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Articles By David Liew, FRACP

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ICYMI: How do we manage difficult discussions about pregnancy in RA?

Most rheumatologists know that it is important to get pregnancy planning right for women of childbearing age living with rheumatic diseases. That is easier said than done, though: the details are difficult, it is overwhelming for the patient, and the conversations are hard.

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multiple traffic lights

When should we be starting therapy in GCA and PMR?

The problem with having therapies that work is that you then have to figure out what to do with them. You cannot hide behind a shrug of the shoulders, or the ambiguity of therapeutic inadequacy. The question that follows the presence of a therapy is the question as to how to best use it. GCA and PMR are at the stage in the growth of their therapeutic development where this problem is moving to the front of mind, and it made for a fitting topic in the ACR Great Debate. Drs. Rob Spiera and Phil Seo - two luminaries in the vasculitis and PMR worlds - were pitted head to head to discuss.

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elderly hands

Why are older RA patients getting mistreated?

Most rheumatologists, if asked, would say that every rheumatoid arthritis patient should be started on a DMARD of some sort - if not at diagnosis, then pretty soon after. So I am genuinely shocked that, in a large United States Medicare 20% sample dataset between 2008-17, less than 30% of new RA patients aged 66 years or older have a DMARD initiated.

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pregnancy,doctor,consult

How do we manage difficult discussions about pregnancy in RA?

Most rheumatologists know that it is important to get pregnancy planning right for women of childbearing age living with rheumatic diseases. That is easier said than done, though: the details are difficult, it is overwhelming for the patient, and the conversations are hard.

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Dr. David Liew

JAKi for PMR: Safe, or a Concern for Older Adults?

JAK inhibitors obviously have dominated a lot of the discussion in our therapeutic landscape over the last couple of years. What about their use in polymyalgia rheumatica? Let's consider.

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Zoster protection for JAK inhibitor patients appears achievable

One of the primary questions about JAK inhibitor safety, ever since its first approval, has been the risk of herpes zoster.

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Magnifying glass

Clinically suspect arthralgias: justified or artefact?

Some subjects in rheumatology seem to create contention the more they get explored, and one of those areas is a traditional crowd favourite for discussion at EULAR - clinically suspect arthralgias.

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Better at Predicting RA from MRI: Humans or Computers?

An artificial intelligence model to assess pre-RA hand MRIs has confirmed what human readers have known before: that bone marrow edema and tenosynovitis are objectively the best predictors of future RA development in patients with clinically suspect arthralgias or undiffer

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Will a vegetarian diet and exercise actually help RA disease activity?

The exact role of diet, physical activity, and stress management in the management of RA has long been debated. While reasonable evidence has supported the importance of physical activity in patients with RA, its capacity to reduce disease activity via conventional measures such as DAS28 was less well delineated.

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tumeric

The spicy topic of turmeric in rheumatoid arthritis

Curcumin, the active constituent of turmeric extract, has increasingly been promoted as a potential rheumatoid arthritis therapy, but data presented at ACR22 suggests that even in ideal situations, it is unable to do any better than placebo in replacing conventional RA therapies.

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