Advice for Young Rheumatologists
You may not want my advice, but I’m going to give it to you anyway.
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You may not want my advice, but I’m going to give it to you anyway.
The antiphospholipid syndrome (APS) is a common disorder affecting patients with and without autoimmune disease. Despite wider recognition of APS among physicians as well as the expanding research collaborations, many clinical questions are still encountered in clinical practice, which require further evidence-based studies. In this “Across the Table” edition, Drs. Cush and Erkan discuss some of these APS-related questions. Our guest expert, Dr. Doruk Erkan offers up his approach to diagnosis and management of APS.
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.
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!
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.
The antiphospholipid syndrome (APS) is a common disorder affecting patients with and without autoimmune disease. Despite wider recognition of APS among physicians as well as the expanding research collaborations, many clinical questions are still encountered in clinical practice, which require further evidence-based studies. In this “Across the Table” edition, Drs. Cush and Erkan discuss some of these APS-related questions. Our guest expert, Dr. Doruk Erkan offers up his approach to diagnosis and management of APS.
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.
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.
The antiphospholipid syndrome (APS) is a common disorder affecting patients with and without autoimmune disease. Despite wider recognition of APS among physicians as well as the expanding research collaborations, many clinical questions are still encountered in clinical practice, which require further evidence-based studies. In this “Across the Table” edition, Drs. Cush and Erkan discuss some of these APS-related questions. Our guest expert, Dr. Doruk Erkan offers up his approach to diagnosis and management of APS.
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.
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.
In the years to come, the availability of numerous new IL-6 inhibitors it will either complicate treatment decisions, alter existing treatment paradigms, or result in an all-out war against TNF inhibitor dominance. Data, differences and time will tell.
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