To TDM or Not in Rheumatology?

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Therapeutic Drug Monitoring (TDM), especially for biologic therapies, has become a standard in gastroenterology, but shunned by most rheumatologists.

Biologic Persistence in Psoriatic Arthritis and Psoriasis

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Two recent studies examined the durability and persistence of biologic agents in patients with psoriasis (PSO) and psoriatic arthritis (PsA) and while some differences were noted overall persistence was low 3 years later.

Rising Incidence of Systemic Lupus Erythematosus

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Data from Olmstead county, MN over the past four decades shows that the incidence and prevalence of systemic lupus erythematosus (SLE) is increasing.

SLE was diagnosed using the EULAR/ACR criteria and looked at patients seen between 1976–2018.

Acute Inflammatory Responses Needed to Resolve Chronic Pain

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Science Translational Medicine has published results of a Canadian study of low back pain (LBP) suggests that pain control by anti-inflammatory treatments might have negative effects on pain duration and may be counterproductive for long-term pain outcomes.

Bimekizumab Development Delayed by FDA

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UCB announced they have received a Complete Response Letter (CRL) from the U.S. Food and Drug Administration (FDA) regarding the Biologics License Application (BLA) for bimekizumab for the treatment of adults with moderate to severe plaque psoriasis (PSO).

Methotrexate Monitoring (5.13.2022)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Bad news for digitial ulcers in Systemic sclerosis, Readmissions in Lupus and Thrombocytopenia in APL patients.

A Day in the Life: Consults with a Rheumatology Fellow

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Join medical resident Siobhan Deshauer, MD, as she visits three hospitals for inpatient rheumatology.

Diagnostic Delays in Spondyloarthritis Still Prolonged

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Previously quoted average  delay in diagnosing axial spondyloarthritis (axSpA) may be improving as a recent UK study shows the mean average time to diagnosis in two different NHS trusts was between five and six years. 

Trends in Rheumatoid Arthritis Disabililty, Despite Biologics

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Disability claims in the U.S. related to rheumatoid arthritis (RA) were just as common in 2015 as in 1999, a government researcher found, against expectations that the advent of biologic therapy would have led to a steady decrease.

Consensus Best Practices for Virtual Care in Rheumatology

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The Canadian Rheumatology Association’s (CRA) Telehealth Working Group (TWG) has developed a series of best practice statements for the virtual care in adult and pediatric rheumatology patients.

The Effect of Socioeconomic Status on Lupus Outcomes

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Socioeconomic status (SES) often associates with poorer outcomes in systemic lupus erythematosus (SLE) patients; and a current study suggests this is unrelated to healthcare access issues.

Poor Outcomes in Lupus Patients Not at Target

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A prospective, longitudinal systemic lupus erythematosus (SLE) cohort study examined outcomes and showed that failure to control SLE was common and associated with poorer outcomes including organ damage, glucocorticoid exposure, poor quality of life, and increased mortality.

Adalimumab Addition vs. Methotrexate Escalation in Psoriatic Arthritis

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An interesting study in Lancet Rheumatology shows that psoriatic arthritis patients not responding to methotrexate alone can respond after adding or escalating adalimumab (ADA) on top of methotrexate (MTX) to reach minimal disease activity (MDA) response. 

Disappointment Behind Acute Gout Hospitalizations

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Analysis of emergency department visits from two UK hospitals shows a high rate of hospitalization, and low use of urate-lowering therapies (ULT) and treat-to-target (T2T) management. 

Ethnic and Behavioral Drivers of Gout Risk

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Gout is common but disproportionately affects certain groups (e.g., the elderly, Pacific Islander, Blacks). Ethnic links to gouts were also shown to be linked to modifiable behavioral factors and such information maybe useful in managing gout patients.

Downside of Holding Methotrexate with COVID-19 Vaccination

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A recent prospective, randomized, blinded clinical trial has shown that a 2 week hold of methotrexate (MTX) following COVID-19 (Sinovac-CoronaVac) vaccination resulted in greater anti-SARS-CoV-2 immunogenicity; but there was an increase in flare rates after the second dose of vaccine.

Diagnostic Delay in Axial Spondyloarthritis (2.25.2022)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week, rheumatologic problems incited by respiratory infections, air pollution and how you live, now where you live.

ACR Addresses Racial Disparities in Lupus Trials

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The American College of Rheumatology (ACR) is launching two new initiatives to reduce racial disparities in lupus clinical trials: Training to Increase Minority Enrollment in Lupus Clinical Trials with CommunitY Engagement (TIMELY) and new Continuing Medical Educatio