CHICAGO—The correct dosing of hydroxychloroquine (HCQ) for systemic lupus erythematosus (SLE) is a concern of all rheumatologists. Petros Efthimiou, MD, clinical professor of medicine at New York University, New York City, opened the Great Debate of the 2018 ACR/ARHP Annual Meeting by stating, “Today, we will be discussing a critical clinical problem that affects everyone’s…
7 Insights into Methotrexate Administration, Drug Resistance & Toxicity
CHICAGO—Once methotrexate enters a cell through the reduced folate carrier (RFC), which thinks it is picking up folate, the drug is polyglutamated. It is this polyglutamate methotrexate that provides the actual clinical effect. These methotrexate polyglutamate “species” are added and lost over time, but it’s a slow process. What difference does it make whether a…
Learn to Lead: Tips for Diagnosing & Resolving Conflict
CHICAGO—Resolving conflict doesn’t start with clever strategizing, but with understanding the bigger picture and the factors that led to conflict in the first place, from cultural differences to resistance to change, an expert said at the 2018 ACR/ARHP Annual Meeting in a session about how to be a better leader. “To me, what’s often missing…
Diagnosing & Managing Pulmonary & Kidney Manifestations in Lupus
CHICAGO—In systemic lupus erythematosus (SLE), most types of severe pulmonary manifestations are relatively rare, but it’s crucial they be caught because of the potentially dire consequences, said Richard Silver, MD, professor in the Rheumatology Division at the Medical University of South Carolina, Charleston, at the 2018 ACR/ARHP Annual Meeting. Pulmonary Manifestations Parenchymal disease—seen in the…
The Tortured Path to the Cortisone Discovery
CHICAGO—The path to the discovery of cortisone—a top-selling, important drug, with dozens of indications—was complicated by failure, false moves, desperation and obsession. The tale, recounted in the Philip Hench, MD, Memorial Lecture: Crossroads of History & Hope: Discovery & First Use of Cortisone for RA at the 2018 ACR/ARHP Annual Meeting in October, is an…
These 3 Tough Cases from the 2018 Thieves Market Underscore Need for Clinical Diligence
CHICAGO—In the Thieves Market session at the 2018 ACR/ARHP Annual Meeting, rheumatologists from around the country presented a slate of challenging cases that emphasized the importance of clinical persistence and attention to detail, and the need to consider diagnoses that might not be common or obvious. Three of them are summarized below. (Look for more…
What to Do with Erosive, Inflammatory Osteoarthritis
CHICAGO—Is erosive, inflammatory osteoarthritis (EOA) a separate condition from osteoarthritis (OA)? Roberta Ramonda, MD, PhD, a rheumatologist at the University of Padova, Italy, spoke at the 2018 ACR/ARHP Annual Meeting on the clinical presentation of EOA and how it differs from OA. EOA is characterized by a frequent aggressive clinical course and occurs most often…
From Kolkata to Chicago: The ACR-IRA International Exchange Program
The ACR–Indian Rheumatology Association (IRA) International Fellows Exchange Program was developed in 2016 to foster scientific collaboration between members of the ACR and junior rheumatologists representing the IRA. I was lucky enough to be selected to participate in this exchange initiative, and I can’t thank these two organizations enough for working together to provide this…
The Rheumatology Research Foundation Honors 153 Award Recipients
CHICAGO—In October, the Rheumatology Research Foundation recognized 153 award and scholarship recipients at an awards luncheon, held in conjunction with the 2018 ACR/ARHP Annual Meeting. The annual event celebrates the accomplishments of rheumatology professionals who have received funding from the Foundation. In congratulating the award recipients, Foundation President Abby Abelson, MD, emphasized the impact the…
Social & Psychological Elements Are Vital to Rheumatology Care
CHICAGO—To drive home the importance of how social determinants can make or break a person’s health, Jillian Rose, LCSW, MPH, the director of community, engagement, diversity and research at the Hospital for Special Surgery in New York City, told a story about a gardener planting flowers at the 2018 ACR/ARHP Annual Meeting. In the story,…
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