A 53-year-old female presented to the clinic for severe polyarticular joint pain and was found to have a seronegative inflammatory arthritis. Six months before, she had completed 10 months of treatment for stage IV metastatic melanoma with the immune checkpoint inhibitors, nivolumab and ipilimumab, achieving complete remission of her cancer. She said that throughout her…
Rheumatology Case Report: Immune-Related Aortitis Associated with Ipilimumab
Ipilimumab (Yervoy) is a monoclonal antibody directed against cytotoxic T-lymphocyte antigen 4 (CTLA-4). It was the first drug to demonstrate a survival benefit in advanced melanoma and was approved by the FDA in 2011.1 By blocking the CTLA-4 receptor, ipilimumab enhances the immune response against tumors via cytotoxic T lymphocyte activation and proliferation.2 However, immunopotentiating…
Experimental Drug Combination Curbs Chikungunya Arthritis in Mice
Doctors have had few options to treat the chronic rheumatoid arthritis-like symptoms associated with chikungunya virus infections beyond over-the-counter pain relievers. A recent study in Science Translational Medicine has spurred new optimism by finding that a combination therapy—the anti-rheumatic drug abatacept paired with a chikungunya-neutralizing monoclonal antibody—abolished acute symptoms in infected mice.1 The strategy must…
Medical Schools Address Bias, Diversity, Inclusion in Variety of Ways
“What are you?” A faculty member at the University of California, San Francisco (UCSF) School of Medicine posed this question to a resident while attending rounds. Both were portraying a scene involving micro-aggression during Differences Matter, a three-day orientation for first-year medical students. On the program’s first day, students are introduced to unconscious bias and…
Rheumatologists Respond to Prescription Opioid Analgesic Crisis
The alarming statistics on prescription opioid overdoses are well known to medical professionals, thanks to the Centers for Disease Control and Prevention (CDC)’s widely cited finding that deaths from opioid analgesics have increased fourfold since 1999.1 Half of all fatal drug overdoses now involve opioids prescribed by a doctor. Meanwhile, a lack of rigorous research…
Rheumatology Coding Corner Answers: Eligibility Quiz
Take the challenge. B—Most employer insurance plans change on Jan. 1. Because of this, it is a best practice for medical office staff to ask if there is any change to a patient’s medical coverage. Even if the patient indicates there are no changes in coverage, staff should still request to review their insurance card….
Rheumatology Coding Corner Questions: Eligibility Quiz
An established patient is seen in the office for a scheduled visit with the rheumatologist at the start of the new year. What should the front desk staff do for all patients at the beginning of each year? Inform the patient that their co-pay is due prior to receiving treatment, and ask how they would…
Bigger, More Expensive Healthcare Practices Not Necessarily Better
(Reuters Health)—You might not get what you pay for when it comes to healthcare, a new study hints. A report in Health Affairs on May 2 found little association between how much physician practices charged and patients’ perceptions of their quality of care.1 “We’re asking consumers to make a lot of decisions about healthcare purchasing…
Treating Uveitis with Adalimumab Improves Quality of Life
NEW YORK (Reuters Health)—Treatment of uveitis with adalimumab is linked with “clinically meaningful” differences in quality of life compared with treatment with placebo, new research shows. Dr. John Sheppard of Eastern Virginia Medical School in Norfolk, Va., tells Reuters Health, “Regardless of underlying etiology or lack thereof, uveitis can have a profoundly adverse effect upon…
Studies Highlight Risk of Damage from Lupus Treatments
WASHINGTON, D.C.—Conference goers who braved the final day of the 2016 ACR/ARHP Annual Meeting were awarded for their stamina by learning about issues relating to the damage caused by systemic lupus erythematosus (SLE) during the session Systemic Lupus Erythematosus—Clinical Aspects and Treatment V: Damage and Morbidity. Minimizing Damage: Early Use of GC-Sparing Strategies Jayne Little,…
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