Transforming growth factor (TGF-β) is known to have potent profibrotic activity and has been implicated in the pathogenesis of systemic sclerosis a futile condition with no effective disease modifying treatments.
Currently there are no FDA-approved medications for the treatment of digital ulcerations in the United States. Digital ulcers are a common, unfortunate and difficult to manage consequence of the vascular obliteration and fibrosis that accompanies systemic sclerosis.
ACP has endorsed the Supreme Court ruling that the premium subsidies created by the Affordable Care Act, essential to making coverage affordable to millions, will continue to be available in states where the federal government manages their health insurance marketplaces.
RheumNow is committed to reporting safety issues in our monthly Drug Safety Bulletins. Each month we will update you with reports of new, ongoing and resolved Drug Shortages that will affect the practicing rheumatologist. If you have suggestions or information about specific drug shortages or drug safety issues please email us at: info@rheumnow.com .
Reported Drug Shortages as of June 25, 2015
An Israeli crossover trial analyzed the efficacy of hyperbaric oxygen therapy (HBOT) in 60 patients with fibromyalgia.
A large ACP survey of over 18,000 US internal medicine residents shows they often incorporate cost of care in discussions and decisions, but may not know the data (citation source http://buff.ly/1KeLq0D).
A survey of internists and family practitioners shows that half of physicians are unaware of how opioids are abused. One-third of doctors did not know that swallowing whole pills was the most popular method of abusing opioids and nearly half thought that (abuse-deterrent) pills that can't be crushed and snorted or injected were less addictive that the regular pills (citation source http://url.ie/z1py).
Using Medicaid data from 2000-2006, 9,600 hydroxychloroquine new users were compared to 3,829 new users of immunosuppressive agents (IS) in patients with SLE. They assessed adherence using the MPR - the medication possession ratio. The mean MPR for HCQ was 47.8% and 42.7% for IS. Nonadherence (80% MPR) was seen in 79% of HCQ users and 83% of IS users were nonadherent.
Rheumatoid management hinges on choosing your best therapies first. Landmark studies, such as the TEAR, SWEFOT, and RACAT trials have questioned the comparative efficacy of initial triple DMARD therapy (methotrexate, sulfasalazine,hydroxychloroquine) and combination therapy with methotrexate (MTX) plus etanercept (ETN).
A 36 year-old white male butcher has right knee pain for 3 weeks. He noted a similar episode 5 years earlier and admits to a traumatic fall on that knee years ago. He denies fever, redness, warmth, other joints or other past medical problems. He only takes OTC ibuprofen prn.
What's your diagnosis?
Biosimilars are copies of the biologic medicines used to treat inflammatory and immunologic conditions such as rheumatoid arthritis, multiple sclerosis and cancer- potentially at lower costs. Although there are few on the market, the number of biosimilars entering the marketplace is exploding. In 2013, nearly 100 biologics had $66.3 million in sales.
Chikungunya virus (CKV) is an acute febrile illness caused by an alpha virus that mimics RA in its clinical presentation. Incidence of CKV fever in the Carribean islands continues to rise steadily since 2013.In the general population, articular manifestations of CKV are transient and respond well to symptomatic treatment.
A retrospective review of 1285 US male veterans showed the prevalence of inflammatory eye disease to be 2%. Uveitis was most common (most being anterior uveitis), followed by keratitis, scleritis, episcleritis, and acute ischemic optic neuropathy. Ocular inflammation was most likely with GPA (1/8), sarcoid (9/198), giant cell arteritis (2/68), and rheumatoid arthritis (11/576).
1998 marked the introduction of citrulline as a unique target in the pathogenesis of rheumatoid arthritis. The hallmark article by Schellekens et al in the Journal of Clinical Investigation has since been cited over 500 times. Dr. David Fox reviews the history and hallmarks of citrullination in the current issue of the Journal of Immunology (July 2015).
Highlights of the article include:
Fatigue is not far behind pain as the complaint that affects the quality of life in numerous rheumatic and autoimmune disorders. But do we need to focus on fatigue in our disease management?
