Blogs
My Take on New Ocular Screening Guidelines for Plaquenil
A recent article published by the American Academy of Ophthalmology presented new recommendations for screening of patients being managed with hydroxychloroquine that changed the previous monitoring paradigm. More importantly, it has repositioned hydroxychloroquine from one of the safest medications that rheumatologists use to a drug that can have potentially significant ocular morbidity (if used in doses greater than 5 mg per kilogram and or for prolonged periods of time).
TIPS for Arthritis Travelers
Travel can be challenging for arthritis patients. Here are some useful tips to travel smoothly and pain free.
It's the engine that kills ya’, not the caboose
This past weekend I was fortunate to lecture at the Harvard Advances in Rheumatology Course, where I reviewed the safety issues surrounding the use of biologic therapies. In discussing infections, cancer, cardiovascular events, etc., it became very clear to me that these problems, while worrisome, are often escalated in their importance – all at the expense of what is most dangerous: RA itself.
Go Ahead, Jump!
You write the prescription, hand it to the patient and explain why it’s needed, how to take it and what the most common or most dangerous side effects might be. Comprehensive, reasonable, and professional. Certainly the patient should fill the prescription and start the drug.
MONEYBALL
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.
TIPS for Arthritis Travelers
Travel can be challenging for arthritis patients. Here are some useful tips to travel smoothly and pain free.
Improving Drug Safety Communications
pWhat do you call it when you say one thing and the listener hears something else? Potential answers would include hard of hearing, parenting or the physician-patient relationship.
Biologic Prescribing and Patient Education
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?
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.
Smoking and Rheumatoid Arthritis
Why don't rheumatologists send their smoker patients to smoking cessation programs or use aids for cessation? Do we think it is not our problem?
The Role of Hydroxychloroquine Blood Levels in SLE
We review the available literature, with a particular focus on the recent findings in the Hopkins Lupus Cohort, regarding the clinical utility of hydroxychloroquine blood levels in helping to clarify some of the issues regarding retinopathy, how best to dose this medication, and medication adherence.
