LONDON—The availability of a biosimilar form of infliximab has dramatically increased the number of Norwegians taking one form or another of the drug, an expert on biosimilars said in a debate-style session at the Annual Congress of the European League Against Rheumatism (EULAR 2016). The expanded uptake of Remicade (infliximab) and its biosimilar, Remsima (international…
Why Rheumatologists Should Ask Patients About Drug Use
SAN FRANCISCO—“We’ve known for a long time that prescription medications and illicit drugs can both mimic and actually induce the autoimmune syndromes treated by rheumatologists,” Jonathan Graf, MD, professor of medicine at the University of California–San Francisco in the Division of Rheumatology at Zuckerberg San Francisco General Hospital (SFGH), said at the California Rheumatology Alliance…
Lung Complications Closely Entwined with Rheumatologic Diseases
SAN FRANCISCO—Lung involvement is a frequent and often life-threatening manifestation of the connective tissue diseases (CTDs) that are commonly encountered by rheumatologists. A variety of rheumatic diseases can affect the lungs, including systemic sclerosis, rheumatoid arthritis, vasculitis, lupus, polymyositis/dermatomyositis (PM/DM) and Sjögren’s syndrome. A panel presentation on lung disease associated with rheumatic diseases at the…
Sexual Dimorphism Found in Immunologic Profiles of Patients with Ankylosing Spondylosis
A study that found distinct sexual dimorphism in the immunologic profiles of patients with ankylosing spondylosis (AS) suggests that sex is an important variable to address in future research and may eventually lead to more effective sex-specific therapy for patients with the disease. The research, published in the March 2016 issue of Arthritis & Rheumatology,…
Understanding Prescription Pathways for Biologic Medication Therapy
Executing evidence-based medicine in the U.S. is challenging, especially utilizing high-cost medications in rheumatologic care. As patients trust their clinicians to be their medical experts, clinicians must trust their care team members to be experts at implementing the care plan. A clinician’s knowledge of human anatomy and physiology is the foundation to understanding pathophysiology. From…
Blacks, Asians at Higher Risk for Allopurinol-Related Skin Reactions
Be careful when prescribing allopurinol to black and Asian gout patients, a study newly advises. Black and Asian patients who take this ubiquitous, more-than-40-year-old medication are at much higher risk of certain serious skin reactions than are Caucasians or Hispanics. Compared with Caucasians, blacks who take allopurinol to lower blood urate levels have an increased…
Chronic Reactive Arthritis Secondary to Intravesical Bacillus Calmette–Guerin in Bladder Carcinoma
A 50-year-old man with history of superficial bladder carcinoma presented to our rheumatology clinic for a three-year history of symmetric polyarthralgias. He had undergone multiple transurethral resection of bladder tumor procedures and bacillus Calmette–Guerin (BCG) treatments. Prior to receiving BCG, he was fully functional and employed. Days after receiving his second BCG treatment, he developed…
Rheumatoid Arthritis Patient Shares Lessons Learned from Breaking Leg in a Fall
Humpty Dumpty sat on a wall Humpty Dumpty had a great fall All the king’s horses and all the king’s men Couldn’t put Humpty together again. —Mother Goose I feel like a female Humpty Dumpty. Recently I took a great fall, and now I am in the process of being put together again. I was…
Long-Term Antibiotic Treatment for Lyme Disease Shows No Benefits
For people in whom symptoms of Lyme disease persist beyond the standard course of two to four weeks of antibiotic therapy, longer term antibiotic treatment provides no additional benefits beyond the shorter term course. This is the conclusion of a recent study published in the New England Journal of Medicine that builds on a number…
Rheumatology Coding Corner Answer: Level 4 New Patient Visit
Take the challenge. Correct Answer: CPT: 99204 ICD-10: I73.00 Coding Rationale This is a new patient, outpatient visit for a self-referred patient. There is no formal consultation request from another physician; therefore, the encounter does not meet criteria for a consultation. This encounter is coded as 99204 because it included: Comprehensive history—Extended history of the…
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