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Managing Comorbidity and Poor Drug Responses
Comorbidity is pervasive and complicates medical care in general. It can be a by-product of aging. It may result from drug therapy or an inciting disease process and may be part of the constellation that defines the primary disorder. A growing body of evidence that suggests that comorbidity has a significant dampening effect on drug responsiveness and, adds to poorer outcomes in patients with inflammatory arthritis.
Read ArticleDr. Roland Moskowitz (1929 - 2018)
Dr. Roland Moskowitz was a giant in the rheumatology world for decades, and one of a handful of researchers who doggedly rose to one of rheumatology's greatest challenge: osteoarthritis. He has passed away at the age 88 years.
Read ArticleSelective Use of HLA-B*5801 Testing in Gout
The current edition of JAMA Internal Medicine describes an Asian gout patient who presents with an allopurinol hypersensitivity reaction that could have been diagnosed by testing for HLA-B*5801.
Read ArticleUnsafe Practices with Ambien Use
Ambien (zolpidem) is the most widely used prescription hypnotic sedative since its introduction in 1992 and is currently the fourth most frequently prescribed psychiatric drug (2013). Recent US Food and Drug Administration Drug Safety Communications suggest limitations on use to reduce adverse effects. A study of the Medical Expenditures Survey in 2015 revealed that over 3.8 million adults reported using one or more prescriptions for zolpidem.
Read ArticleBest of 2017: Are ANA Tests Unreliable?
Pisetsky and colleagues have reported in the Annals of Rheumatic Disease that ANA tests done on established SLE patients may yield surprisingly disparate results.
While ANA negative lupus was a problem of old assays and the loss of ANA positivity may be seen with chronicity or age, most rheumatologists believe that ANA positivity is an absolute requirement for the diagnosis of systemic lupus erythematosus.
Read ArticleEULAR 2018 - Day 2 Report
Highlights from Day 2 of the EULAR meeting in Amsterdam include high MBDA scores in ACPA negative RA predicts remission; characterization of difficult RA; and gender differences in psoriatic responses to TNF inhibitors.
Read ArticleAdvance Practice Clinicians Proliferating in Specialty Practices
An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices. By 2016, 28% of all specialty practices employed APCs.
Read ArticleACP Policy Calls for Increased Efforts in Women's Health Issues
The American College of Physicians have published a position paper in Annals of Internal Medicine calling for an examination of the challenges facing women in the U.S.
Read ArticleThe RheumNow Week in Review - Nonadherence and Astronomic Costs (5.11.18)
Dr. Jack Cush reviews highlights, news and journal articles from the past week on RheumNow.com.
Read ArticlePatients May Not Fill Your Prescription
A new study linking administrative claims and electronic health records (EHRs) shows that nearly 40% of patients fill and take newly prescribed methotrexate (MTX), tofacitinib or biologics.
Kan et al set out to estimate the extent and predictors of primary nonadherence in rheumatoid arthritis (RA) patients who received new prescriptions for methotrexate, biologics or tofacitinib.
Read ArticleRising Need for Weight Loss Counseling in Arthritic Patients
The CDC's May 4th MMWR reports that from 2002 to 2014, the prevalence of health care provider counseling for weight loss among adults with arthritis and overweight or obesity increased by 10% (from 35% to 45%).
Among the 54.4 million adults with doctor-diagnosed arthritis in the United States, 32.7% are overweight and 38.1% are obese. Moreover obesity is more prevalent among persons with arthritis than among those who do not have arthritis.
Read ArticleTobacco Associated Deaths in the USA
JAMA Internal Medicine reports that in the USA, those who smoke cigar, pipe, or cigarette have a significant overall mortality risk, and a much highers cancer mortality risk compared to nonsmokers.
Read ArticleACR Projects Significant Manpower Shortages for 2030
Arthritis & Rheumatology has published the results of the 2015 Workforce Study of Rheumatology Specialists, and estimates a current shortage (demand > supply) of 700 (12.9%) full-time rheumatologists and that this deficit will worsen (102%) to 4133 FTE by 2030.
Read ArticleMedicare Drug Prices Jump Ten Times the Inflation Rate
CNN reports that a new congressional analysis of Medicare drug pricing shows the prices of the 20 most commonly prescribed brand-name drugs have risen nearly 10 times the annual rate of inflation in the past five years.
Read ArticleAre ANA Tests Unreliable?
Pisetsky and colleagues have reported in the Annals of Rheumatic Disease that ANA tests done on established SLE patients may yield surprisingly disparate results.
While ANA negative lupus was a problem of old assays and the loss of ANA positivity may be seen with chronicity or age, most rheumatologists believe that ANA positivity is an absolute requirement for the diagnosis of systemic lupus erythematosus.
Read ArticleT2T Improves Primary Care Gout Management
Researchers from Geisinger Medical center tested a pilot primary care gout management improvement intervention, and demonstrated significantly improved primary care gout management metrics when a treat to target approach was implemented.
Read ArticleRWCS Day 4 Podcast
Listen in on the proceedings from the 2018 RWCS meeting in Maui, with excerpts from leading teachers in rheumatology. This podcast features presentations from Drs.
Read ArticleFuture Shortage of Rheumatologists in the USA
In Arthritis & Rheumatology, the American College of Rheumatology updates their projections for the rheumatology workforce between 2015 and 2030, noting that despite an aging population and an increase in the rheumatology fellowship positions, there will be a significant shortage of rheumatologists by 2030.
Read ArticleACR Urges Reforms by HHS
Dr. David Daikh, president of the American College of Rheumatology (ACR) has written a letter to the Department of Health and Human Services (HHS) in response to their Request for Information on Promoting Health Care Choice and Competition Across the United States.
Read ArticleProblems with Biologic Drug Storage
Is your patient’s refrigerator the problem with the inefficacy of biologic therapies? Studies show most patients don't store their biologics correctly, which may be a source of limited drug efficacy.
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