Articles By Michael Putman, MD, MSCI
Is Your Practice Up to Date? New Guidelines for SLE Nephritis
Randomized controlled trials (RCTs) drive guidelines; guidelines drive clinical practice. Because updated guidelines lag trials by many years and dissemination of guidelines takes additional time, rheumatologists often practice “behind the data.” The 2024 ACR Guidelines for the Management of SLE Nephritis reaffirmed many of our typical practice patterns, including hydroxychloroquine for all, renin/angiotensin blockade, and favoring mycophenolate mofetil over cyclophosphamide.
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ACR 2024: What Exactly do JAKs and TYKs Do?
Let me start by confessing something embarrassing: the immune system is just too complex for me to understand. I suspect the onslaught of new drugs with new mechanisms at ACR 2024 may have left many of you feeling similarly. This may be particularly true for the TYK/JAK/STAT signaling pathway, where each agent has a slightly-different combination of binding affinity to various JAK and TYK signaling dimers. In this article I want to share some diagrams from ACR 2024 that may help.
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Taking CAR-T for a Test Drive
When the ACR Convergence 2024 abstract site went live, the first query I typed into the search bar was, “CAR-T.” I consider myself a CAR-T skeptic and would be surprised if the magical results from this NEJM case series replicate at scale, but it seems likely that CAR-T will revolutionize the care for (some) patients with rheumatic diseases. What new data will be presented at ACR?
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ICYMI: Effective Treatments for Rheumatoid Arthritis ILD
The American College of Rheumatology guidelines for the diagnosis and management of interstitial lung disease, which includes rheumatoid arthritis interstitial lung disease (RA-ILD), has been one of the most controversial topics in the runup to ACR Convergence.
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ICYMI: Bimekizumab is Coming…in Third Place
Of the many exciting advancements for patients with psoriatic arthritis at ACR Convergence, one upcoming therapy stood out: the dual IL-17A/F inhibitor bimekizumab. Nearly two dozen bimekizumab abstracts will be featured at this year’s meeting and it recently received authorization in Europe and the U.S. for psoriasis. That makes this the year I plan to figure out where this drug will be useful for my patients with PsA.
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ICYMI: Here at Last: Treatment Options for VEXAS
We have known about the VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome for nearly 3 years, but there has been relatively little to say about how to treat it. To date there have been over twice as many publications about VEXAS (263 publications) as there have been patients described with respect to treatment strategies (116 patients). One of the late breaking abstracts may finally have rectified this imbalance.
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Here at Last: Treatment Options for VEXAS
We have known about the VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome for nearly 3 years, but there has been relatively little to say about how to treat it. To date there have been over twice as many publications about VEXAS (263 publications) as there have been patients described with respect to treatment strategies (116 patients). One of the late breaking abstracts may finally have rectified this imbalance.
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Effective Treatments for Rheumatoid Arthritis ILD
The American College of Rheumatology guidelines for the diagnosis and management of interstitial lung disease, which includes rheumatoid arthritis interstitial lung disease (RA-ILD), has been one of the most controversial topics in the runup to ACR Convergence.
Read Article
Bimekizumab is Coming… in Third Place
Of the many exciting advancements for patients with psoriatic arthritis at ACR Convergence, one upcoming therapy stood out: the dual IL-17A/F inhibitor bimekizumab. Nearly two dozen bimekizumab abstracts will be featured at this year’s meeting and it recently received authorization in Europe and the U.S. for psoriasis. That makes this the year I plan to figure out where this drug will be useful for my patients with PsA.
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Universal Imaging for GCA in PMR? Not So Fast
For decades we've been screening GCA with a patient history and exam. Doing so with imaging would be a sharp departure from the current standard of care. And you may be asking yourself, well, yeah, but what could it hurt? Don't you want to catch GCA early? Let me tell you the problems with this.
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