The International Osteoporosis Foundation has established the Chronic Inflammation and Bone Structure (CIBS) Working Group to address bone loss in rheumatoid arthritis (RA) and the role of biologic therapies. They conclude that early and aggressive treatment with biologic disease-modifying anti-rheumatic drugs will help prevent progressive bone loss in patients with RA.

RA increases CV risk considerably. But whose responsibility is it to manage CV risk in RA patients?

Etanercept (Enbrel) received FDA approval Friday for use in children with moderate to severe, chronic plaque psoriasis.  Previously approved for adults with plaque psoriasis the new indication will be for chronic plaque psoriasis for those over age 4 years.  Etanercept is now the first systemic therapy approved to treat pediatric psoriasis patients (ages 4-17).

Flu season is upon us. While we try our best to vaccinate as many patients as possible, at times it can be challenging for reasons ranging from patient’s perceptions that the vaccine gives them the flu to others stating they are allergic to vaccine components. A patient with rheumatoid arthritis told me she has an egg allergy and cannot take the flu shot; what do I tell her?

Dr. Jack Cush reviews highlights and reports from this week on RheumNow.com, including drug-induced cutaneous lupus, pediatric lupus being worse, new gout drug SEL-12, Gut microbiome and IgA plasmablasts, and the weakly-received new ACP guidelines on gout.

The opioid abuse epidemic is well known and the focus of many regulators and health care personnel.  The problem also affects the youngest Americans, according to a recent Washington Post article. 

The rising incidence of gout has been directly linked to the obesity epidemic.  The influence of obesity on gout was further tested in a cohort study of obese patients undergoing bariatric surgery as part of the Swedish Obese Subjects (SOS) study.

ACP released clinical practice guidelines for the diagnosis and management of gout. Interestingly, these are not always aligned with the 2012 ACR gout guidelines.

Rituximab (RTX) is a monoclonal antibody directed against the CD20 antigen on B cells and when administered causes a marked depletion of CD20+ B cells.  Yet the exact mechanism by which B cell directed therapy results in long lasting clinical improvement in rheumatoid arthritis is unknown.

A possible mechanism behind the fibrosis that occurs in scleroderma has now been identified, a mechanism, researchers say, that may one day lead to a treatment for the disease.

Serum antibodies precede the development of clinical rheumatoid arthritis (RAby) by many years, and yet we still have much to learn about this preclinical phase. Of particular interest has been the observation that IgA anti-CCP antibodies are commonly encountered in patients with RA raising questions regarding the relationship of mucosal-associated immunity and breach of tolerance to this critical neoantigen.

The Wall Street Journal has reported an alarming trend in generic drug pricing that affects many, especially the elderly and those with arthrtis.

The MMWR has reported that Crohn’s disease and ulcerative colitis, collectively known as inflammatory bowel disease (IBD), previously (1999) had an estimated 1.8 million (0.9%) prevalence. But as of 2015, an estimated 3.1 million (1.3%) of U.S. adults have been diagnosis with IBD according to the NHIS - a large, nationally representative data source.