Advice for Young Rheumatologists
You may not want my advice, but I’m going to give it to you anyway.
Blogs
Prescription Drugs and the Effect on Access to Biosimilars in the US
The word “access” is thrown around a lot these days, particularly regarding health care and specifically, prescription medications. Access to medications essentially revolves around two things: availability and affordability. Immediately, pharmaceutical manufacturers come to mind, as they are responsible for production and setting the list price. However, ultimate availability and affordability of medications is shared with another entity. The final arbiter of access is the Pharmacy Benefit Manager. Their power resides in the fact that they control the formulary and determine the “preferred drugs” list. How does this relate to the uptake of biosimilars?Best of 2017: Rules for Drug Cessation with Infection
Everyone gets their education about drug-related infection risk from television ads. Rheumatologists should know what the real risks are and educate their patients that they have a higher than normal rate of nonserious infections. But the infection risk is way more related to inflammation than any specific drug risk.
Throw Me Rope
A gal with rheumatoid arthritis moved to my town and has transferred her care to me. Despite having RA for 3 years and swollen joints at the last three visits, she has taken surprisingly few effective drugs thus far.
On this visit I declared my concerns for her future health, especially if we didn’t make significant changes in therapy. So I recommended she start a new drug. She asked several good questions, then stated she wanted to go home and think about this further and she would get back to me with her decision.
But wait, that’s what she said at her last visit 2 months ago!
The Story Teller (Best of 2017)
Angie is my last patient before lunch. I've known her since her RA diagnosis at age 17 years. And for the last 7 years, she’s matured into a fabulous young woman who has adeptly grown her professional life, her dating life and developed her independence, despite her severely active rheumatoid arthritis. But today I see she has a troubled and anxious look as I greet her.
Rules for Drug Cessation with Infection (Best of 2017)
Almost everyone gets their education about drug-related infection risk from television ads. Rheumatologists should know what the real risks are and educate their patients that they have a higher than normal rate of nonserious infections. But the infection risk is way more related to inflammation than any specific drug risk.
Creaky Joints Nails New Patient Pregnancy and Family Planning Guidelines
Patients and physicians are riddled with misconceptions when pregnancy is concerned. As construed by Dr. Jack Cush, most rheumatologists treat pregnancy like a cancer and avoid the gravid patient, deferring to obstetricians who do not have training in rheumatology to manage the rheumatic condition as well as the pregnancy.
ACR 2017 Highlights: RA, SpA, PsA, OA, Lupus and More
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.
Rules for Drug Cessation with Infection
Everyone gets their education about drug-related infection risk from television ads. Rheumatologists should know what the real risks are and educate their patients that they have a higher than normal rate of nonserious infections. But the infection risk is way more related to inflammation than any specific drug risk.
Q Fever - The Intersection of Rheum and ID
Today in clinic, I saw a patient with longstanding seropositive, erosive rheumatoid arthritis who had been treated with etanercept for over 10 years. She had undergone valve replacement years ago for regurgitation.
“The Big Sick” Movie Review
It's Monday morning and my first patient is a newly diagnosed rheumatoid. This is his first visit back after starting methotrexate 6 weeks ago. Despite doing great and in remission with only one active joint, he asks, “Are sure this is RA? Or could this be Still’s disease?” Admittedly, this is a weird second-visit question, but I was impressed.
Forced, Rational or Glitch-Ridden Prescribing Practices
A recent analysis of 3 groups of treatment-naïve, early rheumatoid arthritis (ERA) patients looked at the factors that influenced the choice of therapy.