Healthcare is a personal and individualized relationship between a provider and patient. Each patient is treated according to their particular symptoms and personal health characteristics.

Today I have a few questions: Is tramadol really a weak narcotic? Should we really still be doing placebo-controlled trials? What are we going to do about our patients who are smokers? This and more, in this week's review of the news and journal articles.

The Journal of Rheumatology reports that current smoking significantly reduces the clinical efficacy of methotrexate (MTX)-based therapy, as studied in an early rheumatoid arthritis (RA) cohort.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are among the most severe drug reactions, as they come with substantial mortality and morbidity.  A review of European centers dealing with SJS and TEN shows that despite best treatment practices, the 6-week mortality rate was 21%.

Patients with rheumatoid arthritis (RA) who had high levels of inflammation at baseline were at increased risk for later heart failure, a large cohort study found.

Registry level data of patients with immune-mediated inflammatory diseases (IMIDs) diagnosed with COVID-19 should continue their TNF inhibitor (TNFi) therapy as such patients were less likely to experience adverse COVID-19 outcomes (compared to other immunomodulatory treatments).

B-cell depletion therapy with obinutuzumab, a type II anti-CD20 monoclonal antibody, in lupus nephritis patients was shown to be effective in in combination with standard lupus therapies.

Tight-control or treat-to-target (T2T) strategy is advocated in several diseases, but the recent TICOSPA trial in axial spondyloarthritis (axSpA) showed that T2T was not superior to usual care (UC).

A recent analysis shows thta glucocorticoids (GCs), usually recommended for short-term use in rheumatoid arthritis (RA), are variably used by rheumatologists, and that provider preference is a strong predictors of long-term glucocorticoid use.

Dr. Jack Cush reviews the FDA approvals, news and the latest journal articles from the past week on RheumNow.com.

EULAR has updated its recommendations (points to consider - PtC) for rheumatologists managing patients during COVID-19; now with 2 overarching principles and 12 PtC.

Both systemic onset juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease are acquired autoinflammatory disorders of uncertain etiology. Yet recent reports of AOSD onset and flare following COVID-19 vaccinations may have important mechanistic implications.