Gout
Dr. Jack Cush reviews Gout in this continuing series for Advanced Practice Rheum. Review the companion slide deck here.
Blogs
Safety of Biologics and Novel Agents
Dr. Jack Cush reviews safety of biologics and novel agents.
Difficult to Treat Rheumatoid Arthritis
Dr. Cush addresses the management of difficult-to-treat rheumatoid arthritis (D2TRA).
Hydroxychloroquine for Everyone
Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit.
Best of 2023: New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?
Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base.
Advancing PMR
Even though polymyalgia rheumatica is not perceived by many physicians as a severe diagnosis, its diagnosis and management actually propose significant challenges. I'd like to talk about those challenges, and what directions our path forward can include to advance our understanding and improve the treatment of patients who have PMR.
JAKi for PMR: Safe, or a Concern for Older Adults?
JAK inhibitors obviously have dominated a lot of the discussion in our therapeutic landscape over the last couple of years. What about their use in polymyalgia rheumatica? Let's consider.
Impact of glucocorticoids: more than just toxicity
As the sole effective treatment for polymyalgia rheumatica since their development in the 1950’s until recently, the impact of glucocorticoids and PMR outcomes are undeniably intertwined. So much so that when the OMERACT PMR working group first set out to develop a PMR core outcome set, they quickly realised that many of the outcomes important to patients were related to their glucocorticoid use.
Unpopular opinion: spinach can be bad for you
PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives.
