Rheumatoid Arthritis   

Questions discussed in this category



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

Patient previously trialed two anti-TNFi and Tocilizumab. Avoiding Rituximab due to positive JC virus testing. 

Patient has had previous failure of methotrexate. Would you switch to alternative (TNFi or Rituximab) or continue abatacept with regular dermatology...

While remission rates after lowering or discontinuing therapy are lower, there is still a population of patients who do not require full-dose therapy ...

Given the drug-drug interaction, do you monitor more closely for methotrexate toxicity, counsel on symptoms of methotrexate toxicity, or avoid the com...

What is your most and least preferred? In case of cancer in remission and in case of non-remission?

Does your choice of DMARD/biologics change due to increased risk of malignancy?

This question is part of a collaboration with RheumMadness and is specifically in reference to: NORD-STAR (Østergaard et al., PMID 3742364...

Do you advocate to taper the TNF-i or simply continue to monitor for long term adverse events? This question is part of a collaboration with Rheu...

Is it different between DMARDs (csDMARDs, biologic DMARDs, and target synthetic DMARDs)?

Would you start with a baseline ultrasound and then pursue further workup such as fibroscan if fatty liver is present, or other?

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

Patient became acutely flushed, developed severe and prolonged hypotension with brief loss of consciousness, dizziness, nausea, dry heaves and headach...

While classically described as seen in seropositive patients, have they been reported in seronegative RA?

Female patient in her 20's with RA/SLE has been on steroids and methotrexate, currently on HCQ and Orencia. Failing Orencia with active disease. Want ...

The patient is on a dose of 22 mg of methotrexate weekly for severe rheumatoid arthritis. If you would discontinue the methotrexate, how long would y...

Data is clear that we should hold methotrexate at least one week after COVID and flu vaccines. How do you approach methotrexate management around Shin...

Would you switch to a non TNFi biologic or continue current regimen with careful monitoring for evolution of lupus manifestations?

This question is part of a collaboration with RheumMadness and is specifically in reference to:BeSt TrialMeasurement of Patient Outcomes in Arthritis

Studies are now being pursued to ability the of implantable bioelectric device stimulation of the vagal nerve to attenuate disease activity in patient...

Given the controversy in the literature regarding TNFi or MTX associated lymphoma in patients with RA.

Continue MTX with monitoring of LFTs vs switching to another oral DMARD (aza, lef) vs GI for fibroscan?

Do you change therapy? If they are also on methotrexate, which medication would you potentially stop first?

Recent articles regarding the use of JAK-Inhibition in RA have suggested to avoid in patients with increased CV risk.  However, RA itself is cons...

For example, would it be appropriate to consider JAK inhibitor therapy as preferable to TNF-alpha inhibitor in patients with heart failure with reduce...

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

How does a diagnosis of active RA inform your treatment approach for patients with breast cancer, if at all? 

Would you change the treatment to rituxan or continue orencia with regular dermatology follow up?

Would you discontinue Methotrexate and TNF inhibitors even if previously no side effects from these medications, and would you consider Cyclophosphami...

Would you use immunosuppression in patients several years after curative treatment for melanoma?

Does Quantiferon gold replace the need for baseline chest x-ray screen? 

Giving "rescue therapy" to patients in the combination group implies that there is room to escalate to the dose at enrollment. 

Withdrawal of methotrexate may lead to more disease flares and lack of recoverability with other TNF inhibitors.

Usual clinical practice is to add TNFi once methotrexate monotherapy has failed. If this is the case in these patients, it would seem to increase the ...

Specifically: starting dose, rapidity of up-titration, frequency of lab monitoring, frequency of office visits, and timing of assessment for treatment...

Reduced requirements for documentation by CMS in 2021 with respect to billing and coding have raised new questions about what aspects of physician exa...

This question is part of our collaboration with ACR Convergence 2024 to Continue the Conversation from the meeeting. This question was inspired by the...

Due to the shortage of rheumatologists, primary care physicians may need to manage some rheumatologic issues.

This question is part of a collaboration with RheumMadness and is specifically in reference to: ADIRA Diet


Papers discussed in this category


Journal of psoriasis and psoriatic arthritis, 2019-04

Arthritis Rheumatol, 2016 Jan

Clin. Rheumatol., 2017 Aug 18

Archives of internal medicine, 2008-09-22

Arthritis and rheumatism, 2010-06

Arthritis care & research, 2012-05

Eur J Rheumatol, 2017 Feb 23

Rev Bras Reumatol Engl Ed, 2016 Mar 16

Arthritis & rheumatology (Hoboken, N.J.), 2016-11

Annals of the rheumatic diseases, 2019-04

Southern medical journal, 2016-11

Annals of the rheumatic diseases, 2011-05

Atherosclerosis, 2015 Aug 28

Clin Rheumatol, 2012 Nov 22

Ann Pharmacother,

Arthritis Care Res (Hoboken), 2016 Jan

JAMA network open, 2018-11-02

Rheumatol Int, 2020 Sep 18

N Engl J Med,

Mediterr J Rheumatol, 2020 Jun 11

J Rheumatol, 2014 Aug 15

Ann Clin Lab Sci,

Pediatr Rheumatol Online J, 2021 Feb 16

Clin Rheumatol, 2020 Mar 23

Ann Rheum Dis, 2019 Aug 14

Arthritis Rheumatol, 2021 Mar 24

Arthritis Rheum,

JAMA Netw Open, 2021 Feb 01

Rheumatology (Oxford),

Arthritis and rheumatism, 1992-08

Arthritis and rheumatism, 1995-12

Arthritis care & research, 2019-11

Arthritis Care Res (Hoboken), 2019 Dec

Int J Rheum Dis, 2020 Sep 10

J Rheumatol, 2015 Jul 15

Lancet,

Arthritis & rheumatology (Hoboken, N.J.), 2016-01

Ann Intern Med, 2020 Sep 22

Ann Rheum Dis, 2021 May 28

RMD Open,

Arthritis Care Res (Hoboken), 2019 Nov 29

Semin Arthritis Rheum, 2008 Dec 31

Ann Intern Med, 2021 Aug 31

Lancet Oncol., 2013-10-01

Arthritis Care Res (Hoboken), 2021 Jul

Clin Liver Dis (Hoboken), 2018 Aug 22

Ann Rheum Dis, 2016 Oct 03

N Engl J Med,

Arthritis Rheumatol, 2021 Mar 24

BMJ Open, 2014 Aug 14

Int J Rheum Dis, 2018 Sep 05

N Engl J Med, 2003 Feb 13

Metabolites, 2022 Nov 05

J Rheumatol, 2022 Mar 15

Semin Arthritis Rheum, 2020 Jul 02

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2019-08

Transpl Int, 2022 Aug 12

Immunity, 2017-06-20

Autonomic neuroscience : basic & clinical, 2008-12-05

Drug Dev Res, 2014 Nov

Thorax, 1985 May

BMJ, 2023 May 30

BMJ, 2023 May 30

Ann Rheum Dis, 2021 Sep 07

Arthritis research & therapy, 2023 Nov 20

Arthritis research & therapy, 2021 Jul 08

Journal for immunotherapy of cancer, 2022 Jan

Clinical rheumatology, 2020 Sep 28

Frontiers in immunology, 2022 Sep 15

Cancer cell, 2022 May 09

Nature communications, 2021 Jun 07

Lancet (London, England), 2023 Feb 24

Lancet (London, England), 2023 Feb 24

The American journal of gastroenterology, 2003 Jun

The Journal of rheumatology, 2015 Jun 15

Medicine, 2014 Oct

Rheumatology (Oxford, England), 2011-12

RMD open, 2022 Nov

British journal of rheumatology, 1992 Nov

Pharmacotherapy, 2002-09

Medicine, 2001 Jul

American journal of respiratory and critical care medicine, 2015 Jul 15

Ann Rheum Dis, 2022 Jan 13

J Immunother Cancer, 2023 Mar

Diagnostics (Basel, Switzerland), 2022 Jul 08

BMC public health, 2008 Jan 21

Rheumatology (Oxford, England), 2021 Nov 03

Arthritis & rheumatology (Hoboken, N.J.), 2017-03

Annals of the rheumatic diseases, 2019 Jul 30

Autoimmunity reviews, 2021 Apr 19

Rheumatology (Oxford, England), 2021 Dec 24

The Lancet. Rheumatology, 2024 Apr 04

Rheumatology (Oxford, England), 2023 Oct 19

JAMA, 2021 May 04

Annals of the rheumatic diseases, 2016 Jul 12

PloS one, 2014

Arthritis care & research, 2017-12

Annals of internal medicine, 2019-06-18

Arthritis care & research, 2022 Jun 19

Clin Rheumatol, 2021 Apr

The Journal of rheumatology, 1997 May

British journal of rheumatology, 1995 May

Annals of the rheumatic diseases, 2016-04

Arthritis research & therapy, 2021 Sep 18

Arthritis and rheumatism, 1988-07

Arthritis and rheumatism, 1993-06

The Journal of rheumatology, 2014 Apr 15

JAMA internal medicine, 2017 Nov 01

Annals of the rheumatic diseases, 2024 Jan 11

Rheumatol Int, 2021 Jan 29