On Feb. 3, the U.S. Food & Drug Administration (FDA) revised its Letters of Authorization for two emergency use authorizations (EUAs), Paxlovid and Lagevrio, to remove the requirement for positive test results to prescribe these drugs. The agency continues to recommend that providers use direct SARS-CoV-2 viral testing to help diagnose COVID-19. The FDA recognizes…
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What We Know about COVID-19 in 2023: Variants, Vaccines, New Therapies & More
Although a less central focus than it was three years ago, rheumatologists must still consider the prevention and management of SARS-CoV-2 in their patients. The following update shares ongoing considerations related to the COVID-19 pandemic. Outcomes At the beginning of the pandemic, it was unclear whether patients with rheumatic disease would be at higher risk…
Long COVID: Experts Weigh in on Increasingly Common Syndrome
AÂ minority of patients experience lingering symptoms after infecÂtion with SARS-CoV-2, similar to some other previously known post-infection syndromes. Although we are just beginning to understand the differÂent presenÂtations, pathophysiology, risk factors, prognosis and treatment of long COVID, rheumatologists can play a leaderÂship role in managing patients with the illness and contributing to this important research…
FDA Approves Sarilumab for the Treatment of Adults with Glucocorticoid-Resistant PMR
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.
Conflicts of Interest in Guideline Development: What to Do When Everyone Has a Conflict
Avoiding real and apparent conflicts of interest is a fundamental principle of guideline development, but what should we do when every thought leader is conflicted? An example of this conundrum in rheumatology has been the ACR’s ongoing effort to establish guidelines for the management of lupus nephritis, which has been stymied by the fact that…
ACR Image Competition 2022, Part 4
Periungual Erythema & Its Translation on Nailfold Videocapillaroscopy in a Patient with Very Early Systemic Sclerosis A 66-year-old woman presented with Raynaud’s phenomenon and periungual erythema. HEp-2 immunofluorescence assay was positive for antinuclear antibodies, showing a centromere pattern. The presence of anti-centromere antibodies was confirmed by chemiluminescent immunoassay. The patient was diagnosed with very early…
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…
Speak Out Rheum: Musings on Our Past & Rheumatology
I have been reading Yuval Harari’s thought-provoking and engaging book, Sapiens: A Brief History of Humankind, about our species’ struggles and the path that led to our emergence as the predominant species. I was captivated by the drawing of the hand of one of our ancestors and mused about what that forebear was thinking as…
Glucocorticoid Use May Result in Loss of Bone Mineral Density
Adami et al. examined the fracture risk associated with glucocorticoid treatment in women with inflammatory rheumatic musculoskeletal diseases, finding that low-dose glucocorticoid use may result in significant bone mineral density loss in patients who are not on anti-osteoporotic drugs.
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…
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