Podcasts about dmards

Ever wondered what do with patient on methotrexate, with and infection, awaiting surgery, with a flare of their arthritis? In this episode Dr Thomas Bond and Dr Harris Fayyaz cover the practical points for managing patients on conventional DMARDs, covering when to stop and when they are safe to continue! 

The Derm on RheumNow podcast is a collection of Citations and Content curated for dermatologists – addressing Psoriasis, PsA, CLE, vasculitis, HS, other CTD skin disorders. dermatology drugs, biiologics, JAKs - their use, efficacy and side effects.  Features Dr. Jack Cush, Editor at RheumNow.com.  SHOW NOTES Lupus Accelerating Breakthroughs Consortium commissioned a stakeholders group (including the FDA) to assess drug development in Cutaneous lupus CLE), and they have endorsed CLASI (CLE Dz Area & Severity Index) as the outcome measure for CLE clinical trials. https://t.co/q7If97AHBa PAPA Syndrome: When Sterile Inflammation Mimics Infection (Pyogenic Arthritis, Pyoderma gangrenosum, Acne) •A rare monogenic autoinflammatory disease •Caused by gain-of-function mutations in PSTPIP1

Flu season hits differently when you're living with autoimmune disease or taking rheumatology medications. In this video, I break down what to do if you think you have the flu, which symptoms should prompt urgent care, and how to think about common rheumatology meds when you're sick.We cover:Flu vs. “just a cold”: key symptoms to watchWhen to call your rheumatology teamFever, dehydration, and red flags that need urgent evaluationHow to approach steroids, DMARDs, biologics, and JAK inhibitors when you're ill (general guidance)Flu prevention: vaccines, household exposure, and practical next stepsThis video is for education only and isn't personal medical advice. If you're immunocompromised, pregnant, or your symptoms are severe, please seek urgent medical care.#flu #influenza #rheumatollgic #autoimmune #inflammation #fluandrheumatologicmedications #dmards #biologics #fluprevention #vaccinations 

In this real Q&A, I answer questions from someone newly diagnosed with RA who's currently taking hydroxychloroquine (Plaquenil). We talk through what “treat-to-target” actually means, why early control of inflammation matters, and how to think about medication fears in a way that's grounded (not scary).In this video, we cover:--What “treat-to-target” means and why timing is a big deal in RA--Minimal Disease Activity (MDA) vs. “just getting by”--When Plaquenil may not be enough, and what escalation can look like (DMARDs/biologics)--How to weigh medication risks against the risks of untreated RA (including long-term steroid use)--Lifestyle support that helps inflammation (stress, sleep, vagus nerve) — plus why smoking mattersQuestion for you: What's the #1 thing you wish someone explained right after your RA diagnosis?#RheumatoidArthritis #RA #AutoimmuneDisease #Rheumatology #Plaquenil #Hydroxychloroquine #Methotrexate #Biologics #TreatToTarget #JointPain #Inflammation #ChronicIllness

Dr. Isabelle Amigues unpacks why patients often recover better, faster, and more deeply in a supportive group. From mirror neurons and oxytocin to vagus nerve activation and the power of clinician belief, she explains how community and medicine accelerates remission—then previews UnabridgedMD's upcoming physician-led healing cohorts.What You'll Learn:From competition to collaboration: How traditional, competitive medical training contrasts with the superior outcomes of team-based care—and why adding patients to the care team elevates results.The brain science of group healingMirror neurons: observing others practice skills (e.g., injections, PT) improves your own learning and adherence.Oxytocin up, cortisol down: group practices (breath, chant, yoga) boost bonding hormones and reduce stress chemistry—fertile ground for recovery.Vagus nerve / parasympathetic activation: group rituals nudge the nervous system into “rest-and-repair,” lowering inflammation.Placebo power, reframed: Why clinician belief and a supportive cohort measurably enhance outcomes (a reason trials are double-blind)—and how to harness that effect ethically.Mindset shapes pain: Attention directs perception; scanning for what's working reduces pain. Group programs for chronic pain (e.g., back pain) consistently show greater relief and fewer relapses than going solo.Medication and milieu: Biologics and DMARDs are powerful tools, but outcomes improve further when paired with community practices that activate anti-inflammatory pathways.Safety, accountability, momentum: Groups create a psychologically safe space to try new habits, show up consistently, and stay on track—especially valuable in rheumatologic conditions.What's next at UnabridgedMD: A webinar and physician-led community cohorts designed to help patients reach and sustain remission through evidence-based medical care plus group-based nervous-system and lifestyle practices.If a trusted group could help you heal 25–40% faster, what habit or symptom would you choose to transform first?

Too busy to read the Lens? Listen to our weekly summary here! In this week's episode we discuss…Corticosteroids and DMARDs together were found to be superior to corticosteroids alone in treating non-anterior sarcoid uveitis. Thousands of Americans have come to the ED over the past few years for pickleball-related ocular traumas, suggesting eye protection could be beneficial in this sport. Glaucoma is associated with sleep-wake and Circadian rhythm disorders, likely secondary to damage to the RGCs and optic nerve causing irregular regulation of sleep-wake physiology.Novel statin nanoparticles injected intravenously can preserve and even double cone photoreceptors in retinitis pigmentosa mouse models by reducing inflammation.

Listen or watch along as we dive into updates on axial spondyloarthritis (axSpA) treatments and 'The 2025 British Society for Rheumatology guideline  for treatment of  axial Spondyloarthritis with biologic and targeted synthetic DMARDs'.In this episode, podcast host Mel Brooke, BIRDs Patient and Public Engagement Programme talks with Professor Raj Sengupta, Consultant rheumatologist  and Lead Consultant for Axial Spondyloarthritis at the RNHRD, RUH Bath about changes to axSpA treatments since our first series in 2020. Useful Links:BSR Guideline⁠National Axial Spondyloarthritis Society⁠Inhealthcare  Connect further with us:Have questions or thoughts about our information Podcast library?  Interested in joining BIRDs patient research panel? Email Mel at  ppe@birdbath.org.ukBe sure to subscribe, rate, and review the podcast to help us continue sharing information that matters!Thank you to all our sponsors for helping us to bring you information that supports you and helps to increase your knowledge of rheumatic diseases.Please visit the⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠BIRD website ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to sign up for news.

Listen or watch along as we dive into updates on axial spondyloarthritis (axSpA) treatments and 'The 2025 British Society for Rheumatology guideline  for treatment of  axial Spondyloarthritis with biologic and targeted synthetic DMARDs'.In this episode, podcast host Mel Brooke, BIRDs Patient and Public Engagement Programme talks with Professor Raj Sengupta, Consultant rheumatologist  and Lead Consultant for Axial Spondyloarthritis at the RNHRD, RUH Bath about changes to axSpA treatments since our first series in 2020. Useful Links:⁠BSR Guideline⁠⁠⁠National Axial Spondyloarthritis Society⁠⁠⁠Inhealthcare  ⁠Connect further with us:Have questions or thoughts about our information Podcast library?  Interested in joining BIRDs patient research panel? Email Mel at  ppe@birdbath.org.ukBe sure to subscribe, rate, and review the podcast to help us continue sharing information that matters!Thank you to all our sponsors for helping us to bring you information that supports you and helps to increase your knowledge of rheumatic diseases.Please visit the⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠BIRD website ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to sign up for news.

Have you ever left your rheumatologist's office feeling like they were speaking an entirely different language? You're not alone. Medical terminology can be overwhelming, especially when you're newly diagnosed with rheumatoid arthritis and trying to make sense of your new reality.This episode brings together a remarkable panel of experts who offer something truly unique – they're not just healthcare professionals who treat RA, they live with it themselves. Dr. Saimun Singla, an integrative pediatric rheumatologist, shares how her own RA diagnosis shaped her holistic approach to patient care, while Stefanie Remsen (known online as the "Rheumatoid Arthritis Coach") brings her perspective as both a nurse practitioner and someone who's navigated RA for over a decade.Together, they break down confusing terms like DMARDs, biologics, and JAK inhibitors in simple, relatable language. You'll learn why your doctor might recommend one treatment over another, what "seronegative" actually means, and how to interpret those mystifying lab results. The panel explains the infamous "spoon theory" of energy management and tackles the often misunderstood concept of remission – is it really possible, and what does it look like?Beyond just clarifying terminology, our guests offer practical advice on communicating with your healthcare team, including how to approach research you've done without creating tension. They emphasize that while medications play a crucial role, factors like diet, stress management, and sleep are equally important parts of the treatment puzzle that often go undiscussed in short medical appointments.Whether you're newly diagnosed or have been living with RA for years, this episode will empower you with knowledge to better navigate your healthcare journey. Subscribe now and join our community of Spoonie Sisters who understand what you're going through.Stef: https://www.instagram.com/rheumatoidarthritiscoach?igsh=NWJqYTFhMDJzMjd6Dr. Saimun Singla: https://www.instagram.com/rheum.to.grow.tx?igsh=dWs1ZjSend us a text Delivering Happy Mail around the world!We have sent thousands of cards to isolated illness warriors, facilitated hundreds of pen pal relationships, and reached countless family members, caregivers, and medical professionals with messages of hope and acknowledgment.Join our mission to send 100,000 cards of support to patients with long-term illnesses.About our organization | Cards2warriors Are you living with a chronic illness and want to make your voice heard? Rare Patient Voice connects patients and caregivers with research opportunities—so you can share your experiences and get paid for your time! Your insights help drive real change in healthcare.Let's Get Started - Rare Patient Voice Keep your spoons close and support system closer.Support the showSupport:https://rarepatientvoice.com/Myspooniesisters/https://www.etsy.com/shop/MySpoonieSistershttps://www.graceandable.com/?bg_ref=980:nzTyG6c9zK (Use code GAJen10) Website: https://myspooniesisters.com/ Discount Codes: GIANT Microbes | Gag Gifts, Teacher Gifts, Doctor Gifts, Gifts for Girlfriends and Boyfriends code SPOONIE20 for 20% off

Report shows rapid declines in health of children and adolescents since 2007; N-acetylcysteine (NAC) for Parkinson's; Statins increase likelihood of hearing loss, tinnitus; Lithium orotate for Alzheimer's; Is tinnitus reversible? Novel implantable electrical vagus nerve stimulator approved for treatment of rheumatoid arthritis.

Join Professors Iain McInnes and Peter Nash for the latest episode on The Immune-Mediated Inflammatory Disease Forum, where they discuss the latest updates in RA. In this episode, they discuss two papers: effectiveness of JAKi compared with bDMARDs on pain reduction and effective second‑line b/tsDMARD for patients with rheumatoid arthritis unresponsive to first‑line b/tsDMARDs.

On this episode, we evaluate current guidelines and evidence-based treatment strategies for managing rheumatoid arthritis. We compare and contrast the efficacy, safety profiles, and appropriate use of disease-modifying antirheumatic drugs (DMARDs), biologics, and other therapies as well as discuss patient-specific treatment strategies considering factors such as disease severity, comorbidities, and patient preferences.  Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. If you purchase an annual membership, you'll also get a free digital copy of High-Powered Medicine 3rd edition by Dr. Alex Poppen, PharmD. HPM is a book/website database of summaries for over 150 landmark clinical trials.You can visit our Patreon page at the website below:  www.patreon.com/corconsultrx We want to give a big thanks to Dr. Alex Poppen, PharmD and High-Powered Medicine for sponsoring the podcast..  You can get a copy of HPM at the links below:  Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to say thank you to our sponsor, Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx We also want to thank our sponsor Freed AI. Freed is an AI scribe that listens, prepares your SOAP notes, and writes patient instructions. Charting is done before your patient walks out of the room. You can try 10 notes for free and after that it only costs $99/month. Visit the website below for more information: https://www.getfreed.ai/  If you have any questions for Cole or me, reach out to us via e-mail: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com

QD clinics - lessons from the Clinic brought to you by RheumNow Live 2025 QD 269 CREST or More? https://youtu.be/GSBfr2S9iL4 Is this CREST or Diffuse PSS? Features Dr. Jack Cush.  QD270 Acute Neck & Back Pain https://youtu.be/qWTGvqL9-wY Acute onset febrile, polyarthritis, neck and low back pain Features Dr. Jack Cush.  QD271 - Treating Overlap with ILD https://youtu.be/eR7O-oy_O_g Polyarthritis, ILD, Dermatomyositis - how to treat? Features Dr. Jack Cush.  QD272 - Natural RA https://youtu.be/Ie1u-_KqxVE PsO/PsA patient avoiding DMARDs and Biologics, and wants Natural therapies Features Dr. Jack Cush.  QD Clinics - lessons from the clinic, sponsored by RNL2025 in Dallas, TX; Feb 8 & 9, 2025  Register at RheumNow.live

A New ACR Best Things I Saw Today in PsA Do TNFis and JAKis Prevent Cancer!? Hold or continue JAKi and IL-17 when receiving COVID boosters? JAK-pot! How fast do DMARDs work? JAKi Studies at ACR Poly-treatment of Polymyalgia Rheumatica? RA Roundup: Is LDA Inappropriate? What about Statins for JAKs? RA: One JAK to Rule Them All? SELECT-GCA: Efficacy and Safety of Upadacitinib "SELECT-GCA: Upadacitinib in Giant Cell Arteritis" SELECTing the right patients: upadacitinib in GCA So really, are JAKs Safe? Summary of JAKi Studies The Case for JAKi in PMR The Real Value of JAKi is Beyond RA When, What and How Long to Treat GCA & PMR Worried about CV Risk and JAKi? What about the Steroids?

JAK-pot! How fast do DMARDs work?:Dr. Mike Putman and Dr. Kim Lauper Paraoxonase-1: Possible Biomarker for Progression to RA:Dr. Jonathan Kay Potential Impact of Weight Loss Drugs in Rheumatic Diseases:Dr. Arthur Kavanaugh PREDICT-SpA: Evaluating the influence of gender on disease assessment tools:Dr. Sheila Reyes SELECT-GCA: Upadacitinib in Giant Cell Arteritis:Dr. Mike Putman Too Many CAR-Ts for Horses?:Dr. Pope Transplant-free Survival Predictors in Idiopathic Inflammatory Myopathies-ILD:Dr. Gaby Martinez

On this episode we discuss the diagnosis and management of axial spondyloarthritis.  We begin by defining axial spondyloarthritis (radiographic axial sponyloarthropathy AKA ankylosing spondylitis vs non-radiographic axial sponyloarthropathy) and describe its clinical presentations, etiologies, and pathophysiology. We then compare and contrast the efficacy, safety profiles, and appropriate use of medications including NSAIDs, non-biologic DMARDs, biologics, and JAK inhibitors.  Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. If you purchase an annual membership, you'll also get a free digital copy of High-Powered Medicine 3rd edition by Dr. Alex Poppen, PharmD. HPM is a book/website database of summaries for over 150 landmark clinical trials.You can visit our Patreon page at the website below:  www.patreon.com/corconsultrx We want to give a big thanks to Dr. Alex Poppen, PharmD and High-Powered Medicine for sponsoring the podcast..  You can get a copy of HPM at the links below:  Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to say thank you to our sponsor, Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx We also want to thank our sponsor Freed AI. Freed is an AI scribe that listens, prepares your SOAP notes, and writes patient instructions. Charting is done before your patient walks out of the room. You can try 10 notes for free and after that it only costs $99/month. Visit the website below for more information: https://www.getfreed.ai/  If you have any questions for Cole or me, reach out to us via e-mail: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com

In this insightful episode, host Dr. Sebastian Herrera delves into the critical topic of comorbidities and related conditions in psoriatic disease, alongside experts Professor Kurt de Vlam MD, PhD, Head of Clinic Rheumatology at the University Hospitals Leuven in Belgium and Dr. Alexis Ogdie, MD, MSCE, Associate Professor of Medicine and Epidemiology at the University of Pennsylvania in the United States.What's inside this episode?Understanding Comorbidities vs. Related Conditions: Discover the distinctions between these two critical aspects and why it's important to differentiate them in psoriatic disease management.Expert Insights: Hear about the influence of comorbidities on treatment choices and patient outcomes.Impact on Treatment: Learn how related conditions and comorbidities affect therapeutic decisions, including the selection of DMARDs.Patient Care: Explore the importance of a comprehensive approach to treating psoriatic disease, addressing both the primary condition and associated health issues.Key Points & Highlights:Definitions and Importance: Clear definitions of comorbidities and related conditions, and their significance in the clinical setting.Treatment Influences: How the presence of comorbidities can alter the choice of therapies and the necessity of personalized treatment plans.Common Comorbidities: Discussion on obesity, cardiovascular disease, depression, and more, and their implications for patient care.Future Directions: The need for ongoing research and proactive management strategies to improve patient outcomes.Why listen?Educational Insight: Gain a deeper understanding of how comorbidities and related conditions impact psoriatic disease.Expert Opinions: Benefit from the knowledge and experience of leading specialists in the field.Comprehensive Care: Learn about the holistic approach to managing psoriatic disease, ensuring better quality of life for patients.Stay Connected:For more intriguing insights and episodes, visit our website. Don't forget to subscribe to Inside GRAPPA for more episodes like this. Share with your colleagues and friends who might benefit from this episode! Hosted on Acast. See acast.com/privacy for more information.

In Escape Rooms müssen die Spieler*innen gemeinsam Rätsel lösen um aus einem geschlossenen Raum zu entkommen. Dr. Myriam Reisch und Dr. David Kickinger (Abteilung für Rheumatologie und Immunologie, MedUni Graz) entwickeln seit einigen Jahren medizinische Escape Rooms: Auf der Jagd nach dem letzten Cortison im Krankenhaus etwa lernen die Teilnehmer*innen ganz nebenbei das Erheben des Gelenkstatus, den Umgang mit Impfungen und DMARDs, den Ultraschall von Gefäßveränderungen im Rahmen einer Vaskulitis etc. Nach 60 Minuten haben die Spieler*innen das Erblinden der (fiktiven) Patientin verhindert und erlebt, dass jeder Mitspieler einen wichtigen Beitrag zur Lösung leistet. Außerdem hatten sie Spaß. Schließlich kann man nicht jeden Tag, wenn es Lieferengpässe bei Medikamenten gibt, ins Zimmer der Klinikleiterin einbrechen…

Mechanistic Promise in RA Doesn't Always Mean Actual Gain Dr. David Liew reports on abstracts OP0007 and OP0069 at Eular 2024 in Vienna, Austria. The Role of Psychosocial Determinants in the Management of Rheumatoid Arthritis Dr. Mrinalini Dey reports from Eular 2024 in Vienna, Austria about an abstract she will present during the meeting, POS0309. A Step Closer to Identifying Phenotypes of RA ILD Dr. Mrinalini Dey discusses abstract OP0202 presented at Eular 2024 in Vienna, Austria. Pain in RA: Different Drugs for Different Mechanisms Dr. Aurelie Najm reports from Eular 2024 in Vienna, Austria, about abstracts OP0072 and OP0086. Predicting Palindromic Prognosis Dr. David Liew discusses abstract OP0127 at Eular 2024 in Vienna, Austria. Top 3 Messages About JAK Inhibitor Safety Dr. Janet Pope discusses a debate she participated in at Eular 2024 in Vienna, Austria, and her top three messages regarding JAKi safety. Abatacept Misses on Shingrix Response Dr. David Liew discusses abstract POS0620 at Eular 2024 in Vienna, Austria. Artificial Intelligence Detection of CPPD on Hand Radiographs Dr. Antoni Chan interviews Dr. Thomas Hugle about abstract OP0112 presented at Eular 2024 in Vienna, Austria. Cognitive Function in Older Adults with Lupus Dr. Mrinalini Dey discusses abstract POS0730 presented at Eular 2024 in Vienna, Austria. Difficult-to-treat Rheumatoid Arthritis Validation of the EULAR Definition Dr. Mrinalini Dey discusses abstract OP0156 presented at Eular 2024 in Vienna, Austria. DMARDs and Herpes Zoster Vaccination To Stop or Not To Stop Dr. Jonathan Kay discusses abstracts POS0620 and OP0020 presented at Eular 2024 in Vienna, Austria. Has JAK POT Hit the Spot About Infection Risk? Dr. Yuz Yusof discusses abstract OP0092 presented at Eular 2024 in Vienna, Austria. Inspirations About RA-ILD Dr. Jonathan Kay discusses abstracts POS0070, POS0043 and POS0022 presented at the Eular 2024 meeting in Vienna, Austria. Depression and Anxiety Associated with Inability to Achieve Remission in RA and PsA Dr. Aurelie Najm reports on abstract POS0946 presented at Eular 2024 in Vienna, Austria. Digital Rheumatology Dr. Jonathan Kay reviews abstracts POS0451 and POS0607 presented at Eular 2024 in Vienna, Austria. Drug-resistant RA Does Blinatumomab BiTE? Dr. Yuz Yusof reports on abstract OP0193, presented at Eular 2024 in Vienna, Austria.  

Do we need more IL-17 and JAK Inhibitors in Spondyloarthritis? Dr. Eric Ruderman shares his perspectives on the following abstracts being presented at Eular 2024 in Vienna, Austria: OP0195 Sonelokimab IL 17 A/F nanobody inhibitor LB0005 Izokibep IL17A nanobody inhibitor POS0803 Vunakizumab, another IL17A inhibitor OP0138 TAK-279 phase 2B selective TYK2 inhibitor Zasocitinib Giant Cell Arteritis and Polymyalgia Rheumatica Update Dr. Janet Pope discusses abstracts LBA0001, OP0233, OP0261 and POS0280 at Eular 2024 in Vienna, Austria. JAK Inhibitors for New Indications Dr. Janet Pope discusses new indications for JAK inhibitors, reporting from Eular 2024 in Vienna, Austria. Pain in RA: Different Drugs for Different Mechanisms Dr. Aurelie Najm reports from Eular 2024 in Vienna, Austria, about abstracts OP0072 and OP0086. Top 3 Messages About JAK Inhibitor Safety Dr. Janet Pope discusses a debate she participated in at Eular 2024 in Vienna, Austria, and her top three messages regarding JAKi safety. DMARDs and Herpes Zoster Vaccination: To Stop or Not To Stop Dr. Jonathan Kay discusses abstracts POS0620 and OP0020 presented at Eular 2024 in Vienna, Austria. Has JAK POT Hit the Spot About Infection Risk? Dr. Yuz Yusof discusses abstract OP0092 presented at Eular 2024 in Vienna, Austria. Select your GCA Therapy Dr. David Liew discusses LBA0001 presented at Eular 2024 in Vienna, Austria.  

Select your GCA Therapy Dr. David Liew discusses LBA0001 presented at Eular 2024 in Vienna, Austria. DMARDs and Herpes Zoster Vaccination: To Stop or Not To Stop Dr. Jonathan Kay discusses abstracts POS0620 and OP0020 presented at Eular 2024 in Vienna, Austria. Has JAK POT Hit the Spot About Infection Risk? Dr. Yuz Yusof discusses abstract OP0092 presented at Eular 2024 in Vienna, Austria. Depression and Anxiety Associated with Inability to Achieve Remission in RA and PsA Dr. Aurelie Najm reports on abstract POS0946 presented at Eular 2024 in Vienna, Austria. PsA Switch or Cycle, the Eternal Question Dr. Aurelie Najm reports on abstracts POS0278 and POS0266 presented at Eular 2024 in Vienna, Austria. DMARDs and Herpes Zoster Vaccination To Stop or Not To Stop Dr. Jonathan Kay discusses abstracts POS0620 and OP0020 presented at Eular 2024 in Vienna, Austria. Difficult-to-treat Rheumatoid Arthritis Validation of the EULAR Definition Dr. Mrinalini Dey discusses abstract OP0156 presented at Eular 2024 in Vienna, Austria. Has JAK POT Hit the Spot About Infection Risk? Dr. Yuz Yusof discusses abstract OP0092 presented at Eular 2024 in Vienna, Austria. Cognitive Function in Older Adults with Lupus Dr. Mrinalini Dey discusses abstract POS0730 presented at Eular 2024 in Vienna, Austria. Artificial Intelligence Detection of CPPD on Hand Radiographs Dr. Antoni Chan interviews Dr. Thomas Hugle about abstract OP0112 presented at Eular 2024 in Vienna, Austria. Abatacept Misses on Shingrix Response Dr. David Liew discusses abstract POS0620 at Eular 2024 in Vienna, Austria. Inspirations About RA-ILD Dr. Jonathan Kay discusses abstracts POS0070, POS0043 and POS0022 presented at the Eular 2024 meeting in Vienna, Austria. We've Got to Talk about CAR T cells Dr. Yuz Yusof discusses abstract OP0017 presented at the Eular 2024 meeting in Vienna, Austria. Does Withdrawing Steroids Increase Flares in SLE? Dr. Janet Pope reports on abstract OP0180 presented at Eular 2024 in Vienna, Austria. Tapering Treatment for Lupus Dr. Andrea Fava at Eular 2024 in Vienna, Austria, shares his perspectives on several sessions that addressed tapering treatment in lupus. The Crossroads of Autoinflammation and Autoimmunity Dr. Andrea Fava shares his perspectives on autoinflammation and autoimmunity at Eular 2024 in Vienna, Austria. Cognitive Function in Older Adults with Lupus Dr. Mrinalini Dey discusses abstract POS0730 presented at Eular 2024 in Vienna, Austria.

Dr. Jonathan Kay discusses abstracts POS0620 and OP0020 presented at Eular 2024 in Vienna, Austria.

Dr. Jonathan Kay discusses abstracts POS0620 and OP0020 presented at Eular 2024 in Vienna, Austria.

Join us for the latest axSpA podcast brought to you by the Immune-mediated Inflammatory Disease forum! This month Dr Sofia Ramiro is joined by Professors Hideto Kameda and Atul Deodhar to discuss the retention rate of secukinumab over two different time periods. Our faculty then move on to discuss another publication, which compares the improvements is sacroiliac joint symptoms across patients with AS and axSpA treated with different DMARDs.

CardioNerds (Dr. Amit Goyal) join Dr. Anureet Malhotra, Dr. John Fritzlen, and Dr. Tarun Dalia from the University of Kansas School of Medicine for some of Kansas City's famous barbeque. They discuss a case of Hydroxychloroquine induced cardiomyopathy. Notes were drafted by Dr. Anureet Malhotra, Dr. John Fritzlen, and Dr. Tarun Dalia. Expert commentary was provided by Dr. Pradeep Mammen. The episode audio was edited by Dr. Akiva Rosenzveig. Drug-induced cardiomyopathy remains an important and under-recognized etiology of cardiomyopathy and heart failure. Hydroxychloroquine is a disease-modifying antirheumatic drug used for various rheumatological conditions, and its long-term use is well-known to have toxic effects on cardiac muscle cells. Multiple cardiac manifestations of these drugs have been identified, the most prominent being electrophysiological disturbances. In this episode, we discuss a biopsy-proven case of hydroxychloroquine-induced cardiotoxicity with detailed histopathological and imaging findings. We develop a roadmap for the diagnosis of hydroxychloroquine-induced cardiomyopathy and discuss the various differentials of drug-induced cardiomyopathy. We highlight the importance of clinical monitoring and early consideration of drug-induced toxicities as a culprit for heart failure. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media - Hydroxychloroquine induced cardiomyopathy Pearls - Hydroxychloroquine induced cardiomyopathy Continued decline in left ventricular systolic function despite appropriate guideline directed medical therapy should prompt a thorough evaluation for unrecognized etiologies and warrants an early referral to advanced heart failure specialists. Transthoracic echocardiogram is a valuable non-invasive screening tool for suspected pulmonary hypertension, but right heart catheterization is required for definitive diagnosis. Cardiac MRI can be used for better characterization of myocardial tissue and can aid in the evaluation of patients with non-ischemic cardiomyopathy. Hydroxychloroquine (HCQ) is a commonly used DMARD that remains an underrecognized etiology of cardiomyopathy and heart failure. In addition to ophthalmological screening, annual ECG, as well as echocardiography screening for patients on long-term HCQ therapy, should be considered in patients at risk for cardiovascular toxicity, including those with pre-existing cardiovascular disease, older age, female sex, longer duration of therapy, and renal impairment. Management of hydroxychloroquine-associated cardiomyopathy consists of discontinuing hydroxychloroquine and standard guideline-directed medical therapy for heart failure.  HCQ cardiomyopathy may persist despite medical therapy, and advanced therapy options may have to be considered in those with refractory heart failure. Show Notes - Hydroxychloroquine induced cardiomyopathy What are the various cardiotoxic effects of hydroxychloroquine (HCQ) and the mechanism of HCQ-mediated cardiomyopathy? One of the most frequently prescribed disease-modifying antirheumatic drugs (DMARDs), HCQ is an immunomodulatory and anti-inflammatory agent that remains an integral part of treatment for a myriad of rheumatological conditions. Its efficacy is linked to inhibiting lysosomal antigen processing, MHC-II antigen presentation, and TLR functions.8 The known cardiac manifestations of HCQ-induced toxicity include conduction abnormalities, ventricular hypertrophy, hypokinesia, and lastly, cardiomyopathy. Conduction Abnormalities - by binding to and inhibiting the human ether-à-go-go-related gene (hERG) voltage-gated potassium channel,

Can a novel scoring system help prevent dementia and stroke? Find out about this and more in today's PV Roundup podcast.

Join Professor Iain McInnes in this month's CSF Podcast, where he discusses the latest information and data in rheumatology. In this episode, he discusses two papers that look at the incidence of disease. The first paper, the GBD 2021 Other Musculoskeletal Disorders Collaborators systematically analysed the global burden of musculoskeletal disorders, and used these data to predict prevalence up to 2050 and the second paper, Yvette Meissner and her colleagues used the German RABBIT registry to investigate the relationship between MACE risk and JAK inhibitors, TNF inhibitors, and DMARDs. To access detailed summary slides for the papers discussed today, visit cytokinesignalling.com.

In this enlightening episode of Inside GRAPPA, we delve deep into the intricate world of peripheral arthritis in psoriatic disease. Today's host, Dr. Sebastian Herrera, is joined by the esteemed Dr. Katy Leung, and Professor Oliver Fitzgerald to discuss the significance, manifestation, and management of peripheral arthritis in patients with psoriatic disease.Dr. Herrera is a rheumatologist at Clínica Las Américas Auna and ARTMEDICA in Medellín, Colombia and also an Associate Professor of Rheumatology at Universidad CES and a member of Young GRAPPA. Dr. Leung is an Associate Professor at Singapore General Hospital and Duke-NUS Medical School in Singapore. Dr. Leung has interest in clinical and translational research in PsA, is the co-chair of the GRAPPA-OMERACT Outcome Measure Working group, and is also a member of the GRAPPA Education Committee. Dr. Fitzgerald is based at University College Dublin and has a major interest in clinical and translational research in PsA. More recent studies have explored genetic factors and biomarker development. Dr. Fitzgerald has been involved for many years with GRAPPA and took up the office of co-President in July 2021. He has been advocating for grant application opportunities addressing critical unmet needs in PsA for some time and this has culminated in the award of the first, significant, joint EU/industry funded Innovative Medicines Initiative (IMI) grant in PsA, the HIPPOCRATES consortium.

In this episode I discuss a quiz from the My Spondylitis Team that discusses how much you may know on DMARDs. As always, this is designed to help you plan the conversations you may need to have with your doctor(s). Here is a link to the article and quiz. Here are the links to the Youtube channels for:Yoga for ASAlex Levine, Fitness Alex's Full Workout VideoAll the below links are affiliate links. If you purchase any of the items, I may earn a small commission. It does not change the price of items. Get paid to take tests. Here is a link to Rare Patient Voice. If you take participate in a study, you can get paid (amount varies). https://rarepatientvoice.com/TheAxialSpondyloarthritisPodcast/Here are some links to Amazon showing some of the items I discussed. Ankylosing Spondylitis and Axial Spondyloarthritis The Facts Series by Dr. KhanUberlube - https://amzn.to/3i604N2 Here is the Bean Bag neck warmer https://amzn.to/3uN6mcgBiofreeze - https://amzn.to/33gygBSCane - https://amzn.to/3uN9ftsHeating Pad - https://amzn.to/3Bjd5vzWeighted Blanket - https://amzn.to/36RCdi7Steff Di Pardo's new book - I Am Not Invisible - https://amzn.to/3JpDScAAll My Ankylosing Spondylitis Shit: Pain and Symptom Tracker by Kinsella Love https://amzn.to/34CHhpx

On this podcast episode, I cover etanercept pharmacology, adverse effects, drug interactions and much more. Etanercept is classified as a DMARD but is different from older DMARDs in that it is a biologic agent and needs to be injected. Vaccination assessment in patients is important prior to initiating etanercept due to the fact that the medication may blunt the effectiveness of the vaccines. Immunosuppression from etanercept can lead to an increased risk for infection and malignancy.

Episode 146: RA vs OA    Future Dr. Magurany explains how to differentiate rheumatoid arthritis from osteoarthritis.  Written by Thomas Magurany, MSIV, Ross University School of Medicine. Comments by Hector Arreaza, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.1. Etiology: Rheumatoid Arthritis (RA): RA is an autoimmune disease wherein the immune system mistakenly attacks healthy tissues, particularly the synovial joints, usually between the ages of 30-50. Genetic predisposition, environmental factors such as smoking or infections, hormonal imbalances, and lower socioeconomic status have been associated with an increased risk of developing RA(1).Osteoarthritis (OA): OA primarily arises due to mechanical stress on the joints over time. Factors contributing to OA include age, obesity, joint injury or trauma, repetitive joint use or overuse, genetic abnormalities in collagen structure, and metabolic disorders affecting cartilage metabolism (2).The greatest risk factor for the development of OA is age with most patients presenting after 45 years of age. The greatest modifiable risk factor for OA is weight. People with a BMI >30 were found to have a 6.8 times greater risk of developing OA. (3) Primary OA is the most common and is diagnosed in the presence of associated risk factors such as: older age, female gender, obesity, anatomical factors, muscle weakness, and joint injury (occupation/sports activities) in the absence of trauma or disease. Secondary OA occurs alongside a pre-existing joint deformity including trauma or injury, congenital joint disorders, inflammatory arthritis, avascular necrosis, infectious arthritis, Paget disease, osteopetrosis, osteochondritis dissecans, metabolic disorders (hemochromatosis, Wilson's disease), Ehlers-Danlos syndrome, or Marfan syndrome.2. Pathogenesis:Rheumatoid Arthritis (RA):In some patients, RA is triggered by some sort of environmental factor in a genetically predisposed person. The best example is tobacco use in a patient with HLA-DRB1. The immune response in RA starts at sites distant from the synovial joints, such as the lung, gums, and GI tract. In these tissues, modified proteins are produced by biochemical reactions such as citrullination. (4)In RA, an abnormal immune response leads to chronic inflammation within the synovium lining the joints. The inflammatory cytokines released cause synovitis and lead to the destruction of articular cartilage and bone erosion through pannus formation. Immune cells infiltrate the synovium causing further damage. (4) In summary: formation of antibodies to citrullinated proteins, these antibodies begin attacking wrong tissues.Osteoarthritis (OA):The primary pathological feature of OA is the degeneration of articular cartilage that cushions the joints causing surface irregularity, and focal erosions. These changes progress down the bone and eventually involve the entire joint surface. Mechanical stress triggers chondrocyte dysfunction, leading to an imbalance between cartilage synthesis and degradation that cause cartilage outgrowths that ossify and form osteophytes. This results in the release of enzymes that degrade the extracellular matrix, leading to progressive cartilage loss. As more of the collagen matrix is damaged, chondrocytes undergo apoptosis. Improperly mineralized collagen causes subchondral bone thickening; in advanced disease, bone cysts infrequently occur (5). In summary: Osteophytes formation and cartilage loss.3. Clinical Presentation:Rheumatoid Arthritis (RA):The most common and predominant symptoms include joint pain and swelling, usually starting insidiously over a period of weeks to months. RA typically affects multiple joints symmetrically, commonly involving small joints of the hands, wrists, feet and progresses to involve proximal joints if left untreated. Morning stiffness lasting more than an hour is a characteristic feature. The affected joint will be painful if pressure is applied to the joint or on movement with or without joint swelling. Synovial thickening with a "boggy" feel on palpation will be noted. The classical physical findings of ulnar deviation, metacarpophalangeal joint subluxation, swan neck deformity, Boutonniere deformity, and the "bowstring" sign (prominent and tight tendons on the dorsum of the hand) are seen in advanced chronic disease. (4) Around ¼ of patients with RA may present with rheumatoid noduleswhich are well demarcated, flesh-colored subcutaneous lumps. They are usually described as being doughy or firm and are not typically tender unless they are inflamed. They are usually found on areas susceptible to repeated trauma or pressure and include the elbows, fingers and forearms. Osteoarthritis (OA):OA primarily affects weight-bearing joints such as knees, hips, spine, and hands. Symptoms include joint pain aggravated by activity and relieved with rest, morning stiffness lasting less than 30 minutes, joint swelling due to secondary inflammation, and occasionally the formation of bony outgrowths called osteophytes (6). Tenderness may be present at joint lines, and there may be pain upon passive motion. Classic physical exam findings in hand OA include Heberden's nodes (posterolateral swellings of DIP joints), Bouchard's nodes (posterolateral swellings of PIP joints), and “squaring” at the base of the thumb (first Carpal-Metarcapal or CMC joints), bony enlargement, crepitus, effusions (non-inflammatory), and a limited range of motion. Patients may also experience bony swelling, joint deformity, and instability (patients complain that the joint is “giving way” or “buckling,” a sign of muscle weakness). (5)4. Lab findings:Rheumatoid Arthritis: Laboratory testing often reveals anemia of chronic disease (increased ferritin, decreased iron and TIBC) and thrombocytosis. Neutropenia may be present if Felty syndrome is present. RF is present in 80-90% of patients with a sensitivity of 69%. In patients who are asymptomatic or those that have arthralgias, a positive RF and especially CCP predicts the onset of clinical RA. Patients with RA with RF, ACPA, or both are designated as having seropositive RA. About 10% of RA patients are seronegative. ESR and levels of CRP are usually elevated in patients with active disease and can be used to assess disease activity. The synovial fluid in RA will also reveal low C3 and C4 levels despite elevated serum levels.(4) Some non-specific inflammatory markers such as ESR, CRP can help you guide your diagnosis of RA.Osteoarthritis:Lab findings are not significant. Clinical diagnosis if the following are present: 1) pain worse with activity and better with rest, 2) age more than 45 years, 3) morning stiffness lasting less than 30 minutes, 4) bony joint enlargement, and 5) limitation in range of motion. Blood tests such as CBC, ESR, rheumatoid factor, ANA are usually normal but usually ordered to rule out an inflammatory process. Synovial fluid should show a white blood cell count less than 2,000/microL, predominantly mononuclear cells (non-inflammatory). X-rays of the affected joint can show findings consistent with OA, such as marginal osteophytes, joint space narrowing, subchondral sclerosis, and cysts; however, radiographic findings do not correlate to the severity of the disease and may not be present early in the disease. (5)5. Treatment Approaches:Rheumatoid Arthritis (RA):There is no cure for RA.The goal of treatment in RA is inducing remission and optimizing quality of life. This is initially done by beginning DMARDs, include methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide. Methotrexate is the initial DMARD of choice. Anti-TNF-alpha inhibitors include etanercept, infliximab, adalimumab, golimumab, and certolizumab may be used if DMARDs fail. NSAIDs are used to control joint pain and inflammation. Corticosteroids may be used as a bridge therapy to DMARDs in a newly diagnosed patient with a very active disease. (7) Coronary artery disease has a strong association with RA. RA is an independent risk factor for the development of coronary artery disease (CAD) and accelerates the development of CAD in these patients. Accelerated atherosclerosis is the primary cause of morbidity and mortality. There is increased insulin resistance and diabetes mellitus associated with RA and is thought to be due to chronic inflammation. When treated with specific DMARDs such as hydroxychloroquine, methotrexate, and TNF antagonists, there was a marked improvement in glucose control in these patients. (8) RA is not just a disease of the joints, it is able to affect multiple organ systems.Osteoarthritis (OA):OA treatment aims at reducing pain and improving joint function through a combination of non-pharmacological interventions like exercise programs tailored to strengthen muscles around affected joints, weight management strategies, and assistive devices like braces or walking aids if required (9). Medications including analgesics or nonsteroidal anti-inflammatory drugs may be prescribed for pain relief when necessary. Duloxetine has modest activity in relieving pain associated with OA. Intraarticular glucocorticoid joint injections have a variable response but are an option for those wanting to postpone surgical intervention. In severe cases where conservative measures fail, surgical options like joint replacement may be considered (9). Weight loss is a critical intervention in those who have overweight and obesity; each pound of weight loss can decrease the load across the knee 3 to 6-fold. (5) Summary: Medications (NSAIDs, topical, duloxetine), weight loss, PT, intraarticular injections of corticosteroids, and joint replacement.________________________________Conclusion: Now we conclude episode number 146, “RA vs. OA.” Future Dr. Magurany explained that rheumatoid arthritis is an autoimmune disease that presents with joint pain and inflammation, mostly on hands and small joints, accompanied by morning stiffness longer than 1 hour. The rheumatoid factor and ACPA may be positive in a percentage of patients but not always. The base of treatment is early treatment with disease-modifying antirheumatic drugs to induce remission of the disease. OA affects weight-bearing joints with little to no inflammation, treatment is mainly lifestyle modifications, analgesics, intraarticular injections, and joint replacement.This week we thank Hector Arreaza and Thomas Magurany. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Myasoedova E, Crowson CS & Gabriel SE et al. (2010). Is the incidence of rheumatoid arthritis rising?: Results from Olmsted County, Minnesota, 1955-2007. Arthritis and Rheumatism, 62(6), 1576-1582.Goldring MB & Goldring SR. (2007). Osteoarthritis. Journal of Cellular Physiology, 213(3), 626-634.King LK, March L, Anandacoomarasamy A. Obesity & osteoarthritis. Indian J Med Res. 2013;138(2):185-93. PMID: 24056594; PMCID: PMC3788203.Chauhan K, Jandu JS, Brent LH, et al. Rheumatoid Arthritis. [Updated 2023 May 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.Sen R, Hurley JA. Osteoarthritis. [Updated 2023 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.Hunter DJ, Bierma-Zeinstra S. & Eckstein F. (2014). OARSI Clinical Trials Recommendations: Design and conduct of clinical trials for primary hip and knee osteoarthritis: An expert consensus initiative of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) Task Force in collaboration with the Osteoarthritis Research Society International (OARSI). Osteoarthritis Cartilage, 22(7), 363-381.van Everdingen AA, Jacobs JW, Siewertsz Van Reesema DR, Bijlsma JW. Low-dose prednisone therapy for patients with early active rheumatoid arthritis: clinical efficacy, disease-modifying properties, and side effects: a randomized, double-blind, placebo-controlled clinical trial. Ann Intern Med. 2002 Jan 1;136(1):1-12. doi: 10.7326/0003-4819-136-1-200201010-00006. PMID: 11777359.Nicolau J, Lequerré T, Bacquet H, Vittecoq O. Rheumatoid arthritis, insulin resistance, and diabetes. Joint Bone Spine. 2017 Jul;84(4):411-416.Fernandes L, Hagen KB, Bijlsma JWJ et al. (2019). EULAR recommendations for non-pharmacological core management of hip and knee osteoarthritis. Annals of Rheumatic Diseases, 79(6), 715-722.Royalty-free music used for this episode: "Driving the Point." Downloaded on July 29, 2023, from https://www.videvo.net/ 

4.05 Scleroderma Rheumatology review for the USMLE Step 1 exam Scleroderma is a chronic autoimmune connective tissue disease that causes thickening and hardening of the skin, as well as fibrosis (excess deposition of collagen and other ECM proteins) throughout the body. Autoreactive immune cells activate endothelial cells, which produce large amounts of endothelin 1, leading to overactivation of fibroblasts that overexpress collagen. It typically affects younger women (35-50 years old) with a F:M ratio of 5:1. There are two distinct forms of scleroderma: diffuse (systemic) and limited, each associated with unique antibodies and clinical presentations. Diffuse scleroderma involves the skin and internal organs and is rapidly progressive. Skin tightens especially in the fingers, and internal organs including the lungs, kidneys, GI system, and heart can be affected. It is associated with anti-Scl-70 antibody and anti-RNA III polymerase. Limited scleroderma tends to only affect the skin, characterized by the mnemonic CREST: Calcinosis cutis, Raynaud phenomenon, Esophageal dysmotility, Sclerodactyly, and Telangiectasia. It is associated with anti-Centromere antibody. Treatment involves NSAIDs and DMARDs for musculoskeletal pain, H2 blockers or PPIs for esophageal reflux, and Ace inhibitors for scleroderma renal crisis. There is no cure for the disease.

Join Prof Iain McInnes as he reviews two interesting papers that help to broaden our understanding and knowledge on the safety of biologic and targeted synthetic DMARDs. In the first of today's papers, Matthew Baker and colleagues determine the risk of developing interstitial lung disease (ILD) in patients with RA, undergoing treatment with different biologic and targeted synthetic DMARDs. In the second paper, Lars Kristensen and team analyse data from ORAL Surveillance to help identify subpopulations with different relative risk (i.e., 'high-risk' and 'low-risk') with tofacitinib versus TNFi. To access detailed summary slides of the papers discussed today, visit cytokinesignalling.com.

Cheryl C. and Cheryl K. share key tools for thriving with arthritis, like finding ways to ask for help, developing health literacy, practicing self-compassion, and getting support. They also discuss the safety of modern medicine and how to balance it with complementary therapies to create an individualized plan for managing rheumatoid arthritis.  Additionally, they delve into the mental health techniques that have helped them cope, including: reframing exercises, and working past bias. Cheryl K. shared how she used her experiences to form Arthritis Consumer Experts, a patient-led and science-based organization with the goal of providing better education to people with arthritis.Episode at a glance:Navigating chronic illness when the internet was just starting: Cheryl Koehn had an athletic background, but when symptoms struck she went to the library to do her own research and advocated for herself despite medical gaslighting.Trialing treatment options: Cheryl K. initially denied Western Medicine before she ended up with 36 active swollen joints within a year and progressively worsening quality of life. Following this, she received gold injections and other conventional DMARDs initially, adding in Methotrexate and later transitioning to newer medications like biologics as they became available.Coping with peer pressure: People trying to convince her that “natural is better” and to avoid medications, however natural isn't inherently better at controlling disease and newer medications are backed by research. Cheryl C. and Cheryl K. discuss how a balance of complementary therapies and medication help people safely manage their conditions. Koen practices reframing exercises, works on explicit and implicit bias, and considers “what can I learn from this person today” with an open mind.Wisdom for newly diagnosed patients: Find ways to ask for help! Develop health literacy as a tool for advocating for yourself and to guide decision making.What does it mean to thrive with rheumatic disease: Practice self-love and self-compassion, love what you do, and give yourself room to breathe.Arthritis Consumer Experts (ACE): Cheryl K. used her experiences of running her own consulting firm, volunteering, and being on the board at the Arthritis Society to form this organization. Her goal is to provide better education to people with arthritis, and to not be the only person with arthritis with a say in arthritis organizations.Medical disclaimer:All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.Episode SponsorsRheum to THRIVE, an online course and support program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. See all the details and join the program or waitlist now!For Full Episode Details Including Transcript:Go to the Arthritis Life website

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This week's episode features Naomi Abrahams, a PhD student at the University of Ottawa, who lives with Juvenile Idiopathic Arthritis. The episode starts off by Naomi talking about how life felt like when being misdiagnosed for 3 years. She brings Natasha along her journey to when her symptoms started with joint swelling and pain in her hips that then moved to her elbows. Eventually, she wasn't able to brush her teeth or eat food without pain. Her world changed and she had frequent visits to the dentist and had tons of MRIs. This led her to finally figure out her personal medication and treatment journey. Moreover, Naomi explains how she never experienced pediatric care but was experiencing symptoms when she was 15. On her 18th birthday, she was given her new diagnosis in which she felt as though she was “thrown into the adult world”. Additionally, Natasha and Naomi both discuss the pros and cons of having a rheumatoid factor negative vs positive one. They also discuss the similarities they had in terms of medications they had been on (DMARDS and biologics). Following that, they continue the conversation by talking about their own physiotherapy pathway, specifically what it's like to do physiotherapy in a flare up and the financial aspects of getting billed through insurance. They discuss the MRI vs infusion fatigue, moving out to university with arthritis, and hair loss/growth with medications. Then, they get into the fun stuff like how Naomi told her boyfriend that she had arthritis and how he now supports her. Natasha and Naomi discuss how they met each other specifically through the Choice Research Lab, patient engagement in research and how important patient partners are. Last but not least, they end off the episode discussing their experience together at the CBC Ottawa Radio station, filming the CBC documentary and more! CBC documentary and article: https://www.cbc.ca/news/canada/ottawa/juvenile-idiopathic-arthritis-podcast-creator-network-cbc-1.6614184CBC radio segment: https://www.cbc.ca/listen/live-radio/1-100-ottawa-morning/clip/15943512-juvenile-idiopathic-arthritis Check out Naomi's socials: Instagram: @naomiabrahams Check out our socials: Website: https://www.takeapaincheck.com/Instagram: https://www.instagram.com/takeapainch... Twitter: https://twitter.com/takeapaincheck​​​ Tiktok: https://www.tiktok.com/@takeapaincheck Growing Pains, Copyright, 2018, Alessia Cara

Frailty in Vasculitis Dr. Patricia Harkins sits down with Professor Sebastian Sattui to discuss Abstract 0444, Prevalence of Frailty and Associated Factors in Patients with Vasculitis, being presented on Saturday at ACR22 Convergence. Lupus, Sex and STDs Dr. Kathryn Dao discusses abstract 0939 presented at the ACR22 Convergence meeting in Philadelphia, PA. Abstract 0939: Pilot Study: A Novel Method for Cervical Health Monitoring in African American Women with Systemic Lupus Erythematosus (SLE) Using a Self- Sampling Brush to Assess Cervical HPV Infection and Cervical Cytology Much gusto for GUSTO: Efficacy of Tocilizumab Monotherapy for Giant Cell Arteritis Dr. Richard Conway discusses abstract 0470, being presented during Poster Session A on Saturday, November 12, 2022 at the ACR 2022 meeting.  Abstract 0470: Long-term Efficacy of Tocilizumab Monotherapy After Ultra-short Glucocorticoid Administration to Treat Giant Cell Arteritis – One Year Follow-up of the GUSTO Trial NSAIDs and CV risk in Inflammatory Arthritis Dr. Richard Conway discusses abstract 1207, being presented during Poster Session C on Sunday, November 13, 2022 at the ACR 2022 meeting.  Abstract 1207: Risk Factors for Major Cardiovascular Events (MACE) in Inflammatory Arthritis: A Time-dependent Analysis on the Inflammatory Burden, Use of DMARDs, NSAIDs, and Steroid Should You Repeat the ENA Panel? Dr. Kathryn Dao discusses abstract 0725, presented at ACR22 Convergence.  Abstract 0725: Utility of Repeat Extractable Nuclear Antigen Antibody Testing- a Retrospective Audit To Beta Block or Not in GCA and Large Vessel Vasculitis Dr. Patricia Harkins discusses abstract 0477 presented on Saturday, November 12, 2022, at ACR22 Convergence. Abstract 0477: Can Beta-blockers Prevent Aortic Dilation in Patients with Giant Cell Arteritis and Large Vessel Vasculitis? A Novel Treatment Response Measurement Tool for Lupus Dr. Kathryn Dao discusses abstract 2054 with Dr. Eric Morand at the ACR22 Convergence meeting. Abstract 2054: Towards a Novel Clinician-Reported Outcome Measure for SLE – Outcomes of an International Consensus Process Sarilumab in Polymyalgia Rheumatica: Results from Phase 3 Trial Dr. Michael Putman interviews Dr. Robert Speira about abstract 1676 presented at the ACR22 Convergence meeting in Philadelphia, PA.  Abstract 1676: Sarilumab in Patients with Relapsing Polymyalgia Rheumatica: A Phase 3, Multicenter, Randomized, Double Blind, Placebo Controlled Trial (SAPHYR) Welcome to ACR 2022 Dr. Jack Cush, Executive Editor of RheumNow, welcomes you to Philadelphia for ACR22 Convergence! 2022 ACR/EULAR Classification Criteria for GCA Dr. Michael Putman discusses interesting take-home messages from the Vasculitis Investigators Meeting at ACR22 Convergence regarding the 2022 ACR/EULAR Classification Criteria for GCA. Gender in AxSpa Dr. Peter Nash, Philadelphia Do Disease Activity Measures Really Capture AS in Women? Dr. Rachel Tate interviews Dr. Sinead Mcguire about Abstract 0406, presented at ACR22 Convergence in Philadelphia, PA. Abstract 0406: https://acrabstracts.org/abstract/are-the-basdai-basfi-capturing-the-full-impact-of-disease-activity-on-quality-of-life-in-women-with-axial-spondyloarthritis/ Dr Aurelie Najm  Opoids and health care utilization in PsA and AS Abstract 402 Poor Medication Adherence in SLE  and How to Improve It Dr. Janet Pope discusses three abstracts presented at the ACR22 Convergence meeting in Philadelphia, PA. 0343: Severe Non-adherence to Hydroxychloroquine Is Associated with Flares, Early Damage, and Mortality in Systemic Lupus Erythematosus: Data from 660 Patients from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort 0115: Facilitators of Immunosuppressive Medication Adherence in Systemic Lupus Erythematosus: A Qualitative Study of Racial Minority Patients, Lupus Providers and Clinic Staff 0063: Implementability of a SLE Medication Adherence Intervention Sputum anti-CCP the new diagnostic test in at-risk RA? Dr. Aurelie Najm discusses abstract 0533 at the ACR22 Convergence meeting in Philadelphia, PA. Abstract 0533: Sputum RA-Associated Autoantibodies Independently Associate with Future Development of Classified RA in an At-Risk Cohort of Individuals with Systemic Anti-CCP Positivity Drs Cush and Fava:  Urinary Biomarkers in Lupus Dr. Jack Cush interviews Dr. Andrea Fava about Abstract 536 at the ACR22 Convergence meeting in Philadelphia, PA. Abstract 0536: Change in Urinary Biomarkers at Three Months Predicts 1-year Treatment Response of Lupus Nephritis Better Than Proteinuria Social Media in Rheumatology Academia Dr. Kathryn Dao, Dallas Jorena Lim, third-year medical student, UTSW, Dallas Abstract 0220 Treatment Choices and Mortality in RA ILd Dr. Julian Segen, Philadephia Dr. Bryant England, Philadephia Dr Tate PsA Cycling or Switching MOAs with Dr  Ogdie Abstracts 1600 and 402. Dr Cassy Sims The Impact of Upacitinib vs  Adalimumab in Psoriatic Arthritis using RAPID Abstract 192. Urinary Biomarkers in Lupus Dr. Jack Cush interviews Dr. Andrea Fava about Abstract 536 at the ACR22 Convergence meeting in Philadelphia, PA. Abstract 0536: Change in Urinary Biomarkers at Three Months Predicts 1-year Treatment Response of Lupus Nephritis Better Than Proteinuria Dr Janet Pope Switching from a JAK Inhibiter Abstract 0274. Dr Yusof Effect of voclosporin in Class 5 lupus nephritis Abstract 0355. Best of PsA Dr. Rachel Tate Drs Yusof and Sexena Breakthrough COVID infection in a lupus cohort during Omicron era Session # 12S119. PsA Cycling or Switching MOAs Dr. Rachel Tate interviews Dr. Alexis Ogdie at ACR22 Convergence in Philadelphia, PA.  Abstract 1600: The Impact of Second-Line Therapeutic on Disease Control After Discontinuation of First Line TNF Inhibitor in Patients with PsA: Analysis from the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry Abstract 402: Opioid Use and Healthcare Utilization in Adults with PsA and AS Urine Proteomics in SLE with Dr. Michelle Petri Dr. Michelle Petri discusses abstract 0536, Change in Urinary Biomarkers at Three Months Predicts 1-year Treatment Response of Lupus Nephritis Better Than Proteinuria, being presented Saturday at ACR22 Convergence.

Episode #2 of a 2-part series. Part 2 is all about how to handle specific scenarios and clinical pearls. We delve into methotrexate optimization, what to do when therapy fails, the safety of JAK inhibitors, pregnancy management in RA, DMARDs and malignancy, palindromic rheumatism, perioperative management, biosimilars and more.

https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.059410?af=RThe Biomarkers say REDUCE-IT was a scamhttps://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2791663NO! Just NO-- stick with the calculator for nowhttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.059038start the SLGT-2 inhibitors early! maybe an early dischargehttps://pubmed.ncbi.nlm.nih.gov/35849407/If we could get the EMR to do it automatically else you cant expect providers tohttps://pubmed.ncbi.nlm.nih.gov/35727595/the head CT for psych stuff can probably be put on holdhttps://eprints.whiterose.ac.uk/180135/continue the disease modifying agents

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about rheumatoid foot, an autoimmune disease that affects the joints. They talk about the development of DMARD medications and how they help control deformities in patients.   “If I was looking at just one joint I would think this is probably osteomyelitis or some type of septic arthritis. But if we are seeing it (no cartilage) uniform across all their joints we know this is most likely rheumatoid arthritis.” -Dr. Raafae Hussain [07:17]   “If your patient is on DMARDs, they are relatively well controlled and they're not dealing with polyarthritis all the time, I would treat them like any other hallux rigidus patient. Give them the option of fusing it or doing an implant. Because this is a progressive problem, you want joint fusion over an implant” -Dr. Damien Dauphinee [22:45]   Top Takeaways: What is rheumatoid foot? Treatment options for rheumatoid arthritis Post-surgery recovery    What You Will Learn: [00:50] Intro [02:00] What is rheumatoid foot  [10:14] Offloading weight from bone sites  [15:17] Treatment options [20:05] DMARDs [23:25] Implants [26:00] Recovery   Resources: Visit our website: https://thepoddoctors.com/ Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

Join Dr Laura Coates, Prof Enrique Soriano, Prof Chris Ritchlin, and Ass Prof Frank Behrens for our first podcast dedicated to the latest publications in PsA! In this edition, our Steering Committee members look at three key papers published in May 2022. The first, from Egeberg et al, looks at drug survival using a large, nationwide cohort study from the DANBIO and DERMBIO registries. The second looks at pooled data from SELECT-PsA-1 and -2 to investigate the safety profile of upadacitinib versus adalimumab in patients with active PsA and IR to biologic/non-biologic DMARDs. And finally, our speakers discuss new data from Merola et al on the effect of secukinumab CV risk factors and inflammatory biomarkers. Everything discussed is available in a more detailed slide format in the publications section at cytokinesignalling.com.

Co-leads Dr Laura Coates (Oxford, UK) and Dr William Tillett (Bath, UK) join us live from our Annual Conference to discuss the new 2022 BSR guideline for the treatment of psoriatic arthritis with biologic and targeted synthetic DMARDs. This episode is hosted by Dr Marwan Bukhari. 

In the first part of this episode, I discuss the website The Faces of Ankylosing Spondylitis. Here is a link to https://thefacesofankylosingspondylitis.com/?blogsub=confirming#subscribe-blog (website). I'm number 158 if you are curious. If you are not part of this wonder page, submit your story. Cookie wants to get to 2700 people on the site, but I bet we can get her way past this. In this episode, I review an article about Conventional DMARDS vs Biologic DMARDS for AS. Here is the link to the https://www.myspondylitisteam.com/resources/conventional-vs-biologic-treatments-for-axial-spondyloarthritis (article). All the below links are affiliate links. If you purchase any of the items, I may earn a small commission. It does not change the price of items. Get paid to take tests. Here is a link to Rare Patient Voice. If you take participate in a study, you can get paid (amount varies). https://rarepatientvoice.com/TheAxialSpondyloarthritisPodcast/ (https://rarepatientvoice.com/TheAxialSpondyloarthritisPodcast/) Here are some links to Amazon showing some of the items I discussed. Uberlube - https://amzn.to/3i604N2 (https://amzn.to/3i604N2) Here is the Bean Bag neck warmer https://amzn.to/3uN6mcg (https://amzn.to/3uN6mcg) Biofreeze - https://amzn.to/33gygBS (https://amzn.to/33gygBS) Cane - https://amzn.to/3uN9fts (https://amzn.to/3uN9fts) Heating Pad - https://amzn.to/3Bjd5vz (https://amzn.to/3Bjd5vz) Weighted Blanket - https://amzn.to/36RCdi7 (https://amzn.to/36RCdi7) Steff Di Pardo's new book - I Am Not Invisible - https://amzn.to/3JpDScA (https://amzn.to/3JpDScA) All My Ankylosing Spondylitis Shit: Pain and Symptom Tracker by Kinsella Love https://amzn.to/34CHhpx (https://amzn.to/34CHhpx)

A quick run through medications that are used to control or reduce inflammation. I review NSAIDs, Corticosteroids, Antigout, and DMARDs. Including the most important points to know about each from a nursing perspective. 

New to RheumNow? Rheumnow.com is a news source dedicated to the field of Rheumatology. It is written by experts in the field, and written for rheumatologists and individuals working in related fields. In this episode, Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com Study of 435 #SLE pts seen during the pandemic. Comparing those seen F2F vs telemedicine, there was no significant difference in SLE disease activity (by SLEDAI-2K) or SLE flare rates or steroid prescribing between visit types https://bit.ly/39wWoQ6 Encouraging DBRPCT of Rituximab in #PMR: 116 screened, 49 enrolled, 47 completed: 23 on RTX vs 24 on PBO. Steroid-free remission at 21 wks seen with 11/23 (48%) RTX pts vs 5/24 (21%) on PBO (p=0·049). Infusion Rxns: 10 RTX vs 3 PBO); 1 SAE (PE) on RTX https://bit.ly/3lSI0rj Pregnancies exposed to ixekizumab (from Eli Lilly Global Safety Database) found 193 pts with psoriasis, PsA, or axSpA who were IXE exposed. Live births reported for 53.8 and 61.1% of known outcomes. No congenital malformations seen. https://t.co/M1rvCH81hT FDA approves Jakafi for chronic GVHD. Ruxolitinib (Jakafi, Incyte), an oral Janus kinase 1/2 inhibitor, previously received approval for treatment of patients aged 12 years or older with steroid-refractory acute GVHD. https://t.co/isItDebNZ8 Retrosp. review of 10–24 yr olds w/ newly Dx #SLE shows 78% given steroid-sparing DMARDs by year 1; Most (69%) given HCQ & fewer (34%) given other immunosuppressants. Adults less likely to recv immDMARDs @1 yr https://t.co/aLi6FXlMd3 Case controlled study shows CPPD pts have no higher risk for MACE. 23,124 CPPD vs 86,629 non-CPPD, w/ ⋗ 250,000 Pt-Yrs FU. CPPD MACE risk not increased (HR 0.98), but there was incr risk of MI, CVA & acute coronary syndr. https://t.co/pgmZBxTg9O Trade names: Generic PFIZER = Comirnaty; MODERNA= Spikevax Moderna; J&J (pending) https://t.co/MM7XiSCczl Prospective study of 77 RA patients in remission -- ⋗ vax w/ BNT162b2 (BioNTech-Pfizer) (w/ temp D/C of DMARDs per ACR) found a vaccine-related flare rate of 7.8% (6 pts) w/ 5/6 flares after 2nd dose (2.6 days), resolved w/in 2 wks https://t.co/YOL3YVS2ne Dr. Calabrese shares his Delta COVID-19 breakthrough story on the blog today. https://t.co/timjB2YPys BMJ Breakthrough infections from UK QResarch database: Among 6.95 million vaccinated, 74.1% recv two vaccine doses, there were 2031 covid-19 deaths & 1929 hosp admissions; ~4.0% deaths & admissions were ⋗14 days after 2nd dose Addendum: COVID deaths increased w/ age, deprivation, male, Indian & Pakistanis. Highest risk w/ Down's syndr (HR 12.7), renal transplant (8.1), sickle cell (7.7), Nursing home (4.1), chemotherapy (4.3), HIV/AIDS (3.3), liver cirrhosis (3), CNS dz (2.6) Addendum: Other conditions w/ a 1.2-2 fold higher risk of COVID death (admission) were CKD, hematologic cancer, epilepsy, COPD, CVD, stroke, atrial fibrillation, CHF, thromboembolism, PVD, type 2 diabetes. https://t.co/bbDsb1zLhX Claims case-controlled study shows statin use does not increase the risk of #RA - 32,726 RA and matched controls ; statin use (34 vs 32%) slightly increased RA risk (OR 1.12, 1.06–1.18), but signif lost after correcting for hyperlipidemia https://t.co/EcTlyE1MPx High Comorbidity Rates with Inclusion Body Myositis Guselkumab Treats Axial Disease in Psoriatic Arthritis 11 Drugs That Cause Arthritis https://rheumnow.com/news/11-drugs-ca... Viewer Question – A positive anti ds DNA in the absence of clinical evidence of lupus? CONNECT WITH RheumNow ✩ Website - https://rheumnow.com/ ✩ Subscribe @ RheumNow: https://rheumnow.com/user/register ✩ LinkedIn - https://www.linkedin.com/in/john-cush... ✩ RheumNow LinkedIn: https://www.linkedin.com/company/rheu... ✩ Twitter - https://twitter.com/RheumNow Listen | PODCAST Apple Podcasts: https://podcasts.apple.com/us/podcast... Spotify: https://open.spotify.com/show/4Mjzj5j... Stitcher: https://www.stitcher.com/show/the-rhe... TuneIn: https://tunein.com/podcasts/Health--W... Podbean: https://rheumnow.podbean.com/ Got a Rheumatology question or case for Dr. Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. BackTalk:https://rheumnow.com/submit-podcast-question-or-comment

New to RheumNow? Rheumnow.com is a news source dedicated to the field of Rheumatology. It is written by experts in the field, and written for rheumatologists and individuals working in related fields. In this episode, Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com Metanalysis of JAK inhibition (tofacitinib & ruxolitinib) in alopecia areata - 12 studies, 346 Pts, Rx success (using SALT50 resp) was 66%, not influenced by age, sex, subtype. Alopecia recurrence seen w/in 3 mos of JAK D/C (in74%) https://t.co/CBSy4Kci80 Population study shows risk of H. Zoster in adults to be high among bDMARD and CTX, also increased w/ AZA and HCQ but not MTX SSZ or LEF users. Data from 254065, 1,826311 Pt-Yrs F/U, 6295 new DMARD users, 17024 incident HZ https://t.co/1TeOAWN9LB MMWR reports that during the COVID Delta variant era, Vaccination against COVID-19: - Reduces risk of COVID-19 infection 5X - Reduces risk of COVID-19 Hospitalization ⋗10X - Reduces risk of COVID-19 DEATH 10X https://t.co/rMRY84xX5F Study of 265 students w/ a positive COVID-19 test looked at 378 close contacts. Infx rates w both persons masked -7.7%, but when unmasked-32.4% (aORs = 4.9) https://t.co/fYdH33JbWR Effect of Diet on COVID Outcomes Probenecid, an OAT3 inhibitor, has inhibitory effects on RNA viruses (influenza, RSV) & decreases ACE2 expression. May have utility in COVID-19 as it was shown to inhibit SARS-CoV-2 replication in animal modelshttps://t.co/MClSjpqpSa Mease and colleagues have catalogued the current practices assessed in the CORRONA registry, noting that increased DMARD switching and decreased time on a given therapy by US physicians. https://t.co/cIWZw6KsuI A retrospective study of systemic sclerosis patients shows that acute hospitalization and mortality were not uncommon and were often linked to SSc-related lung disease. #RheumNow https://t.co/s5wSlndTrt Cases and Questions (AKA Back Talk) “What treatment do you use after 2 years of teraparitide in a woman with a hx of OP, spiral fracture while on a bisphosphonate”? Forteo PI. “Do you have any inside info on the vaccines for COVID-19 during pregnancy?” OCOG Statement “Status of the Tocilizumab Shortage”? Genentech Statement “How would you treat polyarthritis in a renal transplant patient?” CONNECT WITH RheumNow ✩ Website - https://rheumnow.com/ ✩ Subscribe @ RheumNow: https://rheumnow.com/user/register ✩ LinkedIn - https://www.linkedin.com/in/john-cush... ✩ RheumNow LinkedIn: https://www.linkedin.com/company/rheu... ✩ Twitter - https://twitter.com/RheumNow Listen | PODCAST Apple Podcasts: https://podcasts.apple.com/us/podcast... Spotify: https://open.spotify.com/show/4Mjzj5j... Stitcher: https://www.stitcher.com/show/the-rhe... TuneIn: https://tunein.com/podcasts/Health--W... Podbean: https://rheumnow.podbean.com/ Got a Rheumatology question or case for Dr. Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. BackTalk:

Prof van Laar and Dr James Galloway, King's College London, UK, talk about the BSR guideline for the prescription and monitoring of non-biologic DMARDs. Dr Galloway explains the need for this update of existing guidelines due development of new drugs and previous treatments no longer being used. He highlights the headline changes from the previous guideline and discusses one of the more controversial recommendations made.

Prof van Laar and Dr James Galloway, King's College London, UK, talk about the BSR guideline for the prescription and monitoring of non-biologic DMARDs. Dr Galloway explains the need for this update of existing guidelines due development of new drugs and previous treatments no longer being used. He highlights the headline changes from the previous guideline and discusses one of the more controversial recommendations made.

Dr James Galloway and Dr Samantha Hider, Keele University, UK discuss a paper by Polina Putrik et al. which looked at access to DMARDs. They discuss the findings of the paper which demonstrated that older patients with low levels of education have less access to DMARDs. They also explore the possible implications of these findings on the daily practice of rheumatologists and the importance of looking at health literacy of patients in practice.

Dr James Galloway and Dr Samantha Hider, Keele University, UK discuss a paper by Polina Putrik et al. which looked at access to DMARDs. They discuss the findings of the paper which demonstrated that older patients with low levels of education have less access to DMARDs. They also explore the possible implications of these findings on the daily practice of rheumatologists and the importance of looking at health literacy of patients in practice.