Infections are a concern for many when using tumor necrosis factor-α inhibitor (TNFi) therapy to treat inflammatory disorders. Even moreso in those at higher risk.

Serial biomarker or clinical metric assessments are ubiquitous and commonly used to assess patients with rheumatoid arthritis (HAQ, CDAI, RAPID3), lupus (C3, C4, dsDNA) and gout (uric acid). But numerous disorders are either harder to assess or have tools or metrics that that are not commonly used.

Patient-reported outcomes in rheumatoid arthritis (RA) correlate independently with measures of inflammation and structural damage on MRI scans, according to data from a longitudinal study.

There is considerable heterogeneity in "red flags" amongst numerous low back pain (LBP) guidelines worldwide.  A "red flags" denotes a finding, which if present, imparts a significantly high risk of underlying serious spinal pathology with considerable subsequent morbidity or mortality.

Dr Jack Cush reviews this week's highlights from RheumNow.com.

Rheumatology News has a novel online report about combined rheumatology-dermatology clinics.  In the last several years, there have been a few of these in operation (Boston, Chicago, Rhode Island).

From tofacitinib developmental trials in RA and psoriasis and adherence to T2T in early RA to a rheumatology pearl about dapsone and much more, here are the highlights of what you may have missed on RheumNow.com this week.

Vitamin D certainly plays a pivotal role in bone health and immune function.

Reuters reports that a study of 6629 Canadian women with osteoporosis taking bisphosphonates found that nearly one in five had a decrease in bone density while on medication. (Citation source: http://buff.ly/2afb7nj) 

With the introduction of ASAS criteria for the diagnosis of axial and peripheral spondyloarthropathy, there has been a debate about whether patients with fibromyalgia (FM) could be mistaken for a spondyloarthropathy, or vice versa.

Dr. Jack Cush reviews highlights from this week's rheumatology news on RheumNow.com.

In Genome Medicine, Mayo Clinic researchers investigated a cohort of rheumatoid arthritis (RA) patients, their relatives and a healthy control group analyzing the gut microbiome vial16S ribosomal DNA analysis of fecal samples.

Female academic physicians at public medical schools had lower average salaries than their male counterparts, a disparity that was only partly accounted for by age, experience, medical specialty, faculty rank and other factors, according to an article published online by JAMA Internal Medicine.

The European League Against Rheumatism (EULAR) has published updated recommendations on the management of fibromyalgia in the Annals of the Rheumatic Diseases (Citation source http://buff.ly/29I7e8C). 

PNAS has published a study wherein an inducible “inflammatory reflex” delivered by vagus nerve stimulation was shown to inhibit the production of tumor necrosis factor (TNF), an inflammatory molecule that is a major therapeutic target in an animal model of rheumatoid arthritis (RA).

The NY Times reports that millions of Americans with osteoporosis are driven to stop or not take bisphosphonate therapies over the fear of exceedingly rare side effects - osteonecrosis of the jaw (ONJ) and atypical femoral fractures (AFF).

Autoimmune ophthalmic disease is a frequent challenge to rheumatologists from both a diagnostic and therapeutic perspective. Approved therapies are limited and have only been infrequently or comfortably utilized by rheumatologists and autoimmune ophthalmologists.

Dr. Jack Cush reviews highlights from the news and social media in the past week on RheumNow.com

A recent report from Johns Hopkins, published in the Annals of Rheumatic Diseases, describes 13 cancer patients treated with the immune checkpoint inhibitors, ipilimumab or nivolumab, who developed inflammatory arthritis and sicca syndrome.

Tocilizumab is currently listed as a Category "C" pregnancy risk based on limited pre-clinical (animal) data that was negative.