Here's what you may have missed: in November 2015, RheumNow published 80 tweets on news, research and teaching points that impact the rheumatology community. We had a reach (impressions) of 79,100, 79 mentions, and over 3399 visits to RheumNow.com to check out what we publish. The average daily “tweet” from RheumNow is seen by 4000-10,000 viewers.

Previously, granulomatous polyangitis (GPA or Wegener's) was known to have an increase risk of cancer, especially bladder cancer, presumeably due to cyclophosphamide (CTX) exposure. With the change in nomenclature comes uncertainty about the risk of cancer in those with ANCA-associated vasculitis (AAV).

Despite the potential contributory role of TNF in the pathogenesis of multiple sclerosis, several trials have shown that TNF inhibitor (TNFi) use may lead to worsening of MS, optic neuritis and other demyelinating disorders. This particular safety warning has been in the product label for nearly 15 years, yet little is known about why this happens, how often or what the scope of potentially inducible neurologic disease may be.

Joint erosions in RA result from a complex process with multiple contributing mechanisms. One of those mechanisms involves RANK receptor activation by RANKL leading to osteoclast differentiation, activation and survival.

Desai and coworkers analyzed public and private insurance claims data (2001-2012) to assess patterns of drug use in pregnant woment with RA, SLE, PsA and AS. Specifically, they looked at immunosuppressive drug use in the 3 months preceding and during pregnancy.

The management of psoriatic disease, including psoriatic arthritis (PsA) has evolved significantly in the last decade.  Nevertheless, there are still some uncertainties - such as what the role of methotrexate should be, and when to use newer and novel therapies.

The Down-Side of Electronic Medical Records. EMRs (or EHRs) have become increasingly utilized in daily practice. The benefits of these include better record-keeping, safe prescribing, patient and drug tracking, adverse event monitoring and checks for drug interaction. Unfortunately, these safety (and efficacy) benefits may go unnoticed by the patient.

Microvesicles are emerging as a new mechanism of intercellular communication by transferring cellular lipid and protein components to target cells, yet their function in disease is only now being explored. Microvesicles are 0.5-1 mm fluid-filled particles released by neutrophils and are thought to transfer lipids and proteins to other cell types. Nevertheless, their role in health and disease remains unclear.

Azathioprine (AZA) is widely used in the treatment of several autoimmune diseases. Its use and optimal dosing may be limited by adverse drug reactions (ADRs). Thiopurine S-methyltransferase (TPMT) is an important enzyme involved in AZA metabolism.

A famous quote from Verna Wright, MD, states, “Clinicians may all too easily spend years writing“doing well” in the notes of a patient who has become progressively crippled before their eyes".

Patients with rheumatoid arthritis (RA) were less likely to discontinue their first biologic when that treatment was a tumor necrosis factor (TNF) inhibitor than if it was a non-TNF biologic, and especially if treatment was initiated prior to 2005.

Burnout among U.S. doctors affects more than half of practicing physicians, according to a new study published in Mayo Clinic Proceedings. (Citation source http://buff.ly/1RpV8Q0) In 2011, 46% of U.S. doctors experienced at least one symptom of burnout. In 2014, this number has grown to 54%. Compared to the average U.S. worker, physicians are twice as likely to suffer from burnout.

Rituximab (RTX) is highly effective at B cell depletion and this may be one of several hypothetical ways in which the drug works.  B cell numbers (measured as CD19+ B cells) plummet rapidly after the first infusion and stay down for 6-12 months.

Weight loss is one of several nonpharmaceutical interventions to reduce serum urate (SUA) levels and control gout. French researchers examined the role of xanthine oxidase (XO), low-grade inflammation, and weight loss on SUA levels in obese patients.

The 2015 ACR meeting in San Francisco highlighted several studies wherein dietary patterns predicted a reduced risk of both rheumatoid arthritis (RA) and gout.