I am usually thrilled to offer Plaquenil as one of the safer  therapy options to my patients with lupus and other autoimmune conditions. Unfortunately, on many occasions, once we go into detailed discussion of the potential side effects with the patient,  the issue of hydroxychloroquine eye toxicity casts a cloud over  overall optimistic view of Plaquenil.

Immune checkpoint inhibitors (ICI) have changed the hematology/oncology world. However, their AEs from a rheumatologic standpoint are still being evaluated and at this time, genetic risk factors for inflammatory arthritis due to ICI are not well understood. Dr. Cappelli et al evaluated a possible connection with HLA typing at their institution.

La Paulee is traditionally the party/feast after harvest and a time when hard work is rewarded with food, fun, and wine. And so it was that evening; after better understanding genes, cytokines, and pathology it was time to have a good time with friends, old and new.

In the last few years, new studies have been published examining if early intervention and tight control (TC) of psoriatic arthritis (PsA) disease activity will have the same beneficial outcomes as it does for rheumatoid arthritis (RA).  

UK researchers have shown that nurse-led gout management, using a treat-to-target urate-lowering strategy, is efficacious and cost-effective compared with usual physicain care. The results are published in the recent Lancet edition. Worldwide, gout management is suboptimal. In the UK only 40% of gout patients receive urate-lowering therapy, and fewer ever achieve a target serum urate (< 6mg/d) concentration.

Dr. Jack Cush summarizes the news and reports from RheumNow.Com this past week and previews RheumNow activities at the upcoming ACR 2018 meeting in Chicago.

Researchers from New Zealand find that in contrast with genetic contributions, diet explains very little variation in serum urate levels in the general population.

This week’s NEJM features a case discussion and debate over whether medical marijuana should be used to treat chronic pain. The debate focuses on a 31-year-old woman with long-standing complex regional pain syndrome in her leg and foot. CRPS followed a sports related hairline fracture in the right fibula. Her pain has been intractable since.

JAMA has a 2018 update/review of the safety issues seen with mmune checkpoint inhibitors (ICIs) - important new cancer therapies, with 14 cancer indications, that have significantly improved survival in several. ICIs are monoclonal antibodies that block inhibitors of T-cell activation and function.

My typically pleasant 76 year old male was livid when I walked into the exam room. He was pacing back and forth with furrowed eyebrows. I gingerly inquired what was bothering him the most. He answered that he was upset with another patient in the waiting room who was trying to compare her intake form with his intake form.

Celgene has announced results from the phase 3 STYLE study, showing apremilast yielding significant improvement in moderate-to-severe scalp psoriasis. STYLE is a phase 3, multicenter, randomized, placebo-controlled, double-blind study evaluating the efficacy and safety of apremilast in subjects with moderate to severe plaque psoriasis of the scalp. The study enrolled 303 people who were randomized 2:1 to receive apremilast 30 mg twice daily or

Some clinical benefits were seen among patients with adult-onset Still's disease treated with tocilizumab (Actemra) in a small clinical trial, but the study's primary endpoint was not met, Japanese researchers reported.

Reuters reports that patients with hip or knee replacements will now be followed for progress using their Apple watches. A multi-site study involving medical facilities from Massachusetts, California, Colorado and Michigan will receive stats including heart rate, steps taken and standing hours from patients waiting for or recovering from hip and knee replacement surgery.

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. New info on scleroderma-SLE overlap, nailfold capillaroscopy, Women with SpA, acute gout management and lupus patient in pain who visit the ED.

Analysis of the Black Women's Health Study shows that obesity as a teenager may be associated with increased risk of systemic lupus erythematous (SLE) in adulthood. The relationship between obesity and SLE risk is unclear. Past studies have predominantly assessed white women, while black women have higher prevalence of both obesity and SLE.