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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. 

Why Not Just Kick the TNFi Habit?

Why do we use TNF inhibitors as our first biologic choice?  Is it the evidence of efficacy, access, safety, and drug retention, or is it a prescriber habit that merits critique?  

Do's and Don'ts of Vaccination: a (Very) Brief Guide for Rheumatologists

The five do's and don'ts when it comes to vaccinating your patients. 

Time for a Paradigm Change in Rheumatoid Arthritis

How many clues are needed for a rheumatologist to know something is wrong with the therapeutic soup he/she is trying to concoct?  One patient's tale leads to rethinking the RA treatment paradigm.

The Week in Review: 5 February 2016

Dr. Cush reviews highlights from last week's news and research in rheumatology.

How to Handle Latex Allergies and Biologics

What to do when a patient has a latex allergy and you prescribe an injectable biologic (many having latex allergy as a contraintication)?

2015 Rheumatology Year in Review

Was 2015 a good year for psoriasis, IL-17, biosimilars, narcotics, the ACR and gout? Our year end review discusses the most impactful news and research from the last 12 months.

11 Pearls for Pregnancy Management in Rheumatoid Arthritis (Best of 2015: #6)

Rheumatoid arthritis affects women in their child-bearing years and many will face the issue of pregnancy and RA management at some point. Here are11 considerations for those managing RA patients who wish to become pregnant.

The Born Again Rheumatoid

While there are currently 9 biologic agents approved and marketed for the treatment of RA, and although each has a valued place in our arsenal, I would propose none has been as influential or dramatic as TNF inhibitors. The “born again” rheumatoid feeling is not well captured by any of the usual metrics or measures. It’s not found in the HAQ, DAS28, SF36 (either mental or physical), fatigue score, or any lab parameter. I believe it’s best described by my patient RH who wrote me a letter soon after starting etanercept.

Drug Safety Risk Communication: The 800 lb Gorilla Approach

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.

A Winning Season*

Winning is everything – in football and in medicine. Rheumatologists have achieved many successes but still struggle to win against a handful of rheumatic foes. This retrospective examines past wins and losses and helps us to look ahead to a new season.

Severe RA and Coccidioidomycosis

RA patient complicated by invasive fungal infection with coccidioidomycosis is discussed by Drs. Tesser and Cush