Rheumatoid arthritis (RA) has been linked to a higher risk of dementia and cognitive dysfunction, but interestingly this association has diminished in the last few decades with aggressive DMARD and targeted therapies.. This makes sense when you see that dementia in RA is associated with age, prior cardiovascular and cerebrovascular events and the severity of joint involvement.

Methotrexate may be a rheumatologist’s best friend, but a key part of counselling any patient about its use has always been the risk of hepatotoxicity. Despite methotrexate’s near-ubiquitous use in rheumatology, and the consequent frequency of patient counselling about it, relatively little is known about what precautions are absolutely required, a situation which might otherwise provoke anxiety for patients.

Uveitis is the most frequent extra-musculoskeletal manifestation (EAM) in Axial Spondyloarthritis (axSpA). The prevalence of uveitis in axSpA is between 25-30%. Up to 50% of patients with an acute episode of uveitis develop recurrent anterior uveitis or iritis. Being such a prevalent EAM in axSpA, we should focus on this condition. There have been some updates on uveitis in SpA at #ACR21 which I will share here.

Pulmonary complications in the setting of Still's disease (juvenile and adult) has seldom but consistently been reported, including reports of pneumonitis, pulmonary hypertension and a severe or fatal lung disease, often associated with hypersensitivity to anticytokine therapy. A multicenter study reports that drug hypersensitivity and pulmonary reactions in Still's patients receiving IL-1 or IL-6 inhibitors is strongly associated with HLA-