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  1. Small fiber neuropathy, a pain-inducing condition that resembles and overlaps with fibromyalgia, may be significantly under-diagnosed in the U.S., according to a presenter at the 2021 Congress of Clinical Rheumatology-West.
    “The etiology and pathophysiology of fibromyalgia is not completely understood,” Khosro Farhad, MD, assistant professor of neurology at Massachusetts General Hospital, said in his presentation.
    That said, Farhad noted that pain sensitivity in fibromyalgia has been shown to be associated with altered pain processing and modulation in the central nervous system. “There

  2. In the absence of curative or disease-altering therapies, patients with sarcoidosis value interventions that improve their quality of life over those for function or even survival, according to a presenter at the 2021 Congress of Clinical Rheumatology-West.
    Sarcoidosis is characterized by granulomas that develop commonly on the lungs and the skin, according to Robert Baughman, MD, professor of medicine at the University of Cincinnati and professor emeritus at the World Society of Sarcoidosis and other Granulomatous Disorders. While sarcoidosis symptoms generally involve granulomas and

  3. A new report showed that about 15 million Americans who enrolled in Medicaid during the public health emergency could lose coverage when the emergency declaration ends.
    Those at risk for losing coverage include almost 9 million adults and 6 million children, according to the analysis published by the Urban Institute with support from the Robert Wood Johnson Foundation.
    “There is good evidence that Medicaid coverage saves lives and increases families’ financial stability. Becoming uninsured would adversely affect both,” Matthew Buettgens, PhD, a senior fellow in the Health

  4. Avoiding cold and reducing stress are key to minimizing Raynaud’s phenomenon events, while “good, generic wound care” can be effective in even the most complicated cases, according to a presenter at the 2021 Congress of Clinical Rheumatology-West.
    “My first question when a patient comes in and they think they have Raynaud’s is: do you feel sensitive to the cold?” Laura K. Hummers, MD, clinical director of the division of rheumatology at Johns Hopkins University, said in her presentation. “Then I ask if their fingers turn colors in the cold.”
    The

  5. A trio of recent clinical trials showed encouraging results for steroid-sparing strategies in ANCA-associated vasculitis, according to a presenter at the 2021 Congress of Clinical Rheumatology-West.
    “Just to remind you, ANCA-associated vasculitis is an extraordinarily multisystem complex disease,” Peter A. Merkel, MD, MPH, chief of the Division of Rheumatology at the University of Pennsylvania, told attendees. “If you have seen one patient, you have seen one patient. There are all different patterns.”
    It is for this reason, that there continue to be unmet needs in the

  6. Janus kinase inhibitors are associated with numerical, but not statistically significant, risks for adverse cardiovascular events and malignancy, according to a presenter at the 2021 Congress of Clinical Rheumatology-West.
    “When we talk about [JAK inhibitors], you have to remember that they affect multiple cytokines,” Roy M. Fleischmann, MD, clinical professor in the Department of Internal Medicine at the University of Texas Southwestern Medical Center and in private practice at Rheumatology Associates in Dallas, Texas. “When you impact so many cytokines, you could get safety

  7. For some time now, we have been discussing COVID-19 as two epidemics. One is the tragic and unnecessary epidemic among those unwilling to be vaccinated who are pushing our fragile health care system to the limit, unnecessarily spreading the infections throughout the community, including to the most vulnerable. The other is one of breakthrough infections in those who have done what they can to protect themselves by being partially or fully vaccinated.
    I have previously commented that I am among this latter breakthrough epidemic, although I am fortunate that both myself and my wife, who are

  8. Clearly defining treatment targets and communicating those targets to patients is essential to optimizing outcomes in psoriatic arthritis, according to a presenter at the 2021 Congress of Clinical Rheumatology-West.
    “There is a single objective for this talk,” Philip J. Mease, MD, of the Swedish Medical Center and the University of Washington, said in his presentation. “Those of you who are practitioners will come away being able to share a treatment target goal with your patients, and then strive together to reach that goal.”
    Defining treatment targets begins with an

  9. Among 410 leading medical journals, just 21% had a woman as editor in chief, according to findings published in JAMA Network Open.
    “Evidence on the gender gap in academia has been mounting over the past few years, and the gendered impact of COVID-19 may have exacerbated longstanding gender inequalities,” Ana-Catarina Pinho-Gomes, DPhil, an honorary research fellow at The George Institute for Global Health in the U.K., told Healio Primary Care. “These have been highlighted at all stages of the academic ladder and in many fronts, from authorship of papers to editorial boards,

  10. Although patients with neuropsychiatric manifestations of systemic lupus erythematosus can exhibit a diverse range of rare manifestations, these symptoms are not necessarily unique to lupus, according to a presenter here.
    “I don’t think I need to prove to anyone in this room that patients with lupus are diverse,” Joan T. Merrill, MD, director of clinical projects in the Arthritis & Clinical Immunology Program at the Oklahoma Medical Research Foundation, told attendees at the 2021 Congress of Clinical Rheumatology-West. “Even when we are trying to focus on

  11. Having well controlled disease is the first and most important step to a safe pregnancy in patients with lupus, according to a presenter at the 2021 Congress of Clinical Rheumatology-West.
    Megan Clowse, MD, MPH, associate professor of medicine in the Division of Rheumatology and Immunology at Duke University, urged rheumatologists to address reproductive issues at every visit with patients of reproductive age. When these issues are poorly addressed, it can lead to ambivalence. “A lot of women want to get pregnant, but maybe think that they should not get pregnant,” she said. “This

  12. While the 2021 American College of Rheumatology rheumatoid arthritis recommendations improved over the 2015 document, understanding the weaknesses and limitations of the most recent iteration can be beneficial, according to a presenter here.
    Roy M. Fleischmann, MD, clinical professor at the University of Texas Southwestern Medical Center and in private practice at Rheumatology Associates in Dallas, Texas, acknowledged that there were positives to the most recent set of recommendations. One was that the whole format was changed to highlight commonly encountered clinical scenarios. “It was

  13. When addressing symptoms of non-renal lupus, there is often a disconnect between the rheumatologist’s focus on inflammation-related symptoms and the patient’s need to improve fatigue and pain, according to a presenter here.
    “What [rheumatology providers] mean by non-renal lupus is not what our patients mean,” Michelle A. Petri, MD, MPH, director of the Johns Hopkins Lupus Center, told attendees at the 2021 Congress of Clinical Rheumatology-West. “What do you and I mean? We mean the classic signs and symptoms of lupus, the ones related to autoimmunity, that we can

  14. It is likely that one or more “promising treatments” currently being investigated for Sjögren’s syndrome will come into use within the next 3 to 5 years, according to a presenter at the 2021 Congress of Clinical Rheumatology-West.
    “If you go to clinicaltrials.gov, you will find that there are about 25 compounds under investigation, either biologics or small molecules for Sjögren’s,” Fredrick B. Vivino, MD, MS, of Penn Presbyterian Medical Center, in Philadelphia, to attendees at the hybrid meeting. “But among all the things that have recently

  15. The FDA recommended health care providers and individuals avoid using compounded products said to be “sterile, produced and distributed nationwide by Prescription Labs Inc.” that does business as Greenpark Compounding Pharmacy.
    The agency based its recommendation on a lack of “sterility assurance.” It also said inspections of Greenpark Compounding Pharmacy operations raised several concerns, including employees wearing nonsterile gear, producing nonsterile drugs in nonsterile areas and failing to have the airflow and air quality at some of its business locations