Addressing chronic pain often leads general practitioners and specialists to prescribe opioids. However, opioids (weak and strong) have not demonstrated efficacy in long-term pain management; their chronic use could even worsen pain in users. Opioids prescription is often perceived as being safer than NSAIDs prescription, especially in respect to MACE.

In the wake of the 2016 AAOS Guidelines, rheumatologists dutifully reduced the dose HCQ take by patients with SLE to some number south of 5mg/kg per day. Though I believe the ophthalmologists correctly interpreted a 2014 paper in JAMA Ophthalmology that quoted a much-higher rate of HCQ associated retinopathy than had previously been appreciated, they and subsequent guidelines published in the field of rheumatology lacked a critical piece of information: what actually happens when you do this?

Significant disparities exist in pregnancy outcomes in women with systemic lupus erythematosus (SLE), with previous cohorts identifying Black women as having a higher risk of maternal mortality compared to White women with SLE.

There has been much focus on the pharmacologic management of axSpA. Despite optimal control of inflammation, symptoms of fatigue and pain can persist. Long term use of analgesics including opioids carries significant risks. Strategies to improve response to treatment in this population is critical.