Bisphosphonate Drug Holidays Drug holidays are common for patients on bisphosphonate therapy. Often, these breaks in treatment are related to known U.S. Food and Drug Administration (FDA) warnings and drug class adverse effects. Currently, data on fracture risk related to drug holidays are limited. In recent research highlighted at the 2017 ACR/ARHP Annual Meeting ,…
Fellows’ Forum Case Report: Progressive Weakness and Debilitation with Skin Rash
The Presentation A pale, quiet woman—her mother—wheeled the girl into my clinic. It was a blistering Florida day, and the girl was shivering. She glanced up at me when I said hello and asked her name. “Hi,” she said, giving me a broad smile. Her smile was the only broad thing about her. Her elbows…
Inside Cambodia’s Struggles with Poverty, Dearth of Trained Rheumatologists
It’s one thing for a developing country to lack physicians due to a scarcity of training. It’s quite another for such a vacuum to exist because the physicians were executed. In Cambodia in the 1970s, genocide perpetrated by the Khmer Rouge spared few of the educated class. If they were spared, chances were they lost…
Key Findings in Basic Science This Year Hold Promise for Potential Rheumatology Therapies
SAN DIEGO—After sifting through the nitty-gritty of the rheumatic disease literature on basic science, Richard Pope, MD—professor of medicine specializing in rheumatology at Northwestern University Feinberg School of Medicine—underscored several findings he thought stood out from the pack in his Year in Review talk at the 2017 ACR/ARHP Annual Meeting. He reviewed findings from November…
Cardiovascular Disease Rate Differs Between SLE Patients of Different Races, Ethnicities
A recent epidemiologic study of patients with systemic lupus erythematosus (SLE) investigated racial and ethnic differences in the risk for cardiovascular disease (CVD). Among SLE patients enrolled in Medicaid, the risk for myocardial infarction (MI) was lower in Hispanics and Asians compared with whites, and the risk of stroke was higher in blacks and Hispanics…
Is Rheumatoid Arthritis Preventable?
Is rheumatoid arthritis (RA) preventable? Results of a newly published study suggest that personalized medicine approaches may result in health behavior that may reduce RA risk. “We have gotten to the point where we’ve identified some modifiable behaviors that affect rheumatoid arthritis risk,” says Jeffrey A. Sparks, MD, MMSc, assistant professor of medicine in the…
Strong Statistical Association Found Between Trauma and Lupus
They say the body remembers what the mind wants to forget. For those who have experienced trauma, not only does the body remember, in some cases it works on making things worse. Such is the situation with trauma and lupus, says a new study published in Arthritis & Rheumatology in October. The study, titled, “Association…
CCL2 Cytokine Serves as Biomarker in Interstitial Lung Disease
A recent prospective, observational cohort study of potential clinical biomarkers for progression to interstitial lung disease (ILD) in patients with early systemic sclerosis (SSc) found that higher levels of CCL2 circulating in their plasma predicted both faster ILD progression and poorer survival rates than in those with lower levels.1 CCL2, also known as monocyte chemoattractant…
How to Recognize, Diagnose Periodic Fever Syndromes in Adults
A number of autoinflammatory syndromes that result from genetic mutations have been described recently. The vast majority occur in children. However, three periodic fever syndromes are important for rheumatologists who treat adults to know about. The goal of this review is to provide a concise description of each condition, and to help the clinician understand…
Fellows’ Forum Case Report: Necrotizing Autoimmune Myopathy
Necrotizing autoimmune myopathy (NAM) is a relatively recently discovered subgroup of inflammatory myopathies. NAM is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation.1 One subgroup of NAM is 3-hydroxy-3-methylglutaryl-CoA reductase antibody (HMGCR Ab)-related immune-mediated necrotizing myopathy (IMNM), which occurs (rarely) after statin exposure, with a rough incidence of two per…
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