Best of 2021: Rheumatologists Rank 2nd in Physician Burnout

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The 2021 Medscape Survey on Physician burnout ranks rheumatology second, just behind Critical Care medicine.

The survey included over 12,000 physcians from 20 specialties. While 42% of MDs claimed to be burnt-out, Rheumatologists claimed this 50% of the time. The top 3 this year were Critical care (51%), Rheumatology (50%) and infectious disease (49%).

Best of 2021: Actemra FDA Approved for Systemic Sclerosis Interstitial Lung Disease

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Genentech announced March 4th that the US Food and Drug Administration approved tocilizumab (Actemra) for the treatment of Systemic Sclerosis-associated Interstitial Lung Disease (SSc-ILD), specifically indicated for slowing the rate of decline in pulmonary function in adults S

Best of 2021: EULAR Guidelines on Intraarticular Therapy

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EULAR has published evidence-based recommendations on the use of intra-articular therapies (IAT) based on the literature review and recommendations of a multidisciplinary international task force. These IAT recommendations apply to adult patients with peripheral arthropathies.

Indications Awaiting (12.17.21)

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There's good news and bad news in rheumatology fellowship matching for 2022.  There's also new FDA approvals and indications, but a new serious safety warning has arisen from the CDC about the J&J COVID-19 vaccine. 

Dr. Jack Cush reviews the latest news, journal reports, regulatory approvals, plus 3 new cases from rheumatologists.

Certain Cancers Increased with Autoimmune Diseases

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Rheumatologists are well aware that inflammation and immune dysregulation are prime contributors to cancer risk, but do oncologists carry the same impressions? A large study from JAMA Oncology shows that patients with immune-mediated diseases (IMD) have an overall increased risk of cancer, especially in organ-specific immune-mediated diseases. 

Rinvoq FDA Approved for Active Psoriatic Arthritis

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The FDA has approved upadacitinib (Rinvoq) today for use in the treatment of adults with active psoriatic arthritis (PsA) who have had an inadequate response or intolerance to one or more tumor necrosis factor (TNF) blockers.

Adherence to Medication - Predictive Factors in RA

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The numbers on treatment adherence is disappointingly low in RA, with a number of psychological, communication and logistical factors that outweigh the potentially negative influence of sociodemographic or clinical factors.

When to Stop Biologics in Systemic JIA?

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Systemic onset juvenile idiopathic arthritis (sJIA) is a dramatic onset inflammatory condition marked by spiking fevers, intermittent rash, polyarthritis and a host of other hyperinflammatory manifestations.

T2T Debate - A Prologue with Dr. Marty Bergman

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Drs. Jack Cush and Martin Bergman review the topic of treat-to-target (T2T) management in rheumatology.

Both will debate the pro's and con's of the T2T strategy at the upcoming RWCS meeting on Feb. 17, 2022.

Pain is the Focus of the 2021 Nobel Prize in Medicine

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The 2021 Nobel Prize in Medicine and Physiology was jointly awarded to Drs.

Telehealth Diet and Exercise Benefits Knee Osteoarthritis

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Annals of Internal Medicine has reported the results of a randomized clinical trial showing that telehealth-delivered exercise and diet programs improved pain and function in knee osteoarthritis patients who were overweight.  While both were beneficial, exercise had a greater effect than die

FDA Puts Boxed Warnings on JAK Inhibitors

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Based on the safety review of tofacitinib in Pfizer's Oral Surveillance (1133) study, the FDA has added serious boxed warnings to all three marketed JAK inhibitors (for inflammatory diseases) and formalized the recommendation that patients should be started on a TNF inhibitor (TNFi) before trying a JAK inhibitor. These recommendations apply to tofacitinib, baricitinib and upadacitinib.

Rheumatoid Arthritis, Dementia and Cognitive Dysfunction

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Rheumatoid arthritis (RA) has been linked to a higher risk of dementia and cognitive dysfunction, but interestingly this association has diminished in the last few decades with aggressive DMARD and targeted therapies..

Methotrexate and hepatic fibrosis: we must be doing something right

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Methotrexate may be a rheumatologist’s best friend, but a key part of counselling any patient about its use has always been the risk of hepatotoxicity.