Still's disease: paediatrics to adults, a continuum or not?

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Still’s disease is a rare inflammatory disorder, affecting less than 1 person per 2000 people. This disease may occur in both children and adults, namely as systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD). The paediatric form was described by George Still in 1896, whereas the adult variant later by Eric Bywaters in 1971. However only the adult disease is identified by the name of Still.

The Still’s Continua

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The concept of a “Still’s disease continuum” that encompasses both sJIA and AOSD is based on the many common clinical, genetic and laboratory features shared by both sJIA and AOSD.

Best of 2021: Drug Safety Risk Communication- The 800 lb Gorilla Approach

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Discussions on drug safety can be as treacherous as quicksand for the patient and physician. What the physician knows and what the patient perceives may not be in sync.

ICYMI: Drug Safety Risk Communication- The 800 lb Gorilla Approach

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Discussions on drug safety can be as treacherous as quicksand for the patient and physician. What the physician knows and what the patient perceives may not be in sync.

Three Healthcare Hashtags You Should Follow 

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I've sent more than 2,000 tweets since joining Twitter in July 2010. Even better, I've read (and sometimes shared) thousands of other educational, informative and sometimes humorous tweets from fellow rheumatologists, physicians, healthcare providers and others around the world. While following individuals and organizations relevant to you is important, so is following hashtags. Here are three I recommend.

Pearls Part 2: Common Sense Rheumatology 

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We live in an era where you need evidence in order to believe, but life’s experiences should not be discounted even if we do not have the statistics to support them…yet. In Part 2 of my annual meeting Pearls Trilogy, I present ten tips and observations shared by Dr. Sterling West from his session, "Rheumatology Top Secrets & Pearls".

A Review of the Review Course + How to Make the Information Stick

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I have been attending the ACR Review Course for more than a decade, and it seems every year it gets better and better. Contrary to what most people think, this is not a board review course; it is more of a review of the latest research delivered by experts condensing rheumatology in eight hours.

Best of 2018: 5 Mistakes When Diagnosing Adult-Onset Still’s Disease

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Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.

Advice for Young Rheumatologists

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You may not want my advice, but I’m going to give it to you anyway. 

Prescription Drugs and the Effect on Access to Biosimilars in the US

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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

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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

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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!