Infectious Disease

Rheumatoid Arthritis

Questions discussed in this category

Do you continue PJP prophylaxis indefinitely in patients on rituximab maintenance therapy?

Does your approach differ based on the underlying condition - such as ANCA-associated vasculitis, rheumatoid arthritis, or another autoimmune disease?

2 Answers available

Is it ever safe to use a biologic DMARD in a patient with RA who is on suppressive antibiotics due to a history of septic prosthetic arthritis?

2 Answers available

How would you manage a patient with progressive/refractory molluscum contagiosum who is well controlled on methotrexate for seropositive rheumatoid arthritis?

Are you aware of any data regarding relative risk of molluscum contagiosum infection in reference to DMARDs/biologics?

1 Answer available

How do you approach restarting cDMARDS/bDMARDS in a patient with active RA after incidence of disseminated CNS VZV infection while on tofacitinib?

1 Answer available

Do you typically adjust or hold immunosuppression in a well-controlled RA patient who is being treated for Mycobacterium avium-intracellulare (MAI)?

1 Answer available

How do you manage a patient with severe RA or SLE that worsens after stopping immunosuppressants due to having chronic foot ulceration?

2 Answers available

How do you approach immunosuppression in patients with a positive Interferon Gamma Release Assay and prior intravesicular BCG treatment for bladder cancer?

Assuming no symptoms of TB, should patients be treated for latent TB prior to starting TNF inhibitors or other immunosuppressive agents?

1 Answer available

How would you approach the use of JAK inhibitors in a patient with stable RA who is now starting treatment for pulmonary MAC infection?

Patient previously failed abatacept and Rituximab.

1 Answer available

How do you approach treatment of RA with methotrexate in a patient with treated Hepatitis C and normal liver function?

1 Answer available

How do you approach DMARD therapy in patients with rheumatoid arthritis and chronic hepatitis B?

Hepatitis screening labs revealing Hep B ag and core positivity with positive PCR

2 Answers available

How long would you treat with antimycobacterials before starting biologic DMARD in a patient with latent TB and active rheumatoid arthritis?

1 Answer available

How would you manage an active rheumatoid arthritis patient on suppressive antibiotic therapy for ocular HSV who has abnormal liver function tests?

1 Answer available

How would you recommend dosing the MMR or other live vaccines for patients with rheumatoid arthritis on immunosuppressive medications such as DMARDs and anti-TNF alpha therapy?

For example, healthcare workers who require these vaccines for employment

1 Answer available

How do you treat RA in patients with pulmonary mycobacterium avium complex (MAC) infections?

1 Answer available

Are there particular concerns related to the use of B-cell depletion therapies such as rituximab for rheumatic disease during the COVID-19 pandemic?

1 Answer available

How would you manage methotrexate therapy in an active rheumatoid arthritis patient undergoing treatment for latent TB with rifampin?

Do you stop methotrexate or adjust the dose?

1 Answer available

How does a history of splenectomy alter how you counsel patients on the infection risk of TNF inhibitors or other biologics?

1 Answer available

Are you recommending the mRNA COVID-19 vaccines to your patients with immune mediated inflammatory diseases?

5 Answers available

Should tuberculosis screening be performed before beginning methotrexate for treatment of rheumatoid arthritis?

1 Answer available

What is your approach to dental prophylaxis for patients on biologics?

1 Answer available

How do you manage patients who are Hepatitis B core antibody positive/surface antigen negative and starting a biologic DMARD (other than rituximab)?

1 Answer available

Papers discussed in this category

Arthritis Rheumatol, 2016 Jan

2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.

Arthritis care & research, 2012-05

2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis.

Rheumatol Int, 2020 Sep 18

High rates of severe disease and death due to SARS-CoV-2 infection in rheumatic disease patients treated with rituximab: a descriptive study.

N Engl J Med,

Clinical practice. Care of the asplenic patient.

Mediterr J Rheumatol, 2020 Jun 11

Infections in Patients with Rheumatoid Arthritis in the Era of Targeted Synthetic Therapies.

Ann Rheum Dis, 2019 Aug 14

2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases.

Arthritis Rheum,

Tuberculosis associated with therapy against tumor necrosis factor alpha.

Arthritis Care Res (Hoboken), 2021 Jul

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.

Clin Liver Dis (Hoboken), 2018 Aug 22

Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance.

Medicine, 2014 Oct

Intravenous immunoglobulin in the therapeutic armamentarium of systemic lupus erythematosus: a systematic review and meta-analysis.

Annals of the rheumatic diseases, 2018-05

Pneumocystis and glucocorticoid use: to prophylax or not to prophylax (and when?); that is the question.

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