The RheumNow Week in Review - 26 May 2017

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

Educational Intervention Facilitates Treat-to-Target Management in Rheumatoid Arthritis

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Treat-to-target education through group-based quality improvement sessions can result in wider use of treat-to-target in practice, according to researchers.

Above-Label Dosing and Noncompliance with Biologics in Psoriatic Arthritis

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Claims data analysis of 4245 psoriatic arthritis patients on TNF inhibitors showed both higher than expected durations of noncompliance and higher than label dosing - all at an increased cost.

Smoking and Worse Outcomes in Spondylitis

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BIRMINGHAM, England -- Smoking was a strong predictor of more severe disease in patients with axial spondyloarthritis (AxSpA), with people who had ever smoked having worse disease activity and worse quality of life than those who had never smoked, researchers reported here.

Lipstick Rheumatology

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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?

Best to Rehab at Home Following Joint Replacement

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A New York Times article sheds light on recent evidence suggesting that those undergoing hip or knee replacement will do just as well with home therapy compared to inpatient rehabilitation following surgery.

Paradoxical Toxicities with TNF Inhibitors

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Something is curiously wrong when a drug induces the disease it is intended to treat. Yet this phenomenon has been described with all five FDA-approved TNF inhibitors.

Mortality in Gout Increased

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Two current articles in the Journal of Rheumatology address issues surrounding mortality risk among those with new and established gout.

ACR Says the New AHCA is Insufficient for Arthritis Patients

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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).

Is a Crisis in Physician Manpower Looming?

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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?

Interns Can Now Work 24 Hour Shifts

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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.  

The UnderManagement of Gout

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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.

Methotrexate and Folate Use by Rheumatologists - Survey Results

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The February 2017 RheumNow “Live Vote” surveyed US and non-US rheumatologists about their beliefs and practices regarding folic acid and methotrexate (MTX) use. A total of 495 responses were tabulated in 2 weeks. Here are the results, and comments from Dr. Kremer on his preferred answers to these questions.

Psychologic Impact of Rheumatoid Arthritis on Men

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Arthritis Care & Research has reported the results of a study that analyzed the perceptions and attitudes of men afflicted with rheumatoid arthritis (RA).  The results are drawn from a series of focus groups involving 22 men with RA.

EULAR Recommendations on Reproductive Issues in Lupus and Anti-Phospholipid Syndrome

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There is a significant unmet need with regard to counseling and managing SLE and APS patients who become pregnant or who may be planning for pregnancy.

Biosimilar Reports – February 2017

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Biosimilar reports is an ongoing series dedicated to advances, discussions and developments in biosimilar agents intended for use by rheumatologists. Many of these items were compiled from news sources, journal articles and regulatory documents and are cited and linked within each section.

The RheumNow Week in Review – 17 February 2017

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Dr. Jack Cush reviews this week's news and information from the 2017 RWCS meeting in Maui.

Top Ten Things Rheumatologists Should Know When Ordering Imaging

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As a musculoskeletal radiologist, I work every day with rheumatologists. I have been in practice for approximately 17 years and had a musculoskeletal radiology fellowship prior to establishing my practice.

Chronic Pain Associated with Poverty and Less Education

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Poorer and less-educated older Americans are more likely to suffer from chronic pain than those with greater wealth and more education, but the disparity between the two groups is much greater than previously thought, according to new research.

Curbside Consults - January 2017

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Curbside Consults are cases submitted by our rheumatology colleagues as challenging therapeutic or safety issues. Answers are based on experience, with added evidence from the medical literature and published guidelines.