Should You De-escalate DMARDs in RA?

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I'm here to talk about de-escalation of DMARDs in patients who are in remission. Should you do it? Here's what I think.

Respiratory Burden of RA

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Lung complications in RA remain a major issue, termed the “respiratory burden of RA.” Respiratory mortality is one of the leading causes of death for people with RA, particularly those with seropositive RA.

Why aren’t we preventing RA yet?

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Ever since the seminal studies demonstrating a prolonged preclinical period for seropositive RA, which have been replicated in multiple cohorts around the world using both retrospective and prospective study designs, the rheumatology community has been tantalized by the prospect of preventing the onset of inflammatory joint disease in seropositive individuals exhibiting no clinically detectable synovitis. So why can’t we prevent RA yet?

Cardiovascular comorbidity in rheumatoid arthritis

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Friday afternoon page: please call to discuss stress test- moderate ischemia. The page was regarding a patient in a study I was conducting on RA and cardiovascular disease. Determining how to better identify and manage RA patients at elevated CV risk was one of the driving reasons that led my colleagues and I to establish an interdisciplinary clinic between cardiology and rheumatology over a decade ago.

Multimorbidity in RA

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Multimorbidity is a little bit different than comorbidity, which may be a term that you're more familiar with. In comorbidity, we put rheumatoid arthritis as our focus, whereas in multimorbidity, we put the patient at the center of our focus.

A Brief History of Rheumatoid Arthritis Mimics

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Imagine that 100 years from now, your great granddaughter, an eminent rheumatologist, reviews the history of rheumatoid arthritis mimics.

New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?

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Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base. 

B Cell Depletion in RA: The future is bright

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The incredible potential of B cell depletion in rheumatic diseases was heralded by its activity in the treatment of rheumatoid arthritis (RA) over 20 years ago. Rituximab (RTX) was cemented into the armamentarium of RA by its efficacy in TNF-inhibitor inadequate responders (REFLEX).

Comorbidities in Rheumatoid Arthritis: A Precarious Stack of Blocks

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Comorbidities can pile up like a stack of blocks for people with rheumatoid arthritis (RA).  At the time when RA is diagnosed, they already have more comorbidities than their peers, and after RA diagnosis they accumulate comorbidities faster than their peers.

Still's disease: paediatrics to adults, a continuum or not?

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Still’s disease is a rare inflammatory disorder, affecting less than 1 person per 2000 people. This disease may occur in both children and adults, namely as systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD). The paediatric form was described by George Still in 1896, whereas the adult variant later by Eric Bywaters in 1971. However only the adult disease is identified by the name of Still.

The Still’s Continua

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The concept of a “Still’s disease continuum” that encompasses both sJIA and AOSD is based on the many common clinical, genetic and laboratory features shared by both sJIA and AOSD.

Best of 2021: Drug Safety Risk Communication- The 800 lb Gorilla Approach

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Discussions on drug safety can be as treacherous as quicksand for the patient and physician. What the physician knows and what the patient perceives may not be in sync.