In response to the required changes in reimbursement from fee for service to value-based payment under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, the ACR is exploring development of a rheumatology-specific alternative payment model (APM) for rheumatologists and practices, which would provide an additional option for payment other than the Merit-Based Incentive…
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More Effective Antifibrotic Therapies for Systemic Sclerosis in Development; Adverse Events A Concern
Systemic sclerosis (SSc) is a rare disease affecting about 49,000 U.S. adults, and it is strongly associated with high levels of morbidity and mortality.1 Of the few available antifibrotic therapies, none is targeted for SSc. However, reason for optimism exists for antifibrotic treatments in early development and clinical trials, says Jörg H.W. Distler, MD, Heisenberg Professor…

How to Appropriately Discharge a Patient to Avoid Abandonment, Medical Malpractice
Are you a physician with a patient who no longer requires medical treatment? Do you have a patient you believe would be better served by another physician, specialist or practice due to a developing condition? Do you want to terminate a patient relationship because it is costing more than it is worth to your practice?…

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….

Plasma Complement Activation in Rheumatic Diseases May Accelerate Coronary Artery Disease
Complement can deposit in various tissues, and previous studies have associated complement deposition with an increased risk for all-cause mortality and stroke. Now, new research underscores the relationship between rheumatic disease, the complement system and cardiovascular disease. In particular, inflammatory rheumatic disease status appears to be uniquely associated with mononuclear cell infiltrates in the vascular…

Prospects for Treating Patients with Arthritis in African Countries with Few Rheumatologists
At present, the U.S. has approximately 5,000 full-time adult rheumatologists. By the year 2025, that number will decline to roughly 3,600.1 Sounds dire, right? Hold that thought. Question: What country has 99 million people and no adult rheumatologists? Answer: Ethiopia.2 The Nigerian Story And then there is Africa’s most populous country, Nigeria, with roughly 170…

Dr. Peter Schur Discusses Lupus Treatment, Management Advances in Past 50 Years
Although systemic lupus erythematosus still does not have a definite cause or cure, rheumatologists and researchers over the past 50 years have witnessed and contributed to a great deal of progress that helps patients, says Peter H. Schur, MD, director emeritus of the Lupus Center, Brigham and Women’s Hospital, and professor, Harvard Medical School, Boston. Dr. Schur’s…
Psoriasis May Itch as Intensely as Atopic Dermatitis
NEW YORK (Reuters Health)—Itch intensity in moderate to severe plaque psoriasis can be substantial, and may be on a par with the notoriously itchy skin condition atopic dermatitis, new research suggests. “Both conventional wisdom and some of our classic dermatologic textbooks have stated that psoriasis is not particularly itchy,” corresponding author Dr. Alexa B. Kimball…

The ACR, ARHP Keep Members, Patients’ Priorities on Congressional Legislative Slate
We can’t change the direction of the wind, but we can adjust our sails. The origin of this proverb is unclear. Some citations link it to ancient Hindu philosophers, and others suggest the origin may be closer to home (i.e., Jimmy Dean or Dolly Parton). Nonetheless, the sentiment is apt: We are living in an…

Voclosporin Promising for Lupus Nephritis
In a recent clinical trial, voclosporin proved safe and effective at both low and high doses as a treatment for lupus nephritis…
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