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Rheumatology Topic Homepage
Rheumatology Overview
Rheumatology is the medical specialty that focuses on the diagnosis and treatment of diseases of the musculoskeletal system (bones, joints, muscles, tendons, and ligaments).1
The specialty of rheumatology encompasses more than 150 diseases such as; rheumatoid arthritis (RA), osteoarthritis, osteoporosis, scleroderma, ankylosing spondylitis, systemic lupus erythematosus, Sjogren's disease and vasculitis.1
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Rheumatic diseases, degenerative or inflammatory, are the most common sources of chronic pain and physical disabilities. They are more common in the elderly and often cause pain, joint deformity and decreased mobility.1 The pain can also lead to poor sleep quality, resulting in a decreased quality of life, increased morbidity and mortality, and an even greater perception of pain.2 Rheumatic diseases are the leading cause of disability and early retirement, their social and economic impact is considerable.1
RA is a progressive inflammatory disease characterised by inflammation of the joints, causing pain, deformities and often joint destruction.3 The exact etiology of RA is still unknown.4 However, it appears to result from a complex interaction between genetic factors and some environmental agents, which are still poorly defined.4 RA does not just affect the musculoskeletal system; extra-articular manifestations usually appear late and may affect the skin, the eyes or the heart.4 RA is the most common type of arthritis and affects approximately 1% of the population.4 It has a worldwide distribution and the incidence is twice as high in women compared with their male counterparts.4 RA can also occur in children and is then called juvenile rheumatoid arthritis.3
In recent years, significant progress has been made in the field of rheumatology. There is a greater scientific understanding of the changes of bone and cartilage at the genetic and molecular level, but much remains to be discovered in order to improve the prevention and treatment of these diseases.1
1. Pereira da Silva J.A. et al. Rheumatology in Practice. Springer. 1st Edition. 2010 : 1.1-1.3.
2. Taylor-Gjevre R.M. et al. Components of Sleep Quality and Sleep Fragmentation in Rheumatoid Arthritis and Osteoarthritis. Musculoskeletal Care. June 2011 ; available online.
3. Beers M.H. et al. The Merck manual of medical information. Merck research laboratories. Second home edition. 2003, 370-377.
4. Cush J.J. et al. Rheumatoid Arthritis : Early Diagnosis and Treatment. Professional Communications Inc. Third edition. 2010 : 368 pages.
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Drug News
Study of Prolia (Amgen/GSK) plus teriparatide shows significant benefits in Osteoporosis
19-05-2013A randomised, controlled trial of postmenopausal women with Osteoporosis shows that teriparatide and Prolia (denosumab), from Amgen/GSK, increased bone mineral densification (BMD) better than previously reported with any available treatment. Ninety four postmenopausal women were assigned in a 1:1:1 ratio to receive 20 ug teriparatide daily, 60 mg denosumab every 6 months, or both. BMD was...
FDA approves Ilaris (Novartis) for treatment of Systemic Juvenile Idiopathic Arthritis
11-05-2013
Novartis announced that the FDA has on 10 May 2013 approved Ilaris (canakinumab) for the treatment of active Systemic Juvenile Idiopathic Arthritis (SJIA) in patients aged 2 years and older. Ilaris is the first interleukin-1 beta (IL-1 beta) inhibitor approved for SJIA and the only treatment approved specifically for SJIA that is given as a once-monthly subcutaneous injection.
SJIA...
PALACE 4 study confirms success of apremilast (Celgene) in treatment of Psoriaric Arthritis
08-05-2013
Celgene International Sàrl,has announced that statistical significance was achieved for the primary endpoint of ACR 20 at week 16 for patients receiving apremilast 20 mg and 30 mg BID monotherapy in PALACE 4 study. PALACE 4 is the fourth randomized, placebo-controlled study evaluating the Company’s novel, oral small-molecule inhibitor of phosphodiesterase 4 (PDE4) in patients with Psoriatic...
Rheumatology Drug Data - A-Z
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Recent Drug Updates
Orencia 125 mg solution for injection (pre-filled syringe)
08-05-2013Rheumatoid arthritis ORENCIA in combination with methotrexate is indicated for the treatment of moderate to severe active rheumatoid arthritis in adult patients who responded inadequately to ...
Bonviva 150mg Film-Coated Tablets
03-05-2013Treatment of osteoporosis in postmenopausal women at increased risk of fracture. A reduction in the risk of vertebral fractures has been demonstrated, efficacy on femoral neck fractures has not...
Etopan XL 600 mg Tablets
09-04-2013Etopan XL 600 mg Tablets are indicated for acute or long-term use in rheumatoid arthritis and osteoarthritis....
Clinical Guidelines
Osteoporosis: assessing the risk of fragility fracture
Aug 2012Osteoporosis is a disease characterised by low bone mass and structural deterioration of bone..
... tissue, with a consequent increase in bone fragility and susceptibility to fracture. Osteoporosis leads to nearly 9 million fractures annually worldwide, and over 300,000 patients present with fragility fractures to hospitals in the UK each year.
Management of early rheumatoid arthritis
Feb 2011This guideline addresses the diagnosis of early RA, its pharmacological treatment including symptom..
... relief and disease modification, and the role of the multidisciplinary team in improving the care of patients with RA. The guideline does not address the treatment of comorbidities (eg anaemia, osteoporosis), complications of drug therapy and their management, or treatment of extra-articular disease (eg vasculitis, ocular complications, amyloid).
Online CME
Newer Strategy for Early Rheumatoid Arthritis Focuses on Prompt, Intensive Treatment
Apr 2013
... more aggressive initial treatment to induce remission in rheumatoid arthritis (RA), represents a paradigmatic shift in the management of early RA, according to a report presented here at the 2012 Annual Meeting of the American College of Physicians. This strategic stance on the part of rheumatologists parallels the emergence of newer agents, such as Janus kinase (JAK) inhibitors, which have shown promise for RA patients who have had an inadequate response to standard therapy.
Managing Chronic Pain Beyond NSAIDs and Opioids: An Education Station™ Enduring Archive Web Activity
Apr 2013
... remains a poorly controlled condition. Major barriers in optimal management include inadequate screening and assessment, lack of understanding of its complicated pathophysiology, and subsequent underuse of neuromodulatory analgesics to target specific underlying pathogenesis. Thus, there is a critical need to discuss how to overcome these knowledge and performance barriers and to provide clinicians with access to experts who can highlight and prioritize emerging data. This Education Station™ activity will include an overview of chronic pain and 3 topics using clinical case scenarios in a discussion-based format.
Clinical Trials
A Retrospective Observational Study on the Use of Biologics in Monotherapy in Patients With Rheumatoid Arthritis
11-04-2013This retrospective, observational, multi-center study will evaluate the use of biological agents (e.g. RoActemra/Actemra [tocilizumab]) in monotherapy in patients with rheumatoid arthritis. Data from medical record files will be collected of patients currently treated with a biologic in monotherapy.
A Phase 2/3 Open-label Extension Study to Evaluate Long-Term Safety and Efficacy With VX-509 in Subjects With Rheumatoid Arthritis
10-04-2013This study is designed to evaluate the long-term safety and tolerability of VX-509 in subjects with active rheumatoid arthritis (RA) on DMARD therapy. This study will enroll subjects who completed a previous designated study with VX-509 (e.g., Study VX12-509-103).
Medical Videos
Medical Journal Abstracts
Which Patients Are Most Likely to Benefit From Total Joint Arthroplasty?
Arthritis & Rheumatism
Apr 2013
Objective: To evaluate patient predictors of good outcome following total joint arthroplasty (TJA). Methods: A population cohort with hip/knee arthritis (osteoarthritis [OA] or inflammatory arthritis) ages ≥55 years was recruited between 1996 and 1998 (baseline) and assessed annually for demographics, troublesome..
Variants in RUNX3 Contribute to Susceptibility to Psoriatic Arthritis, Exhibiting Further Common Ground With Ankylosing Spondylitis
Arthritis & Rheumatism
Apr 2013
Objective: Psoriatic arthritis (PsA) is a common inflammatory joint disease distinct from other chronic arthritides and frequently accompanied by psoriasis vulgaris. In a first genome-wide association study (GWAS), we were able to identify several genetic risk factors. However, even combined with previously identified..
Medical Apps
Miniatlas Osteoporosis - £1.49
Rheumatoid Arthritis - £6.19
Rheumatology hperguide - Free
Rheumatology - £1.22
Social Media
Frailty. Is it an important clinical syndrome?
on doc2doc... are undergoing haemodialysis, or who have a chronic disease such as rheumatoid or COPD.Measuring frailty is itself controversial - there are indexes ...
women don't do enough housework
on doc2doc... and buckets of coal have to be fetched daily (shared task and good osteoporosis prevention) from the coal shed - a 50metre round trip. These are just ...
Importance and Limitations of Gram Staining in Diagnostic Microbiology
on doc2doc... are cerebrospinal fluid for meningitis and synovial fluid for septic arthritis. Many Grams’ stains from specimens with Polymicrobial flora are ...
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