Herpes zoster (HZ) infection, also known as shingles, is caused by reactivation of latent varicella-zoster virus infection generally acquired decades earlier. This study was designed to test the hypothesis that the incidence of stroke immediately following HZ infection is increased in patients with autoimmune diseases compared with the incidence of stroke at later time points. Results: In patients with autoimmune diseases, incident HZ was associated with as much as a twofold increased risk of stroke. Prompt antiviral therapy was associated with lower incidence of subsequent stroke…
Medical Paradoxes in Clinic, Lab Should Encourage Physicians to Reappraise Ideas about Health and Disease
Wash your hands. This most basic tenet of proper hygiene has been drummed into our heads for years. It’s an obvious infection prevention activity, yet for years, compliance among physicians and other caregivers has been lackluster. To rectify this matter, regulatory agencies began auditing hospital staff adherence to this axiom of infection prevention. Not only…
Gout Treatments Effective If Patients Maintain Lifelong Adherence to Therapies
Although gout is one of the most effectively treated of all rheumatic diseases, it is among the worst-managed diseases long term, as shown by many studies. “Treatments are excellent, yet are dramatically under-utilized,” says Theodore Fields, MD, FACP, rheumatologist, Hospital for Special Surgery (HSS), New York. “This is because some gout patients feel better between…
Rheumatology Drug Updates: Giant Cell Arteritis Relapse Possible if Tocilizumab Discontinued; Plus Updates on Rituximab, Etanercept
GCA Relapse Possible When Discontinuing Tocilizumab In a Phase 2 randomized, controlled trial, tocilizumab, an anti-IL-6 biologic agent, was shown to induce and maintain remission for up to 52 weeks in patients with giant cell arteritis (GCA).1 During this trial, patients with GCA were randomized in a 2:1 ratio to receive 8 mg/kg bodyweight tocilizumab…
Mesenchymal Stem Cell Therapy May Help Slow, Repair Degenerative Signs of Osteoarthritis, Musculoskeletal Disease
WASHINGTON, D.C.—For patients with osteoarthritis and other age-related musculoskeletal diseases, treatment with mesenchymal stem cells may soon offer a potent way to slow and repair degenerative signs of disease. This is the goal, a goal that is moving from the laboratory to the clinic as results from ongoing randomized clinical trials show the safety and…
Do Fevers Offer Insight into Diagnosis & Disease?
Patients experience fevers for many reasons, but can they help physicians diagnose disease? Using modern technology and social media, Jonathan S. Hausmann, MD, is working to further the understanding of body temperatures…
Lesinurad with Allopurinol When Allopurinol Alone Is Insufficient
Current guidelines for the long-term management of gout recommend a combination of lifestyle management and/or pharmacotherapy to lower serum UA levels to <6.0 mg/dL in most patients or <5.0 mg/dL in patients with more severe disease. Allopurinol is the most widely used xanthine oxidase inhibitor and is recommended in treatment guidelines as a first-line urate-lowering…
Rheumatology Drug Updates: Celecoxib and Cardiovascular Safety Trial Results Reviewed
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used therapeutically since the 1960s.1 Evidence of adverse cardiovascular outcomes led to the withdrawal of the selective COX-2 inhibitor rofecoxib in September 2004, when the question of cardiovascular safety of NSAIDs first came into the limelight.2 Valdecoxib (Bextra) was subsequently withdrawn from the market in April 2005 due to…
RISE Registry Promises to Improve Care & Research for Rheumatology
In 2014, the ACR launched the Rheumatology Informatics System for Effectiveness (RISE), a national electronic health record (EHR)-enabled registry. The goal: To help participating rheumatologists and practices leverage the new wave of big data created by the use of EHR, advance research and improve overall quality of care. A new analysis examines the RISE structure and the initial patient data collected by the registry…
Effect of Diet & Sodium Intake on Serum Uric Acid
Serum uric acid (UA) is an important factor in the causal pathway for gout. It has also been implicated as a potential risk factor and/or mediator of cardiovascular disease outcomes and mortality in a large number of observational studies. Although many of the clinical trials targeting serum UA reduction have focused on pharmacologic interventions, diet…
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