Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or programmed cell death protein 1 (PD-1) axes have revolutionized therapy and improved survival in advanced cancers. However, these immune system modulators also lead to immune-related adverse events (IRAEs).1,2 In clinical trials, IRAEs mainly involved the gastrointestinal tract, skin, endocrine glands, liver and lung,…
Case Presentation A 45-year-old man with crystal-proven gout, poorly controlled diabetes and chronic kidney disease was lost to follow-up for six years and presented back to the VA clinic in the midst of a gout flare. He stated he had continued taking 100 mg of allopurinol daily, but his serum urate level was 13.8 mg/dL….
We all have a short list of famous individuals whose writings inspire us and guide us. At the start of my presidential year, I turned to my own short list for some words of wisdom from Peter Drucker, whom many consider to be the founder of modern management theory. Underpinning Drucker’s teachings is a strong…
As Ellen M. Gravallese, MD, begins the ACR presidency, her goals include workforce expansion, improved access to care and support for members in all areas of practice.
A 43-year-old woman is establishing care in your new urban clinic after her previous rheumaÂtologist stopped accepting her Medicaid insurance more than a year ago. Since that time, she has been trying to find a new rheumatologist who will accept Medicaid. She lives 90 miles away in a small town without a rheumatologist. Seven years…
A recent study in The Journal of Rheumatology sheds light on the importance of preconceptional cardiovascular health in women with systemic lupus erythematosus. Although many questions remain, improved cardiovascular health measures seem to positively affect pregnancy outcomes, suggesting a potential role for preconception cardiovascular interventions.1 Women with lupus now have healthier pregnancies than in the…
The traditional model for subspecialist consultations on hospitalized patients by outpatient-based rheumatologists may seem straightforward. Hospitalists (the inpatient specialists who now manage most in-hospital medical care in the majority of U.S. hospitals) typically call upon the rheumatologist’s expertise for joint swelling and a rash or fever of unknown origin, says Lianne Gensler, MD, of the…
(Reuters Health)—About a quarter of the dollars spent on healthcare in the U.S. may be wasted, a new analysis suggests. Six types of waste in healthcare could be costing as much as $935 billion annually, according to the study published in JAMA.1,2 The biggest source of waste is “administrative complexity,” says the study’s lead author…
NEW YORK (Reuters Health)—Mortality rates in patients with antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) decreased from 1999 to 2017, according to records from the Centers for Disease Control and Prevention (CDC). “The mortality attributed to several rare diseases [e.g., hypersensitivity pneumonitis] has increased in recent years,” Alexander W. Steinberg, MD, from Saint Joseph Hospital, Denver, tells…
According to new research, women with SLE are at the highest risk for adverse pregnancy outcomes during a lupus flare. The data may enable clinicians to use risk stratification and tailored monitoring to counsel SLE patients who are pregnant or considering pregnancy. Researchers also found that maternal age, lupus nephritis and antiphospholipid antibodies may affect pregnancy outcomes…