterology. Then he took a rotation in rheumatology. The rest, as they say, is history. “It’s a complicated field, and it requires a balance of left brained-ness and…
A 36-year-old woman presented at the Johns Hopkins Arthritis Center for a second opinion regarding a diagnosis of psoriatic arthritis (PsA). One year prior to our evaluation, she had developed pain and stiffness in her hands, feet, knees, ankles, elbows and shoulders. She had mild plaque psoriasis of the scalp and base of the neck,…
The data tell the story. Despite improvements in overall outcomes for common rheumatologic conditions, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), white patients fare better than minority patients, and sometimes substantially better. Even with new biologic therapies that have significantly altered the course of disease for patients with RA, outcomes for minorities…
Studies highlighting the large numbers of people affected by knee osteoarthritis (OA) point to what clinicians who treat knee OA have been seeing for the past few decades: a substantial increase in the prevalence of knee OA in the U.S. and globally. Roughly 250 million people are affected by knee OA worldwide, and about 14…
Immune checkpoint inhibitors (ICIs) are at the forefront of advances in cancer therapy and have shown promising results for progression-free survival. Checkpoint signaling pathways, such as cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1), normally regulate the immune response to promote self-tolerance and prevent tissue damage and inflammation. PD-1 is a…
A study published in Annals of Internal Medicine in December 2017 looked at trends in lupus mortality over a 46-year period. The researchers say they set out to close some knowledge gaps. “There [was] a knowledge gap relating to the large differences we see in death rates from one study to another, which could have…
Sir William Osler, the father of modern medicine, said “the desire to take medicine is perhaps the greatest feature that separates man from animal.” Determination of the benefit of a medication can be challenging and includes a number of factors, such as pharmacologic activities on the disease pathophysiology, pharmacokinetic properties and patient characteristics.1,2 An additional,…
AMSTERDAM—Research in myositis treatments is beginning to find its way, with investigators pursuing avenues special to the disease so therapy for patients may no longer involve piggybacking on existing treatments for other illnesses, an expert said at EULAR: the Annual European Congress of Rheumatology. “Finally, in myositis there are targets being investigated that are more…
AMSTERDAM—Early identification and treatment of rheumatoid arthritis (RA) are two of the most pressing concerns in the field, an expert said at EULAR: the Annual European Congress of Rheumatology. He described the latest efforts to identify patients at risk of RA development and insights on quick referral to rheumatologists. Karim Raza, BM, BCh, PhD, Arthritis…
AMSTERDAM—Low-grade inflammation in older adults can impede immune responsiveness, and researchers have shed light on how this happens. They have developed a short-term treatment that blocks inflammation and boosts the immune response, an expert said at EULAR: the Annual European Congress of Rheumatology. The findings were presented in a session on cellular senescence related to…
AMSTERDAM—Clinicians who are counseling women with systemic lupus erythematosus (SLE) have the benefit of an array of new insights into factors linked with increased risk of pregnancy loss, how SLE therapies affect pregnancy and data on outcomes of children born to mothers with SLE, an expert said in a session at EULAR: the Annual European…
AMSTERDAM—Newly proposed systemic lupus erythematosus (SLE) classification criteria and new findings on SLE pathogenesis are two ways in which researchers and clinicians are getting a better grasp on the heterogeneous disease. The criteria and findings were discussed this June in a session at EULAR: the Annual European Congress of Rheumatology. ‘Paradigm Shift’ Sindhu Johnson, MD,…
AMSTERDAM—Just how seldom prednisone is successful at inducing remission in giant cell arteritis (GCA), despite such a long history of use for the disease, is one of the many lessons to emerge from the data in the GiACTA trial, said the principal investigator of the trial, which is the largest ever in GCA and is…
AMSTERDAM—A variety of factors lead to delays in patients seeking medical care for rheumatoid arthritis—from the nature of symptoms to coping tendencies—requiring more awareness from physicians when managing patients, researchers said at EULAR: the Annual European Congress of Rheumatology. Longer delays in treatment bring about more emotional distress to patients, missed chances to ease symptoms…
AMSTERDAM—With new therapies coming into the marketplace, researchers are working to tease out the risk of infection for rheumatoid arthritis (RA) patients. Existing data suggest the risk of infections—even fatal ones—is real. But over time, improvements have taken hold, particularly for tuberculosis, according to an infectious disease expert at EULAR: the Annual European Congress of…
AMSTERDAM—It’s been many years since adipose tissue came to be appreciated not just as a store of energy, but also as a regulator of metabolism and an important player in immune function. Rheumatology researchers continue to drill down into the role of fat cells in the search for mechanisms that could reveal targets for the…
It is no surprise to practicing physicians that the healthcare landscape is becoming more and more unpredictable. Because of the volatility surrounding today’s healthcare environment, such as increasing overhead costs and decreasing reimbursement rates, many physicians are asking themselves whether there is a different, more lucrative way to practice medicine. Concierge medicine may just be…
New research shows tanezumab may be safe and effective for patients with osteoarthritis pain…
In a long-term study, apremilast was well tolerated by patients with psoriatic arthritis, who showed sustained improvements for up to five years…
With sadness we honor the passing of Morris Reichlin, MD. Dr. “Moe” Reichlin enjoyed a distinguished clinical, investigative, rheumatology career that spanned more than five decades. Moe was inquisitive, persistent, humble and inspiring. His achievements were many and diverse. Moe Reichlin received his BA and MD degrees from Washington University in St. Louis, where he…
Another exciting ACR/ARHP Annual Meeting is planned for this October. Show your support for the Foundation’s mission and enjoy your time in vibrant Chicago at one of the Foundation’s many events. Donations made to the Foundation support the extensive awards program that funds research, training and education opportunities for current and potential rheumatologists and rheumatology…
Multiple studies show that hydroxychloroquine (HCQ) has many benefits in systemic lupus erythematosus (SLE), including cardiovascular benefits, such as reducing coronary artery and thrombosis risks. HCQ can prevent disease flares, including in renal and central nervous system lupus, and is the only drug shown to prolong survival in lupus. However, guidelines released in 2016 by…
Join us virtually in Chicago, as we stream the 2018 ACR Review Course and ACR/ARHP Annual Meeting live. Registration is now open, and the events will take place Oct. 20‒24. Watch the sessions live in real time, chat with other attendees, and participate in question-and-answer sessions when available. You can also enjoy access to the…
RheumPAC is the ACR/ARHP’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 electing and supporting federal lawmakers who understand and are in a position to support the…
Two of the ACR’s Collaborative Initiatives (COIN) programs share a goal: to educate non-rheumatologist providers about systemic lupus erythematosus (SLE) symptoms to facilitate referrals, accurate diagnosis and therapy. Small Group Provider Sessions Launched in 2016, Small Group Provider Sessions provide lupus education while connecting frontline providers to a local rheumatologist in often underserved areas. The…
Effective management of healthcare compliance requires an office compliance plan that stays current with changing government regulations, payer requirements, office operations and technology. Many still wonder, why is a compliance program needed—if something isn’t broken, don’t fix it, right? This is not always the case; compliance is an essential part of practice operations, but providing…
A 55-year-old female patient with pain in multiple joints is referred to the office by her primary care physician. She complains of pain in both knees and both shoulders. She rates the pain at 7 on the pain scale. Her pain is worse at night after she gets off work. Soaking in her hot tub…
Take the challenge. CPT codes: 99203/99243 ICD-10: M25.521, M25.522, M25.561, M25.562 History—Comprehensive: The history of present illness is extended, the review of systems is complete, and the past medical, family and social history are documented. All three of the HPI, ROS and PFSH are needed to achieve the history level as comprehensive. Examination—Detailed: This level…