War on RA – Part 4: Desperado – Time to Open the Gate

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Do you know what the best-selling album of all time is? Could it be Bing Crosby? U2? Fleetwood Mac? AC/DC? I know, it’s Michael Jackson’s “Thriller” right?

Actually it’s the Eagles Greatest Hits – it surpassed Jackson’s Thriller in August 2019 as the best-selling with a total of 36 million copies sold since it was released in 1976. Wait! Are we not Rheumatologists? Aren’t we supposed to be discussing rheumatoid arthritis?

New EULAR/ACR Classification Criteria for SLE

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The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) have jointly developed new classification criteria for systemic lupus erythematosus (SLE); prompted by the need for criteria that were both highly sensitive and specific. The net result is improved sensitivity and specificity, but the use of positive ANA requirement along with a longer list of weighted criteria ensures its utility in SLE research (including early or latent SLE), but not clinical practice.

War on RA - Part 3: Useless Drugs

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We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.

War on RA - Part 2: It's All About You

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Part II of this series is a direct message to rheumatologists. If we’re doing such a great job in RA, then why do we need a war on RA? Why is this conflict being laid at the feet of good soldier rheumatologists, those who toil daily at winning therapeutic battles one patient at a time? The reasons are blunt and true.

War on RA - Part 1: Walk on the Moon

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It’s a great time to be a rheumatologist and to manage RA. But, if you keep doing what you’re doing, you’re going to keep getting what you’ve got.

Recommendations for Exercise in Ankylosing Spondylitis

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Australian researchers have assessed the problem of exercise in ankylosing spondylitis (AS). After posing 10 questions to 11 experts they have provided evidence and consensus-based ecommendations on exercise in AS.

The Cost of Physician Burnout

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An article in the Annals of Internal Medicine has analyzed the cost-consequences of physician burnout, including costs related to physician turnover and reduced clinical hours.

Sleep Myths Debunked

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A panel of 10 sleep experts studied 20 common sleep myths and found little or no evidence in support of these beliefs.

Sleep issues are highly prevalent among US adults, but few admit to it or do anything to manage it. 

Polypharmacy Blunts Responses and Ups the Safety Risks

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A study from the British Society for Rheumatology Biologics Register (BSRBR-RA) demonstrates that polypharmacy is a predictor of lower treatment responses and more serious adverse events (SAEs) in rheumatoid arthritis (RA) patients.

Dr. Harold E. Paulus (1929-2019)

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Dr. Harold “Hal” Paulus lives in the annals of Rheumatology as a major contributor, mentor, researcher and clinical trialist. He passed away last week, one day after his 89th birthday. I met Dr. Paulus as a fellow in 1985, when he easily included me in his discussions and research on rheumatoid arthritis. I admired his easy demeanor, wry humor and every man character. Most remark on his calm recessive and kind personality that was complemented by a body of work that was large, impactful and usually at the cutting edge.

Many of Dr. Paulus’ colleagues and friends have contributed their testimonies and fond memories of this great man.

Dietary Supplements Fail to Reduce Mortality Risks

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An NIH funded prospective study has shown that the use of daily dietary supplements was not associated with a subsequent lowering of mortality risk.

An Autoimmune Diagnosis Alters Perceptions of Pregnancy and Lactation

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A study from UT Southwestern and the Baylor Research Institute examined the preceptions and practices of women with autoimmune or inflammatory rheumatic diseases (AIRD) noting that an AIRD diagnosis changed most womens future hopes and plans regarding pregnancy and lactation.

ACR Position Statements on Drug Pricing and Step Therapy

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The American College of Rheumatology Committee on Rheumatologic Care has released new drug pricing and step therapy position statements that they hope legislators will consider as they continue to explore policy and regulatory options to make drugs more affordable and accessible.  

2018 Swedish Guidelines for Giant Cell Arteritis Treatment

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The Swedish Society of Rheumatology has developed evidence-based guidelines for the management of giant cell arteritis (GCA) with a focus on the appropriate use of corticosteroids and tocilizumab. 

Multiple Delays in Referral of New RA Patients

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A UK study of early onset arthritis or new rheumatoid arthritis patients shows multiple sources of delayed referral to the first rheumatology consultation.

Medical Meetings: Should I Stay or Should I Go?

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Say a conference in your field was just announced. You think you "should" go, and you know you'll be choosing from many presentation opportunities that feature the latest research — which you want to know about. And you'll get to hang with like minds and talk about things that matter.

Multidisciplinary Recommendations for Rheumatoid Foot Problems

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Approximately 90% of patients with rheumatoid arthritis (RA) have foot problems.

2019: the Year of Price Hikes

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In 2019 there have been numerous reports of higher drug pricing for many drugs.  Yesterday it was reported that the price of insulin drugs have more than doubled from 2012 to 2016.

Smoking Doesn't Influence Rituximab Responses in Rheumatoid Arthritis

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Alcohol, smoking and obesity have all been shown to influence the risk and activity of rheumatoid arthritis (RA) and may also influence response to therapy. This study assesssed whether smoking would influence response to rituximab (RTX) in RA.