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…
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Demand for Revision Total Knee Arthroplasty Is on the Rise
In the next five to 10 years, the frequency of revision total knee arthroplasty is expected to grow 600%, due to the rise in obesity in the U.S. population and increase in primary knee replacement surgeries. Physicians can use different tools to help decrease the risk of premature implant failure and improve patient outcome…
Tocilizumab Is Effective to Treat GCA
In a recent clinical trial, tocilizumab helped sustain glucocorticoid-free remission in patients with giant cell arteritis. Patients also received a prednisone taper, and 50% of tocilizumab-treated patients achieved prednisone-free remission and were less likely to experience disease flare compared with placebo…
How to Manage Pain & Treatment in Elderly Patients
Elderly patients have unique requirements with regard to treatment for pain, rheumatic disease and other ailments. Collaboration between rheumatologists, geriatricians and primary care physicians is essential to avoid unnecessary interventions and improve care for this patient population…
Hepatitis Virus, Rheumatic Disease Connection Explored
CHICAGO—Leonard H. Calabrese, DO, professor of medicine at Cleveland Clinic in Ohio, presented on emerging concepts of viral infections and rheumatic disease at the ACR’s State-of-the-Art Clinical Symposium in April. “We are at a pivotal point in rheumatology in understanding the relationship between viruses and rheumatic disease,” began Dr. Calabrese. “It’s a very exciting time.” Dr. Calabrese…
A Stiff Man: A Case Study in Ankylosing Spondylitis
First Appearances I watched the old man, his back painfully bent, shuffle toward the scale. A blocky rigidity draped over him. His feet seemed stuck to the floor. His head hung heavily over his chest. Observing him from the end of the hallway, instead of a face, I saw only a mound of shaggy, matted…
Disease-Activity-Guided TNF Inhibitor Dose Reduction Works Long-Term in RA
NEW YORK (Reuters Health)—In patients with rheumatoid arthritis (RA), disease-activity-guided dose reduction of a tumor necrosis factor inhibitor (TNFi) is safe and effective in the long-term and leads to a large reduction in TNFi use, according to three-year data from the DRESS study. Implementation of this strategy would “vastly improve the cost-effective use of TNFi,” conclude Dr….
Rheumatologist Dr. Sandra Pagnussat Recalls Journey from Patient to Physician
When she was in elementary school, Sandra Pagnussat, MD, began experiencing unrelenting pain and stiffness, first in her pinky and then in her other fingers. Her pediatrician diagnosed her with polyarticular juvenile idiopathic arthritis (JIA). In high school, Sandra decided to pursue a career in medicine and began taking advanced placement classes in biology and chemistry….
The Biomarkers of Lupus Disease Study
Most SLE clinical trials continue standard background medications being taken by patients at entry, based on assumptions that this minimizes the risk of serious flares and that immunologic interference is minimal. These assumptions are not evidence based, but eliminating polypharmacy in trials studying patients with active lupus remains controversial. These researchers tested the withdrawal of immunosuppressants to make SLE trial results more interpretable…
Tips for Managing Young Adult Rheumatology Patients
Often, young adults (18–23 years old) with rheumatic illness demonstrate poor adherence to treatment regimens, lack advocacy skills and have inadequate knowledge about diagnosis and treatment.1 Patients presenting at a transition clinic are typically comfortable with having their parents continue to be centrally involved with their care, but this is a time in life when…
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