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Non-Tuberculous Mycobacterial Infections - Diagnosis and Management for the Rheumatologist

Non-Tuberculous Mycobacterial infections are among the most frequently reported opportunistic infections in the setting of biologic therapy. While there are hundreds of NTM species, only a minority are clinically relevant. In this review, I'll address important NTM diagnosis and management issues relevant to patients receiving biologic therapy.

 

IV Golimumab Shines in Psoriatic Arthritis

Golimumab (GOL) is one of five marketed TNF inhibitors (TNFi) that is FDA approved for use in psoriatic arthritis (PsA).

Treat-to-Target a Bust with Rheumatologists

Treat-to-target strategy is widely advocated as an important means of optimizing treatment responses in patients with rheumatoid arthritis. Even though T2T is encouraged by most guidelines, a current report shows that US Rheumatologists fail to implement T2T in their daily practice.

It's Rheumatoid Arthritis, not the TNF inhibitor, that Drives Lymphoma Risk

Evidence from multiple studies suggests there is an increased risk of lymphoma in rheumatoid arthritis (RA) that is believed to be linked to the cumulative activity of the disease.  

Therapeutic Update: 5 Questions on FDA Hearing for Tofacitinib in PsA

In this Therapeutic Update, Drs. Mease, Gibofsky and Cush answer five questions regarding the August 3rd FDA Arthritis Advisory Committee meeting that reviewed the potential approval of tofacitinib (Xeljanz) in patients with active psoriatic arthritis. The panel was nearly unanimous (10-1) in favor of the efficacy and safety profile of of tofacitinib, and similarly voted 10-1 to approve this drug for use in PsA. Final decisions on these recommendations from the AAC panel will be made at a later date by the FDA. 

Rheumatoid Arthritis Increases Risk of Repeat Coronary Events and Mortality

Studies have shown that rheumatoid arthritis (RA) patients have increased risk of acute coronary syndrome (ACS) and may suffer from poorer short-term outcomes after ACS. The long-term outcomes in patients with RA with ACS was shown to be worse than matched non-RA patients also with ACS.

The Unregulated $37 Billion Supplement Industry

In 1994 there were 600 supplement companies, producing 4,000 OTC supplement products for a total revenue of about $4 billion. Today we have close to 6,000 companies, producting nearly 75,000 supplement products, bringing in $37 billion annually.

Pegloticase Infusion Reactions Largely Seen in Non-Responders

The introduction of intravenous pegloticase (PEG) in 2010 was felt by many to be a major advance in the treatment of patients with severe, refractory tophaceous gout.  But for some, concerns over infusion reactions and safety have limited its use.

The RheumNow Week in Review – 18 August 2017

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com.

Bad Knees Through the Ages

The average American today is twice as likely to be diagnosed with knee osteoarthritis as in the years before World War II, Harvard scientists say. And the reasons are less clear than you might think.

Based on a study of more than 2,000 skeletons from cadaveric and archaeological collections across the United States, a Harvard report is the first to definitively show that knee osteoarthritis prevalence has dramatically increased in recent decades.

Osteoporosis Care for RA Patients Found Suboptimal, Declining

Fewer than half of rheumatoid arthritis (RA) patients at a risk of fracture sufficient to warrant guideline-recommended osteoporosis treatment received appropriate care, according to a large study of U.S. osteoarthritis (OA) and RA patients.

How Much Testing is Enough?

I saw a patient this past week with new onset polyarthralgia, which led me to ponder how my fellow rheumatologists would utilize laboratory testing in such a patient.

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