Questions discussed in this category
Have you found dose adjustments to be effective?
Have you tried Vitamin K2? In light of a recent publication: Tan et al., PMID 39466236
X-rays without inflammatory changes. RF >120, CCP >250.This question is part of a collaboration with RheumMadness and is specifically in referen...
This question is part of a collaboration with RheumMadness and is specifically in reference to: Cost Effectiveness of HCQ Screening.
The patient has no extraocular features of a spondyloarthropathy and is on methotrexate. No active eye disease for past 1 year.
Normal Vitamin D, bone scan showed osteoarthritis.
The last SHINGRIX was about 4 years ago and both doses were given.
Patient is asymptomatic and on therapy but has the finding on bone scan. Do we add therapy or change or do nothing and monitor only?
Do you generally feel they work well? Have patients tried using this a few days before an activity, such as skiing? Especially for otherwise healthy, ...
Is there any data to suggest one time-frame is better than the other?
The CDC states give "2024–2025 Dose 2 (Moderna, Novavax or Pfizer-BioNTec...
Does the recommendation change based on the DMARD?
No active joint disease, patient on Hydroxychloroquine and Cimzia. Normal ESR/CRP.
SLE manifestations include arthralgias and cytopenias which are stable. Previously did well on methotrexate, but developed GI side effects. HCQ is on ...
The patient was treated with two doses of Rituximab and on MMF. Now with stable lung function and normalized CK.
Which csDMARD do you taper in order, and is there a tapering strategy (duration/dose)?
Given the drug-drug interaction, do you monitor more closely for methotrexate toxicity, counsel on symptoms of methotrexate toxicity, or avoid the com...
Would it be safe to resume and if so, when?
Do you frequently order liver biopsies for these patients?This question is part of a collaboration with RheumMadness and is specifically in reference ...
This question is part of a collaboration with RheumMadness and is specifically in reference to: Prevention of Autoimmune Disease: Vitamin D and O...
What formulation of topical nitroglycerin do you use?
How do you approach ongoing screening for TB in patients with history of treated latent TB, but have ongoing use of DMARDs and/or biologics given quan...
How has this impacted your counseling and management?
If so, do you routinely recommend use of an additional form of contraception?
How much cumulative prednisone exposure do you tolerate and how many attempts at tapering will you pursue before considering addition of a steroid spa...
This question is part of a collaboration with RheumMadness and is specifically in reference to: Antibodies Before SLE.
After what interval of sustained remission will you attempt to taper, and will you do so by first widening the dosing interval?
Do you universally perform baseline DEXA and Hgb A1C? How often are you obtaining routine labs?
Patient has received treatment with Rituximab and is taking hydroxychloroquine.
For example, patients who have been maintained on 5mg of prednisone for years without previous tapering attempts and the rheumatic disease is not acti...
Patient is on antibiotics for chronic spinal hardware infection.
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...
Such as Leflunomide, Sulfasalazine, Mycophenolate or Azathioprine, since all of these medications have potential to cause liver enzyme elevation and i...
(Patient with active RA despite hydroxychloroquine)
In what cases do you discontinue the medication?
Do you attempt to taper fully or maintain at a low dose?
When it seems fairly certain that this is a drug effect is it something that can just be monitored or requires a change in approach?
I.e., what constitutes well-controlled cancer, IBD, nephrotic syndrome, etc. What other diseases do you put in this category (obesity, autoimmune dise...
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...
Dr. Charles-Schoeman presented data at ACR 21 showing that, paradoxically, there is a U-shaped relationship between inflammation and LDL levels in pat...
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