In 2018, Gerson Bernhard, MD, FACP, MACR, received a call from a primary care physician at a rural clinic in Florida who was treating patients with varying degrees of arthritis. One patient’s case was more complex than the others. Dr. Bernhard guided the doctor through the patient’s history, reviewed lab results, referred related studies, expanded…
In a multicenter, prospective, open-label study, ustekinumab therapy was effective in treating oral ulcers resistant to colchicine in patients with Behçet’s disease, according to study author David Saadoun, MD, PhD, Department of Internal Medicine and Clinical Immunology, Sorbonne University, Paris, and fellow researchers.1 Researchers focused on the topic because oral ulcers are often disabling, have…
A 13-year-old, adopted girl of unknown ancestry with social anxiety, selective mutism and Takayasu arteritis presented for evaluation of severe, painful, gingival hyperplasia, which limited her oral intake and resulted in weight loss. The young patient was diagnosed with Takayasu arteritis at age 8, when she presented with a persistently elevated erythrocyte sedimentation rate (ESR),…
Given how unexpectedly front and center hydroxychloroquine has been in discussions about the treatment of COVID-19 this year, it makes sense to look at how it became so central to the treatment of a rheumatologic condition. In 1991, an article appeared in The New England Journal of Medicine that would alter the way rheumatologists approached…
Primary hemophagocytic lymphohistiocytosis (HLH) is caused by genetic mutations and inherited syndromes; it therefore occurs in the pediatric age group. Secondary HLH, however, is more common in adults and is often triggered by other disease states, such as malignancies, chronic immunosuppression, infections and autoimmune disease.1,2 Macrophage activation syndrome (MAS) is a subset of secondary HLH…
As useful stand-ins for biologics targeting a range of inflammatory diseases, biosimilars have made significant inroads across Europe as less expensive alternatives. Denmark, for example, realized a cost savings of 64% after instituting a mandatory national switch from the originator infliximab to its biosimilar counterpart. In the U.S., however, a considerably smaller fraction of rheumatologists…
These are truly extraordinary times. The COVID-19 pandemic has affected the rheumatology community, both providers and patients, in many ways, and our advocacy efforts are now more important than ever to ensure policymakers hear us and help address the issues facing our community. As with so many things during this pandemic, we are reimagining advocacy…
“No!” she screamed. My niece just finished her first semester as a freshman at the University of St. Andrews in Scotland. If the institution sounds familiar to you, it may be because you remember a particularly famous graduate—William Windsor, who sometimes goes by his formal titles: Duke of Cambridge and heir to the British throne….
Serological testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies may play a critical role in the management of the worldwide health crisis. Such testing may reveal key information for epidemiology, convalescent plasma therapies and vaccine development. However, the situation is complex, and much is unknown. Although such testing may ultimately be used to…
Prescribing stewardship is just one ethical consideration facing rheumatologists during the COVID-19 pandemic.