A 25 year-old female recently diagnosed with seronegative rheumatoid arthritis was started on a TNF inhibitor. She came in for a follow-up visit and noted that her toenails were brittle and discolored when she removed her nail polish recently.  She is concerned that she may have psoriasis or that this may be a side effect of the TNF inhibitor.

What is your next step?

Dr. Jack Cush reviews highlights from the past week on RheumNow.com:

The NY Times points out "there is is an out-of-control epidemic in the United States that costs more and affects more people than any disease Americans currently worry about. It’s called nonadherence to prescribed medications, and it is — potentially, at least — 100 percent preventable by the very individuals it afflicts.

Dr. Jack Cush reviews the past week's news, articles and advances from RheumNow.com.

Dr. Jack Cush reviews highlights from this week's meeting at the Cleveland Clinic Foundation - Biologics Summit VII; and of course a few other tweets and journal articles.

An updated systematic literature review has provided reassuring evidence regarding the increasing safety of biologic disease-modifying anti-rheumatic drugs (DMARDs) in the treatment of rheumatoid arthritis (RA), European researchers reported. 

Dr. Jack Cush reviews highlights from the news and Advances in Targeted Therapies meeting in Mandelieu, France:

Tweeting this week from Advances in Targeted Therapies #ATT2017 in Mandelieu, France.

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

A comprehensive review of psoriatic arthritis (PsA) was published this week in the NEJM, authored by leaders in the field, Drs. Ritchlin, Colbert and Gladman.

High points from their review inlcuded:

SLE-related hepatitis (“lupus hepatitis”) and “lupoid hepatitis” are 2 different diseases. The term "lupoid hepatitis", now known as autoimmune hepatitis (AIH), was first coined in 1959. AIH was initially called “lupoid hepatitis” by MacKay.  A review by Adiga and Nugent reviews, defines and distinguishes between lupus-related hepatitis and lupoid hepatitis.

Dr. Sharad Lakhanpal, MBBS, MD, President of the American College of Rheumatology (ACR) has issued a press release condeming the insufficiencies of the newly proposed American Health Care Act (AHCA).

Dr. Jack Cush reviews highlights in the news from the past week at RheumNow.com.  News on hepatitis C in RA and risk of hepatotoxicity; TNF inhibitor persistence in PsA; unnecessary injections in pre-operative OA knee patients; and a delay in the FDA decision on abaloparatide.

The March 2017 issue of the ACP Internist has reviewed the ubiquitous practice of medication adherence. 

CNN has reported that changes in immigration policies is but one of many factors that may add to an existing doctor shortage. This and other events now begs the the question, why the federal government doesn't train more doctors in the US?

The ACGME has revised its traing guidelines such that, starting July 1st, new interns are allowed to work shifts lasting as long as 24 hours, and as much as 28 hours according to a recent New York Times article.  

Most physicians believe they understand and can manage gout. Yet, the number of gout patients has risen at an alarming rate and the introduction of 4 new drugs has done little to close the education gap and improve the care and outcomes of gout patients. Misuse, misunderstandings and missed opportunities abound in the wide world of gout.

Treat-to-target (T2T) works when they are pragmatic and conform well to daily practice.  

Gout is an ideal therapeutic area where T2T could be and should be applied.

Dr. Jack Cush reviews news and highlights from the past week on RheumNow.com.  Sign up at RheumNow.com to received daily or weekly news, blogs and tweets on all things rheumatology

In the United States, doctor-diagnosed arthritis is a common and widespread chronic condition (1,2). Arthritis is a leading cause of disability (3) and is projected to affect 78.4 million adults by 2040.

Dr. Cush reviews the highlights and news from the past week on RheumNow.com.