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When do you recommend initiation of targeted therapies in active RA with history of malignancy?

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Mednet MemberInvited Expert
Rheumatology · Northwestern University Feinberg School of Medicine

In patient with RA and a history of malignancy, I generally recommend the same therapy that I would recommend in the absence of a malignancy history. This is consistent with the most recent ACR guidelines for the management of RA (Fraenkel et al., PMID 34101387). Consistent with FDA labeling, I'd ge...

How would you manage axial spondyloarthritis in a patient who was doing well on TNF inhibitor therapy then developed a new solid organ malignancy while on treatment?

2
1 Answers

Mednet MemberInvited Expert
Rheumatology · Stanford University

The story here is an important one. I was able to discuss this with @Dr. First Last, who supplied important insights. Most of the good (and bad) data supporting what to do when your patient had a prior malignancy in remission or who develops one on treatment comes from experience with treating rheum...

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

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2 Answers

Mednet Member
Rheumatology · Pacific Northwest University of Health Sciences

Patients with hepatitis B core positivity, surface antigen positivity, and positive PCR for viral DNA, should be treated with entecavir prior to starting any DMARD. Given the DNA PCR is positive too, that indicates active viral replication and they may need treatment for a while before starting anyt...