On Sept. 1, 2017, the San Diego County declared a local public health emergency due to the ongoing hepatitis A outbreak in the county.The outbreak is being spread person-to-person and through contact with fecally contaminated environments. The majority of people who have contracted hepatitis A during this outbreak have been homeless and/or illicit drug users.

Mease et al has reported in the NEJM the results of a phase 3 trial showing tofacitinib (Tofa) to be significantly more effective than placebo in active psoriatic arthritis (PsA) patients who previously failed to respond to tumor necrosis factor inhibitor (TNFi) therapies. 

The paradigm of rheumatoid arthritis (RA) therapy mandates early diagnosis and aggressive treatment.  Yet a recent cohort study has shown that RA patients with moderate to high disease activity (MHDAS) were met with infrequent DMARD adjustments; with median time to DMARD adjustment being 5 months and median time to low disease activity (LDAS) was roughly 10 months. 

Gout coassociates with many of the disorders within the metabolic syndrome - diabetes, hypertension, hyperlipidemia and obesity.  Not surprisingly, gout is a risk factor for cardiovascular disease, but the risk magnitude for  myocardial infarction (MI), and stroke are unclear.

I recently had a follow up with an SLE patient who wanted to discuss sun protection options since moving to Dallas, where we have 232 days of sunshine yearly. Sun protection is important for our patients. As rheumatologists, we have an obligation to go beyond 'avoid the sun or wear sunscreen when you're out' platitudes.

Johnson & Johnson has announced that they have received an expanded FDA approval for the use of ustekinumab (Stelara) in treating adolescent patients, aged 12 and over, with moderate to severe plaque psoriais.

The antiphospholipid syndrome (APS) is a common disorder affecting patients with and without autoimmune disease. Despite wider recognition of APS among physicians as well as the expanding research collaborations, many clinical questions are still encountered in clinical practice, which require further evidence-based studies. In this “Across the Table” edition, Drs. Cush and Erkan discuss some of these APS-related questions. Our guest expert, Dr

Compliance and adherence was shown to be quite poor in fibromyalgia (FM) patients, with high rates of drug discontinuation and greater than 60% demonstrated low adherence.

Although tumour necrosis factor inhibitors (TNFi) are highly effective (on clinical grounds) in ankylosing spondylitis (AS), proof that they may alter the course of spinal radiographic progression has been scant. That's primarily because of the insidisous nature of the disease, comparatively slow progression and difficulties in imaging and scoring the sacroiliac and axial joints. 

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses a novel antiviral drug or the use of stem cell therapy for scleroderma, rituximab in HSP, when to withdraw NSAIDS in RA, and congrats to PAs and NPs!

Despite being one of the most satisfying of medical subspecialties, the number of U.S. rheumatologists is about to sharply decline.  These data were presented at the 2016 ACR meeting, where it was shown that the estimated total number of U.S. rheumatologists in in 2015 was 4,933 and is projected decrease to 3,645 by 2025. During this declining clinical supply, there will be a 138% increase in demand from 6,155 to 8,184 by 2030.

Scientists at the Institute for Basic Science have invented a hydrogel capable of delivering drug at sites of inflammation in disorders such as rheumatoid arthritis. Published in Advanced Materials, this jelly-like material could be used to absorb extra fluids in swelling joints and release drugs wherever nitric oxide is produced in abundance.

Arthritis of all types in the U.S. carried an economic burden of $303.5 billion in 2013, nearly 1% of the gross domestic product that year, according to a CDC analysis.

In the UK, NICE has accredited the British Society of Rheumatology (BSR) to develop a guidance document on the management of systemic lupus erythematosus in adults.  The last published guidelines for lupus were published in 2008 by EULAR and in 2012 by the ACR.

Flexion Therapeutics announced friday that the U.S. Food and Drug Administration (FDA) has approved its osteoarthritis (OA) of the knee injectable steroid drug Zilretta with the indication of moderate-to-severe knee pain. Zilretta is the commonly used triamcinolon acetonide combined with a drug delivery system designed to provide extended pain relief over three months.