Sarilumab is now FDA approved to treat adults with polymyalgia rheumatica who have had an inadequate response to glucocorticoids or who cannot tolerate a glucocorticoid taper. This new indication is based on results from the multicenter, phase 3 SAPHYR trial.
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Case Report: Is It Cardiac Sarcoidosis or COVID-19 Myocarditis?
COVID-19 causes myriad cardiac dysfunctions, ranging from mild to fulminant disease, including myocarditis, acute congestive heart failure, cardiogenic shock and sudden cardiac death.1,2 COVID-19 myocarditis can mimic cardiac sarcoidosis clinically and on cardiac imaging, which can lead to diagnostic challenges and treatment delays. We present a case of cardiac sarcoidosis with interval development of metabolic…
ACR Releases New Vaccination Guideline
The ACR recently released its first guideline focused on vaccination in adult and pediatric patients with rheumatic and musculoskeletal diseases.1 The guideline recommends modifications to certain vaccine and medication schedules to increase immunogenicity and ensure patient safety, while encouraging providers not to miss vaccination opportunities. The Need Patients with rheumatic conditions who are on immunosuppressive…
Point-of-Care Uric Acid Testing
In June 2022, I listened to several presentations on gout at EULAR’s European Congress of Rheumatology. Most began with data confirming a sad truth that we, as rheumatology providers, are all aware of: too many patients are taking subtherapeutic doses of urate-lowering therapy (ULT).1,2 Recommendations from the American College of Physicians in 2017 advocated for…
2022 ACR Guideline for Vaccinations in Patients with RMDs
This guideline provides evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases. It includes expanded indications for some vaccines, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy.
3 AC&R Study Summaries: Treat to Target in Gout, Response to Biologics in Patients with JIA, & Rehabilitation Dose in Adults with RA
Treat to Target in Gout Monitoring & achievement of target serum urate levels By Jing Li & Gabriela Schmajuk, MD, MS Why was this study done? The ACR’s 2020 guideline for the management of gout recommends using a treat-to-target (T2T) approach to lower serum urate (SU). Using the ACR’s RISE registry, we examined the use…
Case Report: Adult-Onset Still’s Disease with Complications
The following report outlines a case of newly diagnosed adult-onset Still’s disease (AOSD) complicated by macrophage activation syndrome (MAS) in a previously healthy and active 32-year-old man who had emigrated from Africa to the U.S. Case A man with no prior medical history presented with acute-onset polyarthritis, fevers and fatigue that began one month previously….
How Long Should Methotrexate Be Held Following Seasonal Vaccinations?
Vaccinations against preventable diseases, including seasonal influenza, are strongly recommended for patients with rheumatoid arthritis (RA), who are at increased risk of infections as a result of underlying immune dysfunction and treatment-induced immunosuppression. Park et al. conducted this clinical trial to investigate whether discontinuing methotrexate for one week after seasonal influenza vaccination is noninferior to discontinuing it for two weeks after vaccination in patients with RA.
A Look Back at the First Use of Cortisone in Rheumatoid Arthritis
In 1949, the first description of patients with rheumatoid arthritis (RA) given cortisone sent shockwaves through the medical community, quickly capturing the public imagination as well. The paradigm-shifting report paved the way for the use of cortisone and related drugs in RA and many other medical conditions.1 The following is a discussion of some of…
Overcoming Healthcare Disparity
PHILADELPHIA—Quality improvement (QI) tools in pediatric rheumatology can help overcome health outcome disparities that are based on race, gender identity, income and other factors, experts said in a session at ACR Convergence. With it well established that these disparities exist, it’s time to begin eliminating them, said Emily Smitherman, MD, MS, assistant professor of pediatric…
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