ACR guidelines include recommendations for the management of patients with particular conditions or diseases. Guidelines are developed using a systematic process and are based on available evidence and the clinical experience and expertise of rheumatologists and other interested stakeholders. In the January issue of Arthritis & Rheumatology, Arthritis Care & Research and the Journal of…
Gene Therapy for OA
Background & objective: One of the major challenges in the treatment of chronic joint diseases, such as osteoarthritis (OA), is the need to provide sustained bioavailability of a therapeutic agent within the joint. Systemically administered drugs cannot sufficiently reach the synovial space, and intra-articularly injected agents are cleared from the joint fluid rapidly by the…
TNFi Exposure in Utero
Vinet et al. evaluated the risk of serious infections in children of women with RA exposed to TNFi’s in the gestational period compared with unexposed offspring of women with RA, as well as with children from the general population. Although the research did not demonstrate a marked excess risk for serious infections, the authors could not exclude a differential risk according to specific TNFi, with infliximab potentially resulting in a threefold increase in the risk of serious infections compared with other TNFi’s. More studies are needed…
An Improved State of Mind?
Evidence suggesting common inflammatory pathways in RA and depression is increasing. However, this study found that improved physical health through pharmacologic treatment does not by itself improve mental health. …
SLE Is a Leading Cause of Death Among Women
Systemic lupus erythematous (SLE) is a chronic inflammatory disease that predominantly affects women and can involve virtually any organ. The authors of this study analyzed secular trends and population characteristics associated with SLE mortality. Objective: Mortality statistics from the Centers for Disease Control and Prevention (CDC) are used for planning healthcare policy and allocating resources….
Pain Links Fibromyalgia & RA
Many patients with rheumatoid arthritis (RA) report pain despite excellent control of inflammation with immunotherapies. Variable degrees of coexisting fibromyalgia (FM) may explain this disparity. RA patients who have the highest 2011 ACR FM survey criteria scores appear to share neurobiologic features consistently observed in FM patients. This study is the first to provide neuroimaging evidence that RA is a mixed pain state, with many patients’ symptoms being related to the central nervous system rather than to classic inflammatory mechanisms…
Gut Microbiota Directly Affects Inflammatory Arthritis
Gut microbiota may provide insight into important environmental triggers for autoimmune diseases. New research in mice indicates that intestinal dysbiosis triggers a mucosal immune response that stimulates T and B cells, which are critical to the development of inflammatory arthritis…
Subcutaneous Belimumab Improves Systemic Lupus Srythematosus Outcomes
NEW YORK (Reuters Health)—Subcutaneous belimumab improves outcomes in anti-dsDNA-positive hypocomplementemic patients with systemic lupus erythematosus (SLE), according to results from a Phase 3 randomized, controlled trial. Intravenous belimumab is approved by the U.S. Food and Drug Administration and the European Medicines Agency for the treatment of patients with active, autoantibody-positive SLE who are receiving standard…
Getting Past the Noise to Identify SpA
Objective: Low-grade bone marrow edema (BME) has been reported in the sacroiliac (SI) joints of 25% of healthy individuals and patients with nonspecific mechanical back pain, thus challenging the specificity and predictive value of magnetic resonance imaging (MRI) for the identification of early spondyloarthritis (SpA). It is unknown whether stress injury in competition sports may…
The Science Behind Biosimilars
Although six biosimilar agents have now been approved by the U.S. Food & Drug Administration for use in rheumatology, scientific, clinical, economic and prescribing questions about the use of biosimilars abound. In fact, at the 2017 ACR/ARHP Annual Meeting in San Diego, Joseph Huffstutter, MD, a rheumatologist in private practice in Chattanooga, Tenn., said that…
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