Blogs
PMR: glad or bad tidings?
Please don’t tell your patient that PMR “typically” lasts two years. According to real-world data from the UK, one in four patients with PMR is prescribed steroids by their primary care physician for over four years. But nobody tells them this at the start, and that causes big problems later on.
Steroid Tapering in PMR: What's the Gold Standard?
Today I will be talking about the gold standard tapering of glucocorticoids and polymyalgia rheumatica or PMR. Now, whenever we talk about a gold standard, it gets tricky because in practice, so many factors influence the way that we approach glucocorticoids and tapering in PMR.
Screening and Overdiagnosis of ILD in RA
Dr. Michael Putman (Milwaukee, WI) reviews his approach to screening for ILD and RA, the potential for overdiagnosis and how this impacts treatment choices. Does this differ from your approach?
Focus on the Fasting Lipid Profile
How best do we communicate CV risk associated with RA to other members of the treating team, most particularly the primary care physicians? After some experimentation, I have come up with an approach that seems to work and which does not take up much time.
Comorbidities in RA: Focus on Difficult-to-Treat Disease
The presence of comorbidities naturally complicates treatment choice, patient adherence to medication and patient outcomes, increasing also the risk of making RA ‘difficult-to-treat’.
Infections Rheums Should Worry About
With the increasing development and use of new biologics and oral targeted therapies to treat RA and other immune mediated inflammatory diseases, an awareness of infection risk and prevention has become of increasing interest as well. While our patients may be susceptible to many different types of infections depending on immunosuppressive regimen, age and co-morbidities, I’ll highlight a few of the “usual suspects”.
Hard Conversations: DMARDs and Malignancy
Cancer is the most difficult DMARD risk to discuss with patients. Few warnings could scare people away from a drug faster than the words “may increase risk of cancer,” yet the risks (even when substantiated) have all been low and may be counterbalanced by the benefits of disease control.
Assessing Cardiovascular Risks: The Responsibility of the Rheumatologist
In 2016, EULAR posted recommendations for the management of cardiovascular risks in patients with rheumatoid arthritis and other inflammatory joint diseases. Three overarching principles emerged, but one caught my attention: “the rheumatologist is responsible for CV disease risk management.” It leaves no room for interpretation.
Should You De-escalate DMARDs in RA?
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
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.
