A 57 year old male is referred for arthritis of the hands for the last 8 years. He complains of pain, swelling, stiffness in the fingers only. He denies rash, bowel, urologic or ocular complaints. Over-the-counter NSAIDs have provided only partial relief.   What is your differential diagnosis?

Common cardiac biomarkers could be used to identify patients with systemic sclerosis (SSc) at risk for developing pulmonary hypertension, French researchers reported.

Increased sodium intake has been shown to increase Th17 cell activity, and in animal models high-salt diets have been shown to drive IL-23-dependent TH17 cells to cause experimental allergic encephalomyelitis (citation source (http://url.ie/z238). In humans, high-salt diets have been shown to increase clinical and imaging activity in multiple sclerosis (citation source 

In a prospective study of 311 rheumatoid arthritis patients starting either adalimumab (ADA) or etanercept, investigators sought to correlate drug levels and/or anti-drug antibodies with clinical outcomes (citation source http://url.ie/z237).  ADA levels best predicted DAS28 at 12 months (R= 0.060) and low drug levels were associated with BMI > 30 and nonadherence.

Obesity is associated with adverse outcomes in pregnancy, especially with higher rates of infertility and miscarriage. 

Regenerative medicine and the use of bone marrow stromal cells (or mesenchymal stem cells - MSC) is controversial in many areas of medicine, including osteoarthritis. MSC use is at a very early stage in orthopedic research, but has been investigated in osteoarthritis of the knee as a potential means of repairing cartilage. These infused cells are thought to initiate repair by differentiating into chondrocytes or b

Systematic review of the literature examined whether obesity is associated with a higher risk of rheumatoid arthritis (citation source http://url.ie/z1y6) and found that obese individuals (BMI > 30) are at a significantly increased risk of rheumatoid arthritis (relative risk = 1.25, 95% confidence interval: 1.07 to

In this edition of “Across the Table”, Drs. Cush and Schwartman discuss uveitis. Our expert, Dr. Sergio Schwartzman offers up his approach to diagnosis and management.

In a 2 year follow-up of the DESIR cohort of patients with early inflammatory back pain (627 patients), TNF inhibitor use was associated with a significantly greater decrease in the median NSAID intake (from 54.9 to 1.9 in TNFi pts versus from 41.9 to 22.3 in non-TNFi pts, p0.05).

615 adults with active PsA were randomized to ustekinumab (45mg group or 90mg group) or placebo with crossover at 24 weeks. At 100 weeks, all groups significantly improved dactylitis and enthesitis scores, ACR20 (56.7-63.6%), DAS28-CRP moderate/good response (71.9-76.7%), and PASI75 (63.9%-72.5%) scores. Radiographic benefits were preserved through 100 weeks and the rate and type of AEs were similar between the dose groups.

What is going on in the wide and wacky world of pain and fatigue? What use to be called fibromyalgia is being reclassified as myalgic encephalomyelitis (ME/CFS) or systemic exertion intolerance disease. Although fibromyalgia has many faces, it does not deserve many names.

Using drug survival as a global measure of a drug's effectiveness, safety and tolerability, UK investigators used a national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register) to compare survival rates of the first biologic used in 3,523 biologic-naive patients with chronic plaque psoriasis.

A prospective cohort of 331 patients tested for anti-adalimumab (n=160) and anti-etanercept (n-171) antibodies after initiation of their TNF inhibitor therapy. At 3 months, ADAbs and low adalimumab drug levels were significant predictors of lack of 12 month EULAR response (area under curve 0.71, 95% CI 0.57-0.85). Etanercept levels were not significantly associated with 12 month EULAR response after adjustment.

Lancet today published the results of the phase 3, prospecitive, multinational, double-blind, randomized controlled trial of secukinumab (an anti-IL-17A monoclonal antibody) in active psoriatic arthritis. Secukinumab (Cosentyx) is currently approved for use only in severe plaque psoriasis. 

Microscopic polyangiitis (MPA) is one of several vasculitides that affects the lung.  Its most common pulmonary complication is diffuse alveolar haemorrhage, which carries a significant morbid risk. MPA association with pulmonary fibrosis (PF) has been increasingly reported.