The diagnosis of axial spondyloarthritis (and anklylosing spondylitis) (axSpA) is often delayed and usually not diagnosed by rheumatologists; a recent metanalysis shows that longer delays were attributable to lower education levels, younger age at onset and absence of extra-articular manifes

According to a recent report in Annals of Rheumatic Disease, public enthusiasm for hydroxychloroquine (HCQ) created significant access issues for rheumatic patients in the early phases of the COVID-19 pandemic.

A novel report from PNAS suggests that in osteoarthritis (OA), the damage is not entirely from body weight and mechanics, instead it may be from adipose tissue itself.

UK Clinical Practice Research Datalink population study shows that patients with immune-mediated inflammatory diseases, such as RA, PMR, GCA and IBD, have an augmented risk of CV outcomes with glucocorticoid use; even lower doses had a near doubling of their underlying CVD risk.

The fate of the Trump administration's "most favored nation" (MFN) rule for bringing down prescription drug prices remains uncertain as President-elect Joe Biden prepares to assume office later this month.

Dr. Jack Cush reviews the news, journal articles and favorite blogs from this past week on RheumNow.com.

A lupus cohort study from British Columbia, Canada has shown that medication adherence with hydroxychloroquine (HCQ) is associated with a 71% to 83% lower mortality. 

Recurrent pericarditis is a rare, probable autoinflammatory disorder mediated by interleukin-1 (IL-1); and is often refractory to glucocorticoids and colchicine.

Non-adherence may be the single most untold risk to suboptimal outcomes in the care of musculoskeletal disease.  It has been estimated that 30-80% of patients with rheumatic and musculoskeletal diseases (RMDs) are nonadherent to prescribed regimens.  EULAR has commissioned a task force

The U.S. Centers for Disease Control and Prevention (CDC) has issued a timeline guidance document on when, how and who should get the commercially available COVID-19 vaccines. 

MMWR has reported on a July 2020 survey study from 1,009 Health Resources and Services Administration–funded health centers showing that urban Health centers were more likely to provide virtual visits than those in rural areas.

Annals of Rheumatic Disease reports on an analysis of lupus (SLE) patients that shows COVID-19 infection rates were similar between those lupus patients who were taking hydroxychloroquine (HCQ) and those not taking HCQ. 

JAMA has published a clinical update of recent studies on GCA. While PET/CT scanning are novel means of demonstrating activity, they have not changed the diagnostic approach to GCA or PMR and although there are no new proven treatment strategies for PMR beyond glucocorticoids, the FDA has approved tocilizumab as a first-line glucocorticoid-sparing agent. 

The ACR has published guidelines to manage reproductive health issues in rheumatic disease (RMD) patients before, during and after pregnancy. In this second excerpt from their guidelines articles, we present recommendations (and good clinical practice statements) for paternal rheumatology medication use by men with RMD and on conventional rheumatology medications and biologic use in pregnancy for women with RMD. 

In this third excerpt from the ACR guidelines on managing reproductive health issues in rheumatic disease patients, we present recommendations regarding the use of glucocorticoids and guidance on lactation and medication use post-partum.

The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) have jointly developed new classification criteria for systemic lupus erythematosus (SLE); prompted by the need for criteria that were both highly sensitive and specific. The net result is improved sensitivity and specificity, but the use of positive ANA requirement along with a longer list of weighted criteria ensures its utility in SLE research (including early or latent SLE), but not clinical practice.