DRIVE Trial: Denosumab and Methotrexate Prevent Joint Erosions

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Joint erosions in RA result from a complex process with multiple contributing mechanisms. One of those mechanisms involves RANK receptor activation by RANKL leading to osteoclast differentiation, activation and survival.

Changing Patterns of Drug Use in Pregnant Rheumatic Patients: Steroids Down, Biologics Up

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Desai and coworkers analyzed public and private insurance claims data (2001-2012) to assess patterns of drug use in pregnant woment with RA, SLE, PsA and AS. Specifically, they looked at immunosuppressive drug use in the 3 months preceding and during pregnancy.

EULAR 2015 Psoriatic Arthritis Treatment Guidelines

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The management of psoriatic disease, including psoriatic arthritis (PsA) has evolved significantly in the last decade.  Nevertheless, there are still some uncertainties - such as what the role of methotrexate should be, and when to use newer and novel therapies.

Drug Safety Update for November 2015

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The Down-Side of Electronic Medical Records. EMRs (or EHRs) have become increasingly utilized in daily practice. The benefits of these include better record-keeping, safe prescribing, patient and drug tracking, adverse event monitoring and checks for drug interaction.

Microvesicles May Ameliorate Arthritis Damage

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Microvesicles are emerging as a new mechanism of intercellular communication by transferring cellular lipid and protein components to target cells, yet their function in disease is only now being explored.

Azathioprine Adverse Events Associated with TPMT Polymorphisms

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Azathioprine (AZA) is widely used in the treatment of several autoimmune diseases. Its use and optimal dosing may be limited by adverse drug reactions (ADRs). Thiopurine S-methyltransferase (TPMT) is an important enzyme involved in AZA metabolism.

Famous Rheumatologist Quotes – Part I

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A famous quote from Verna Wright, MD, states, “Clinicians may all too easily spend years writing“doing well” in the notes of a patient who has become progressively crippled before their eyes".

In RA TNF-Inhibitors Prove To Be Durable Choice

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Patients with rheumatoid arthritis (RA) were less likely to discontinue their first biologic when that treatment was a tumor necrosis factor (TNF) inhibitor than if it was a non-TNF biologic, and especially if treatment was initiated prior to 2005.

Physician Burnout on the Rise

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Burnout among U.S. doctors affects more than half of practicing physicians, according to a new study published in Mayo Clinic Proceedings. (Citation source http://buff.ly/1RpV8Q0)

Reduced Uric Acid from Weight Loss Tied to Triglycerides

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Weight loss is one of several nonpharmaceutical interventions to reduce serum urate (SUA) levels and control gout. French researchers examined the role of xanthine oxidase (XO), low-grade inflammation, and weight loss on SUA levels in obese patients.

Prudent Diet Reduces Risk of RA and Gout

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The 2015 ACR meeting in San Francisco highlighted several studies wherein dietary patterns predicted a reduced risk of both rheumatoid arthritis (RA) and gout.

EHR Connected Doctors May Be Disconnected from Patients

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Reuters reports doctors who entered data into electronic health records (EHR) during patients' appointments tend to communicate less and receive lower ratings from their patients.

UCSF Study Shows Weight Loss Protects OA Cartilage

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Researchers at the University of California at San Francisco have shown that >10% weight loss may impact the rate of cartilage loss as determined by MRI scanning.  They presented their findings yesterday at the annual meeting of the Radiological Society of North America (RSNA). 

Curbside Consults - December 2015

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The following is a collection of cases presented to me by my colleagues in Canada during a day of workshop case discussions among clinical consultants. Each case is presented because of a challenging therapeutic issue.

The Rising Price of Dermatologic Drugs

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Containment of health care costs was a primary goal of the Patient Protection and Affordable Care Act. But there is little evidence of success in curbing the rising price of prescription drugs. As such, many medications are unaffordable to those who need them.

Fertility in RA Linked to Disease Activity, NSAIDs and Prednisone

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Brouwer and colleagues from the University Medical Center Rotterdam in The Netherlands have studied the issue of infertility in a cohort of RA patients followed prospectively.

Chronic Digital Ulcers in Systemic Sclerosis Portends More Complications

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A prospective, international observational study of systemic sclerosis patients enrolled in the Digital Ulcers Outcome (DUO) Registry: Patients were required to have ≥3 follow-up visits over at least a 2 year observation period between 2008-2013.

Don't Blame the L-Tryptophan and Turkey

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The harvest holiday is upon us and many will huddle around the television to enjoy their post-turkey coma; only to awaken and see the highlights of the football they intended to watch.

An article in Science Daily quotes experts at Loyola University on this matter.