The Delayed Diagnosis of Spondyloarthritis

Save

You see them from the corner of your eye, standing with a kyphosis in the waiting room. They are filling out their paperwork, standing up because sitting is just not pleasant. You are the rheumatologist with an  interest in ankylosing spondylitis (AS) and spondyloarthritis, so more likely than not, the patient with the bent spine is going to be your next new patient. In the back of your mind you are hoping that they are not so far along so that the therapy you may prescribe can make a difference in their life.

ACR 2017 Highlights: RA, SpA, PsA, OA, Lupus and More

Save

The quality of the meeting was on par with the host city, with extensive data presented on a range of topics, from social media to drug safety. The organization committee did a great job and I got the feeling that most people felt the congress was user friendly given the magnitude of the event. During this year’s meeting, I had the privilege of working with the RheumNow team, which gave me the opportunity to hone my social media skills and get my Twitter game on. After reviewing plenty of posters and going to numerous presentations, here are my top take home messages as classified by disease state.

If You See Something, Say Something

Save

MONEYBALL

Save

The movie Moneyball is a David versus Goliath tale with the A’s (David) struggling to compete with Goliath teams like the Yankees. The movie pits hunch-driven “expertise” (convention) against a mathematic approach to decision making (Moneyball). Would you trust a big Whopper computer printout of next best drug(s) to give to Mrs. Hawking who has psoriatic arthritis and needs to start a DMARD? I believe most of you would huff and scoff at a formulaic or number-driven approach.

The Brooklyn HAQ

Save

The Health Assessment Questionnaire is a utilitarian outcome measure, often used in clinical trials and daily practice. Unless you’re still prescribing penacillamine, never attended an ACR meeting, and never read an RA clinical trial, you’re quite familiar with the HAQ and its use in practice. So, surely you’ve heard of the “Brooklyn HAQ”?

Guiding Patients Considering Biologics

Save

What are the questions patients should ask their doctors about biologics? Are there rules for starting and stopping biologics?

Biologic Prescribing and Patient Education

Save

Biologics are big. Their popularity is reflected in their growing use since being introduced in 1998. Biologics have been used by more than 3 million patients worldwide. In 2013, Enbrel, Remicade and Humira accounted for nearly $30 billion in worldwide sales. In the USA, it is estimated that we will spend $220 billion on biologics by 2017. 

KOLs Predict: What Will the Next Year Bring?

Save

A new subspecialty may emerge. New drugs will be approved (but it will be difficult for patients to get coverage for them). And an American team will win the World Series. All these and more: here are predictions for 2017 and beyond from rheumatologists across the country and around the world.

Do's and Don'ts of Vaccination: a (Very) Brief Guide for Rheumatologists

Save

The five do's and don'ts when it comes to vaccinating your patients. 

Methotrexate: Where it All Began

Save

It’s somewhat bizarre that a designer drug from over 65 years ago would become the cornerstone of treatment for rheumatoid arthritis in the 21st century. When Sidney Farber designed a molecule that would interfere with folate metabolism in the middle of the 20th century, he was looking for a ubiquitous antimetabolite to treat cancer. Farber was actually quite concerned with the potential side effects of a drug that competitively inhibits folate metabolism. That is part of the reason he combined the “met” for metabolism with an “x”. The x was found on poison bottles and he thought it wise to include it in the name of this agent.

The Week in Review: 5 February 2016

Save

Dr. Cush reviews highlights from last week's news and research in rheumatology.

How to Handle Latex Allergies and Biologics

Save

What to do when a patient has a latex allergy and you prescribe an injectable biologic (many having latex allergy as a contraintication)?