Gastroenterology

General Rheumatology

Questions discussed in this category

In an infant whose mother resumes TNF inhibitor therapy (e.g., adalimumab, infliximab, certolizumab) after delivery and is breastfeeding, do you recommend delaying live vaccinations?

Does the answer differ if mother remained on TNFi throughout pregnancy?

1 Answer available

What is your approach to explaining the role of the microbiome to patients with inflammatory arthritis?

Patients often ask questions regarding role of diet and gut health in relation to their arthritis or have had gut microbiome analysis testing

1 Answer available

How do you decide when to use acid-suppressive medications for GI prophylaxis when patients are on prolonged corticosteroid therapy?

Do you prescribe it universally or based on specific risk factors?

2 Answers available

How would you approach diagnosis of a patient with recurrent episodes of abdominal pain, severe myalgias, low grade fevers and urticaria?

Does this presentation fall within the autoinflammatory spectrum, and is it consistent with FMF or would you consider another cytokine-driven process?...

5 Answers available

What is the role of inebilizumab in the maintenance treatment of IgG4-related disease?

Are there situations when you would choose it over Rituximab?

1 Answer available

What are your vaccine recommendations while patients are on biologics?

2 Answers available

How do you approach a patient on anti-TNF with positive Quantiferon (previously negative) with negative chest x-ray and no symptoms?

11 Answers available

How do you approach managing nausea and GI side effects when initiating methotrexate?

5 Answers available

How do you counsel patients who experience diarrhea from mycophenolate mofetil (Cellcept)?

Do you generally recommend anti-diarrheals, dietary modifications, or consider this an unacceptable side effect and move to other therapies?

2 Answers available

Is there a role for the use of transient elastography (FibroScan) to monitor liver fibrosis in patients on long term methotrexate?

3 Answers available

Is there a risk of hepatitis C activation with rituximab in a patient who has a history of HCV treated with antivirals and who is in sustained viral response?

1 Answer available

How do you monitor patients with incidentally found high titer anti-smooth muscle antibodies without stigmata of liver disease?

3 Answers available

How do you approach ongoing screening for TB in patients with a history of treated latent TB, but who have ongoing use of DMARDs and/or biologics given Quantiferon testing and PPD can remain positive?

How do you approach ongoing screening for TB in patients with history of treated latent TB, but have ongoing use of DMARDs and/or biologics given quan...

1 Answer available

What is your approach to working up diarrhea in an immunocompromised patient?

1 Answer available

Do you have concerns with the use of oral contraceptives in patients on JAK inhibitors given the black box warning for thromboembolic events?

How has this impacted your counseling and management?

2 Answers available

How do you approach GI prophylaxis (e.g., PPIs, H2 blockers) in patients on long-term NSAIDs?

1 Answer available

Do you consider anti-viral prophylaxis in patients taking JAK inhibitors who have recurrent uncomplicated Zoster infection, but would prefer not changing therapy?

2 Answers available

Does hepatitis B vaccination reduce the risk of HBV reactivation associated with immunosuppressive therapy?

For example, in patients who are HbSAg negative, anti-HBc positive and HbSAb negative, does vaccination reduce reactivation risk?

2 Answers available

Do you have a preference between Quantiferon Gold and T-spot TB for screening in patients starting immunosuppressive agents?

1 Answer available

Do you stop TNF inhibitors during the third trimester of pregnancy?

2 Answers available

What is your approach to continuing or altering therapy when inheriting a patient with combined biologic immunosuppression that is in excess of guidelines?

How do you approach de-escalation or justify therapy maintenance? Do you have tiers of medications that you attempt to de-escalate first? In one parti...

1 Answer available

What is your approach to management of elevated liver enzymes in patients who recently started treatment with tocilizumab?

1 Answer available

How do you approach management of patients with active RA and recurrent non-severe C.diff?

(Patient with active RA despite hydroxychloroquine)

1 Answer available

Would you be comfortable using a JAK inhibitor in a patient with baseline thrombocytosis?

Would the etiology of the thrombocytosis play a role in your decision-making?

1 Answer available

How do you counsel patients about the malignancy risk associated with azathioprine?

1 Answer available

Do you discontinue or adjust azathioprine when a patient develops elevated MCV after starting it?