Questions discussed in this category
The patient was diagnosed on the basis of ANA 1:1,280, strongly positive Smith, Sm-RNP, dsDNA, pericarditis, inflammatory arthritis, and discoid lupus...
Are you aware of any data regarding relative risk of molluscum contagiosum infection in reference to DMARDs/biologics?
SLE manifestations include arthralgias and cytopenias which are stable. Previously did well on methotrexate, but developed GI side effects. HCQ is on ...
Would you view this as a sign that disease is not adequately controlled despite labs and imaging suggesting no active vasculitis?
Patient has had previous failure of methotrexate. Would you switch to alternative (TNFi or Rituximab) or continue abatacept with regular dermatology...
The patient has ongoing inflammatory arthritis despite methotrexate, apremilast, and jak inhibitor trials.
Would you be comfortable combining a TNFi with Rituxan in this patient?
Do you taper one DMARD as you uptitrate another versus do you stop the first DMARD and quickly uptitrate another one?
I have a patient with recently diagnosed primary biliary cholangitis/cirrhosis (PBC) with SSc. Her laboratory values are within normal limits, but end...
When do you switch to steroid-sparing medications? What steroid-sparing therapies do you prefer?
Given the lack of efficacy of most treatment options, do you generally try to treat calcinosis cutis that is not bothering the patient even if it is q...
In which situations or patient populations do you find this useful? How is it sterilized?
The patient is a young African American female of reproductive age with positive Fibrillarin antibody and nucleolar antibody. No ILD.
What side effects do you highlight in conversation with them? How do you approach toxicity monitoring?
Relatively newly diagnosed RNA Pol 3+ dcSSc with rapidly progressive skin involvement now on methotrexate 20mg/week and tocilizumab for concurrent inf...
If so, what dose-fractionation do you utilize? What other factors do you take into consideration?
Is a BM biopsy a must when there is skin involvement?
If tryptase level is mildly elevated but less than 20 would you recommend a BM biopsy?
Do you frequently order liver biopsies for these patients?This question is part of a collaboration with RheumMadness and is specifically in reference ...
Will you still favor starting with steroids and traditional immunosuppressive agents, move IVIG earlier in your treatment strategy, or start with IVIG...
How has this impacted your counseling and management?
This question is part of a collaboration with RheumMadness and is in reference to Pathogenic ANCA (RAVE Trial).
How should IVIG and either biologic injections or infusions be spaced?
(Refractory to mycophenolate, azathioprine, and methotrexate. UpToDate suggests thalidomide or IVIG with mixed efficacy, while there are some case rep...
And if so, what is your approach to the diagnosis?
Do you do blood work? Or do you rely on review of systems?
Do you typically start the patient on hydroxychloroquine?
What work-up do you perform?
In what cases do you discontinue the medication?
Do you attempt to taper fully or maintain at a low dose?
Are there ways to overcome barriers in insurance coverage of this combination of treatments?
Several speakers at ACR 2021 commented on the important role of drug levels in the management of these patients and cautioned against adding medicatio...
Have you tried hyaluronidase?
4 cutaneous biopsies with no evidence of vasculitis. Sjogren’s diagnosis based prominent sicca symptoms and a significantly elevated SSA.
For example, in the setting of cirrhosis incidentally found on imaging.
Are there any medications that surgeons like discontinued before their procedure?
When would you de-escalate therapy?
Any indications for triple therapy in the patients with subclinical ILD associated with MDA-5 dermatomyositis?
Does your evaluation hinge on nonresolution with warming? How extensive is your workup?
Other than inflammatory markers and following symptoms/exam, do you need any other specific monitoring for progression to systemic disease?
Do you obtain vascular imaging routinely in these cases, and if so, do you use cross-sectional or invasive angiography?
In other words, do we think of TNFi induced lupus and TNFi induced psoriasis as a drug effect or a class effect?
Would you change rituximab maintenance dose or schedule?
Specifically: starting dose, rapidity of up-titration, frequency of lab monitoring, frequency of office visits, and timing of assessment for treatment...
Muscle disease is quiescent and no other manifestations such as ILD
In the ADVOCATE trial, patients were not re-dosed with rituximab.
E.g., MPO vs PR3, newly diagnosed vs relapsed, renal involvement. Acknowledge that the ADVOCATE study was not powered to detect these differences, but...
What if the patient has MGUS?
Do patients with type 1 cryoglobulins need a bone marrow biopsy as part of the work up?
If so, are there specific patient populations for which you would use this metric?
If you use both, how do you decide which to use for a particular patient?
This question is part of a collaboration with RheumMadness and is specifically in reference to: ADIRA Diet
22244191031967219277212122187621884214112146219512212472124421181206521938720876207742092094952077316879205442014020429176891682618615196932005873139098138421917113428190021680311657169001618917909178041492481171043284731574114545181371680212070175741812816925153211533517686151081043873191664717084165471639113892144831153516101113201409415206127301501113752994714664142531334314136140871374413423132731348813648117961362911697132371300012978129221292512471126911241612453100621224112125121301166911201919610974104691027510267102181008395309422953195299417942191699348804086219010890388318886873985428686865084858524731484778355828281187317815173278071808379317967796678867816782673227737
Papers discussed in this category
N Engl J Med, 2020 Feb 13
The New England journal of medicine, 2010-07-15
Medicine (Baltimore),
The New England journal of medicine, 2010-07-15
,
, 2016 Aug 30
N Engl J Med, 2022 Oct 06
J. Am. Coll. Cardiol.,
Arthritis and rheumatism, 1982-11
Arthritis and rheumatism, 2012-08
, 2019 Aug 06
Arthritis Rheum.,
Ann. Rheum. Dis., 2018 Apr 25
Ann. Rheum. Dis., 2017 May 25
Ann. Rheum. Dis., 2018 May 03
Medicine, 1976-05
Arthritis and rheumatism, 2010-01
J. Rheumatol., 2019 Sep 01
Annals of the rheumatic diseases, 2009-03
JAMA ophthalmology, 2014-12
Can J Ophthalmol,
J Am Acad Dermatol, 2016 Feb 03
JAMA network open, 2018-11-02
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2008-10
Clin Rheumatol, 2006 Dec 21
Rheumatol Int, 2020 Sep 18
Arthritis Rheumatol, 2016 Jan
Kidney international reports, 2018-03
Rheumatology (Oxford),
Journal of psoriasis and psoriatic arthritis, 2019-04
Front Pharmacol, 2019 Mar 26
Nat Rev Dis Primers, 2018 Aug 02
N Engl J Med, 2021 Feb 18
British journal of cancer, 2023 Feb 04
Int J Clin Pract, 2021 Mar 24
Mod Rheumatol, 2021 Feb 09
Heart Rhythm, 2020 Jun 28
Arthritis care & research, 2018-03
J Clin Rheumatol, 2020 Sep 18
Cureus, 2020 Aug 02
Ann Intern Med,
Ann Rheum Dis, 2011 Nov 29
Respir Med, 2012 Apr 09
Am J Respir Crit Care Med,
Autoimmunity reviews, 2009-02
Arthritis and rheumatism, 2013-07
Arthritis Rheumatol, 2021 Mar 24
Rev Med Interne, 2016 Oct 13
Arthritis Care Res (Hoboken), 2021 Mar 30
JAMA Dermatol,
Mod Rheumatol, 2020 Sep 17
Ann Rheum Dis, 2014 Feb 13
Ann Rheum Dis, 2019 Jan 04
Ann Rheum Dis, 2014 Apr 16
N Engl J Med, 2019 Dec 18
Seminars in arthritis and rheumatism, 2010-12
Clin Exp Rheumatol, 2012 Oct 17
Inflamm Bowel Dis,
Am J Clin Dermatol,
Radiographics : a review publication of the Radiological Society of North America, Inc, 2001
International journal of clinical rheumatology, 2010
Lupus science & medicine, 2014
The Journal of rheumatology, 2015-11
Ophthalmology, 2016-06
Lupus science & medicine, 2017
Journal of immunology research, 2017
Lupus science & medicine, 2018
Arthritis care & research, 2019-07
Clin Pharmacol Ther, 2018 Jun
Lupus Sci Med, 2016
Lupus Sci Med, 2016 Feb 01
Lupus Sci Med,
ACR Open Rheumatol, 2020 Oct 12
Arthritis Rheumatol, 2021 May 02
Ann Rheum Dis, 2012 Nov 10
Arthritis Rheum,
Lupus,
Arthritis Rheumatol, 2020 Jan 07
Lupus Sci Med, 2019
Best practice & research. Clinical rheumatology, 2013-06
Dermatol Ther, 2016 Apr 12
The Lancet. Respiratory medicine, 2016-09
J Immunother Cancer,
J Dermatol,
N Engl J Med,
Minerva Gastroenterol Dietol, 2016 Sep 07
Free Radic Biol Med,
Eur J Dermatol,
Rheum Dis Clin North Am, 2020 Aug
Rheumatology (Oxford),
The British journal of dermatology, 2019-11
Frontiers in immunology, 2019
J Am Acad Dermatol, 2020 Sep 04
Rheumatology (Oxford),
Case reports in rheumatology, 2017
J Immunother Cancer,
Am J Clin Dermatol,
Arthritis care & research, 2014-08
Intern Med J, 2022 Mar 16
Support Care Cancer, 2019 Dec 13
Eur J Dermatol,
Journal of the American Academy of Dermatology, 2011-05
Lupus, 2016 May 27
Clin Exp Rheumatol, 2013 Aug 02
J Rheumatol, 2022 Aug 01
Clinical pharmacokinetics, 2018-12
Frontiers in immunology, 2018
Clinical immunology (Orlando, Fla.), 2020 Jul 15
The Pediatric infectious disease journal, 2018 Oct
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2017 Nov 03
The Journal of rheumatology, 2012-01
JAAD Case Rep, 2019 Oct 10
Arthritis Care Res (Hoboken), 2022 Aug 04
JAMA dermatology, 2018-10-01
Archives of dermatology, 2002 Sep
Ann Acad Med Singap, 2012 Sep
Lupus, 2017 May 08
Arthritis care & research, 2018-10
Breast Care (Basel), 2019 Aug 16
Current rheumatology reviews, 2019
Am J Clin Dermatol, 2022 Jun 23
Ann Afr Med, 2020 Jul-Sep
Arch Dermatol, 2006 Mar
Clin Rev Allergy Immunol, 2010 Apr
Lupus, 2020 Mar 19
The New England journal of medicine, 1993-12-30
Clinical rheumatology, 1988 Sep
Journal of the American Academy of Dermatology, 1987 Apr
Journal of the American Academy of Dermatology, 2020 May 19
J Rheumatol, 2022 May 15
Clinical and experimental dermatology, 2021 Mar 09
JAAD case reports, 2019 Mar 01
Dermatologic therapy, 2020 May 03
The Journal of allergy and clinical immunology, 2012 Feb 14
Lupus, 2019-05
Journal of the American Academy of Dermatology, 2020 Apr 28
The British journal of dermatology, 2003 Jul
Annals of the rheumatic diseases, 2018-09
Arthritis & rheumatology (Hoboken, N.J.), 2019-02
RMD open, 2020 Feb
Trials, 2022 Sep 05
Arthritis & rheumatology (Hoboken, N.J.), 2023 Jul 24
Annals of the rheumatic diseases, 2024 Mar 18
Ann Rheum Dis, 2020 Dec 17
Arthritis care & research, 2016 Jan
Lupus, 2014 Feb 06
Annals of the rheumatic diseases, 2023 Oct 12
Journal of the American Academy of Dermatology, 2015 Jan 30
Journal of the European Academy of Dermatology and Venereology : JEADV, 2016 Dec 20
Arthritis care & research, 2023 Nov 28
Autoimmunity reviews, 2023 Dec 20
Cancer cell, 2022 May 09
Antibiotics (Basel, Switzerland), 2023 May 29
Clinical kidney journal, 2016 Nov 10
Expert review of anticancer therapy, 2009-01
Lancet Gastroenterol Hepatol, 2023 Feb 01
JAMA internal medicine, 2017 Nov 01
Annals of the rheumatic diseases, 2024 Jan 11