Rheumatologists tend to be a conservative bunch of people. We’re law abiding and we (mostly) follow guidelines. Which is fine when they are in the best interests of our patients, but what do we do when we fundamentally disagree?

Dr. Joseph Smolen delivered one of the most elegant and informative talk on rheumatoid arthritis at this ACR’s meeting as a tribute to Dr. Paul Klemperer. Dr. Smolen led us on a journey, and had us feeling content with what we are doing in practice as we walked with him from historical discoveries of RA through new drug development. Then Dr. Smolen did the unthinkable: he made us crash!

RheumNow is in Chicago covering the ACR annual meeting. Here are the highlights from Sunday (day one). Be sure to check our complete coverage, including articles, video reports and tweets, at acr18.rheumnow.com.

We are diving head first into flu season and we need to prepare ourselves. Last year we now know that 80,000 Americans died from influenza.

Immune checkpoint inhibitors (ICI) have changed the hematology/oncology world. However, their AEs from a rheumatologic standpoint are still being evaluated and at this time, genetic risk factors for inflammatory arthritis due to ICI are not well understood. Dr. Cappelli et al evaluated a possible connection with HLA typing at their institution.

This week’s NEJM features a case discussion and debate over whether medical marijuana should be used to treat chronic pain. The debate focuses on a 31-year-old woman with long-standing complex regional pain syndrome in her leg and foot.

JAMA has a 2018 update/review of the safety issues seen with mmune checkpoint inhibitors (ICIs) - important new cancer therapies, with 14 cancer indications, that have significantly improved survival in several. ICIs are monoclonal antibodies that block inhibitors of T-cell activation and function.

Some clinical benefits were seen among patients with adult-onset Still's disease treated with tocilizumab (Actemra) in a small clinical trial, but the study's primary endpoint was not met, Japanese researchers reported.

Some patients typically contraindicated for prescription nonsteroidal anti-inflammatory drug (NSAID) use may be able to take them with no increased risk of harm, according to a large observational study.

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

Researchers from Germany have studied a large cohort of juvenile idiopathic arthritis (JIA) patients and shown that JIA disease activity scores and laboratory biomarkers could be used to better define the group of JIA patients at high risk of uveitis onset.

Multiple studies have shown that elderly rheumatoid arthritis (RA) patients tend to be under-treated and receive DMARD therapies less often than younger RA patients.

Only inhibitors of IL-1 (canakinumab) and IL-6 (tocilizumab) are FDA approved for use in children with systemic onset juvenile idiopathic arthritis (sJIA). Now, long-term data from the extension studies from two phase III studies shows that canakinumab yields long-term improvements with reduced glucocorticoid dosing with no new safety findings with long-term use.

Researchers from the British Society for Rheumatology Biologics (BSRBR) set out to define under what circumstances will rheumatoid arthritis (RA) patients manifest biologic disease-modifying antirheumatic drugs (bDMARDs) refractory disease.

Fernandez and colleagues have shed further light on a significant subset of patients with knee pain - specifically, those with neuropathic like knee pain (NKP) that includes those with knee pain modified by central and peripheral neurologic dysfunction.

Dr. Jack Cush reviews the news from the past week on RheumNow.com, including news on inappropriate opioids, pre-clinical RA treatment, DMARDs in Gout, the decline of arthroscopy, and a pain in the mouth.

Venous thromboembolism (VTE) is a common adverse event throughout medicine and includes both pulmonary embolism (PE) and deep vein thrombosis (DVT).   The cost of diagnosing a thromboembolic event is approximately $4000 - $5550, while the annual cost of treating one case of VTE is betwe

Researchers at the University of California - Davis have shown that elderly women who had an upper body fracture or multiple fractures had more loss of hip density compared to those who who did not fracture. Systemic bone loss may increase the risk of future fractures.