Systemic onset juvenile idiopathic arthritis (sJIA) is a dramatic onset inflammatory condition marked by spiking fevers, intermittent rash, polyarthritis and a host of other hyperinflammatory manifestations.

Drs. Jack Cush and Martin Bergman review the topic of treat-to-target (T2T) management in rheumatology.

Both will debate the pro's and con's of the T2T strategy at the upcoming RWCS meeting on Feb. 17, 2022.

Excess adiposity and genetic predisposition both contributed to risk of gout among U.S. women, with the risks being highest when both factors are present, a large prospective study found.

The 2021 Nobel Prize in Medicine and Physiology was jointly awarded to Drs.

Annals of Internal Medicine has reported the results of a randomized clinical trial showing that telehealth-delivered exercise and diet programs improved pain and function in knee osteoarthritis patients who were overweight.  While both were beneficial, exercise had a greater effect than die

Based on the safety review of tofacitinib in Pfizer's Oral Surveillance (1133) study, the FDA has added serious boxed warnings to all three marketed JAK inhibitors (for inflammatory diseases) and formalized the recommendation that patients should be started on a TNF inhibitor (TNFi) before trying a JAK inhibitor. These recommendations apply to tofacitinib, baricitinib and upadacitinib.

In spite of the transformative growth of telemedicine during the COVID-19 pandemic, rheumatologists use of telemedicine is waning, much like the use of masks. Dr. Jack Cush interviews telemedicine guru, Dr. Alvin Wells, on the current state of telemedicine and what the future holds for telehealth in rheumatology.

Rheumatoid arthritis (RA) has been linked to a higher risk of dementia and cognitive dysfunction, but interestingly this association has diminished in the last few decades with aggressive DMARD and targeted therapies..

Pulmonary complications in the setting of Still's disease (juvenile and adult) has seldom but consistently been reported, including reports of pneumonitis, pulmonary hypertension and a severe or fatal lung disease, often associated with hypersensitivity to anticytokine therapy. A multicenter study reports that drug hypersensitivity and pulmonary reactions in Still's patients receiving IL-1 or IL-6 inhibitors is strongly associated with HLA-DRB1*15 haplotypes.

Proponents of treat to target in systemic lupus erythematosus (SLE) have all agreed that "remission" should be the goal, but defining remission may be tricky in SLE.  A SLE Definitions Of Remission (DORIS)Task Force was convened in 2015 and first published their work in 2016.

Dr. Jack Cush interviews Professor Edward Keystone, MD (University of Toronto) on the origins and science behind the 60/40/20 benchmark and outcomes in rheumatoid arthritis.

Appropriate assessment and management of comorbidities and multimorbidity in patients with RA is vital for overall health and well-being of the patient, as well as to encourage treatment adherence, and address social, psychological and quality of life factors. 

Dr. Jonathan Kay's provocative video addresses whether the increased cancer risk associated with tofacitinib (Tofa) seen in the Pfizer Oral Surveillance (1133) study represents a real increased risk, an increased risk relative to a decreased risk with TNF inhibitors (TNFi) or an actual decreased cancer risk (unknown as there was no placebo comparator in this trial).

How to best book patient appointments in rheumatology clinic? Should these be scheduled every 3 or 4 months regardless of patient status? Should they be scheduled by patient need or disease activity? 

Surely you’ve seen this or been plagued by this patient, one that is not doing well, in need of a new regimen; you outline it, timeline it, define the side effects and send them off with a new prescription..

My research shows that up to 50% of rheumatologists measure something in the course of their daily assessments, and RAPID3 is most popular, being employed by 31% of rheumatologists.

The GLORIA study (ABST# 1678) was a pragmatic, blinded placebo-controlled randomized trial from Dr. Martin Boers and colleagues where they assessed whether prednisolone (vs. placebo) use would alter clinical outcomes over 2 years.

The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.