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New CDC Guidelines on Prescribing Opiates for Pain
The use of opioids has become increasingly problematic in the last few years. First, the rising rates of use and abuse, followed by greater restrictions and regulations that have curtailed use, and, finally, a resultant increase in illicit drug use (heroin) and opioid overdoses.
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Leflunomide and Weight Loss in Rheumatoid Arthritis
Weight change can have substantial effects on the outcomes of patients with arthritis. It has long been known that weight loss and low body mass index (BMI) are associated with poorer arthritis outcomes.
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ACR Invites Comment on Perioperative Management Guidelines
The ACR is inviting members and rheumatologists to comment on their proposal to develop recommendations for the "Perioperative Management of Rheumatic Disease Medications in Total Joint Arthroplasty of the Hip and Knee".
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Combined Dermatology-Rheumatology Clinics Benefits Patients
Healio reports that patients followed in a combined Dermatology and Rheumatology clinic in Canada revealed high patient satisfaction.
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Biosimilars Reviewed by Expert Panel
As the number of biosimilars in development keeps on growing, reaching nearly 700 products to date, demand for data from randomized controlled trials (RCTs) and an understanding of these new biologics is peaking the interest of many.
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Novel Protein as a Potential Autoantigen in JIA
Juvenile idiopathic arthritis (JIA) is clearly not related to rheumatoid arthritis and until recently has no identifiabile autoantigen linked to JIA.
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AAOS Guidelines on Carpal Tunnel Diagnosis
Three million Americans are diagnosed with carpal tunnel syndrome each year.
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Methotrexate Safety with Chronic Hepatitis B Infection
Chronic liver disease, and in particular hepatitis B infection, is a contraindication to methotrexate (MTX) use.
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Early Aggressive Treatment of Elderly RA Results in Less Joint Surgery
Two population-based cohorts from Ontario (ON) and Quebec (QC) were used to assess if early DMARD influenced the need for joint replacement surgery among elderly patients with incident rheumatoid arthritis.
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Less Treatment, Responses and Safety in Elder-Onset Rheumatoid Arthritis
A recent review compared elderly-onset rheumatoid arthritis (EORA) to those with younger-onset rheumatoid arthritis (YORA) to assess treatment responses and safety issues with biologics and DMARDS. EORA is generally defined as the onset of rheumatoid arthritis after age 60 years.
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Rheumatoid Arthritis Alone is Not a Risk for Post-Op CV Events
Using hospitalization claims from 7 states, reasearchers studied the risk of cardiovascular outcomes following surgery in rheumatoid arthritis (RA) patients. (Citation source http://buff.ly/1TDsVG6)
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Curbside Consults - February 2016
The following is a collection of cases presented to me by rheumatology colleagues. Each has a challenging therapeutic or safety issue. Answers are based on experience with references from literature and guidelines.
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RA Flares Common After Anti-TNF Withdrawal
The risk of a flare increased by more than three-fold over 1 year when patients with longstanding rheumatoid arthritis (RA) in remission, or with stable low disease activity, stopped their anti-tumor necrosis factor (TNF) treatment, Dutch researchers reported.
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CBC Hidden Pearls
CBC…it’s easy as 123! The complete blood count (aka, CBC) is the most routine, but indispensable, of all medical assessments.
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Ultrasound Training Escalates in the United States
A recent report cites the frequency of musculoskeletal (MSK) ultrasound (US) education in US residency and fellowship training programs.
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Lupus Flares After Renal Transplant
Whether lupus activity is ameliorated by end-stage renal disease (ESRD) or transplantation has been debated.
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Smoking and Age Linked to Development of Inflammatory Arthritis
A prospective cohort of RA first-degree relatives were prospectively studied for genetic and environmental factors (smoking, body mass index, education, and parity) and RA-related autoantibodies that may influence future development of inflammatory joint symptoms over a 2 year 
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Prescribers More Likely to Escalate to Biologics than Triple DMARD Therapy
The paradigm for DMARD use in rheumatoid arthritis (RA) begins with DMARD monotherapy and then escalates to combination therapy with either DMARDs or a combination of conventional DMARD plus a biologic DMARD (bDMARD).
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