Management of psoriatic arthritis (PsA) can be notoriously complicated due to factors such as heterogeneity of disease manifestations and comorbidity considerations. Despite the emergence of promising new therapies, there remains considerable variation in quality of care from diagnosis through treatment and follow-up management.
Does rheumatoid arthritis (RA) raise the risk of developing type 2 diabetes mellitus (DM)? Previous epidemiologic studies have drawn varying conclusions. Now, a large population-based cohort study bolsters the case that RA in fact is not associated with a heightened risk.
The American College of Rheumatology’s annual Convergence conference, which took place Nov. 5–9, featured significant contributions from Brigham and Women’s Hospital physicians and scientists. The tally included over 120 abstracts: two plenary presentations, 36 oral presentations, one late-breaking poster and 86 poster presentations.
Hydroxychloroquine (HCQ) is a mainstay of therapy for rheumatic diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). However, its use in treating COVID-19 patients in recent months has raised concerns over a possible link to acute cardiac toxicity.
“Who knew that rheumatology patients would be right in the middle of the COVID-19 crisis?”
This question was posed by rheumatologist Karen H. Costenbader, MD, MPH, director of the Brigham and Women’s Hospital Lupus Program and chair of the Medical and Scientific Advisory Council for the Lupus Foundation of America. In these roles, she has found herself at the center of the controversy around the use of hydroxychloroquine (HCQ) and other rheumatology medications in COVID-19. Read More
In the span of just a few months, the COVID-19 pandemic has transformed the practice of rheumatology and the entire field of clinical medicine. Traditional ways of doing things, from seeing patients to leading teaching rounds, have been temporarily or permanently abandoned.
Nevertheless, teaching hospitals must stay true to their mission of educating the next generation of clinicians. And so, many are striving to adapt to this strange new reality. Read More
Cytokine storm syndromes are associated with autoimmune diseases such as systemic juvenile idiopathic arthritis (sJIA), adult onset Still’s disease and systemic lupus erythematosus. Speculation is mounting that they may also play a role in severe cases of COVID-19.
“We don’t know for sure yet if there’s cytokine storm in COVID-19, but it certainly looks that way in some patients,” said Peter A. Nigrovic, MD, director of the Brigham and Women’s Hospital Center for Adults with Pediatric Rheumatic Illness and the principal investigator of a basic science laboratory focused on mechanisms of inflammation. “Based on some of the findings in the blood of the sickest individuals, it may well be that the immune system mediates damage rather than serving to protect the host. We want to be able to recognize those cases where immunosuppression could optimize patient outcomes.” Read More
As of early May 2020, the United States had 1.19 million confirmed coronavirus cases and nearly 70,000 deaths due to COVID-19. In the urgent quest for therapeutic solutions, some have looked to antimalarial medications such as hydroxychloroquine (HCQ).
A recent paper in Annals of the Rheumatic Diseases argues that rheumatologists as well as “researchers and patient partners must advocate for the appropriate distribution and use of HCQ, as millions of people with rheumatic diseases worldwide depend on HCQ to control disease activity and maintain quality of life.” Read More
As the scope of the coronavirus pandemic broadens, it is only natural for people to look to the scientific and research communities for solutions. In recent weeks, however, the thirst for viable treatment options has contributed to drug shortages and misinformation for patients with rheumatic diseases.
Two cases in point involve hydroxychloroquine and ibuprofen. Laura L. Tarter, MD, and Daniel Hal Solomon, MD, MPH, of the Brigham and Women’s Hospital’s Division of Rheumatology, Inflammation and Immunity offer their perspectives on each of these issues, which carry significant implications for rheumatic care during this health crisis. Read More
Rheumatologists have a critical role to play in optimizing the response to COVID-19 and outcomes for our patients with rheumatic diseases. In just the past few weeks, rheumatologists at Brigham and Women’s Hospital and around the world have joined forces for this purpose.
“I’ve been very impressed by how quickly the rheumatology community has come together,” said rheumatologist Susan Y. Ritter, MD, PhD, associate medical director of the Brigham’s Arthritis Center. “I’ve seen multiple people communicating via email, Twitter and Facebook to get the word out to rheumatologists and make sure we have as much data as possible.” Read More