20 question(s) listed

Clinical Trials

Management of extra-articular manifestations associated with rheumatoid arthritis
How should I be managing the extra-articular manifestations of RA, such as interstitial lung disease, vasculitis, and scleritis?
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Management of common comorbidities associated with rheumatoid arthritis
How do you manage comorbidities such as cardiovascular disease and osteoporosis? Do you team with other specialists, and if so, how?
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Rituximab treatment results in the death of specific B-cell populations
What happens to the B cells after a patient receives a course of rituximab infusions?
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The influence of rituximab-induced B-cell depletion on infection incidence
Are there known risks associated with the immunologic changes induced by rituximab infusions?
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CME - Safety issues in switching an RA patient from one tumor necrosis factor agent to another
What advice can you offer about transitioning a patient from etanercept to another tumor necrosis factor (TNF) agent with regard to safety? Should there be an extended interval between administration ...
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CME - Adalimumab therapy in a 57-year-old female patient with RA and hepatitis C
I have a 57-year-old female patient with very active rheumatoid arthritis (RA) who is currently being treated with adalimumab. She was recently diagnosed with hepatitis C. Can she continue on adalimum...
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CME - Use of biologic agents in RA patients who are not current with their vaccinations
What are the recommendations for patients who were tested for tuberculosis (TB) prior to initiating therapy with a biologic but did not receive all the vaccinations listed in the published American Co...
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CME - Treatment alternatives for a patient with inadequate response to adalimumab and methotrexate
A 59-year-old male with recent-onset active RA was referred to our clinic from a local rheumatologist after he was tried on a course of adalimumab and methotrexate (MTX) 20 mg/wk for 12 weeks with min...
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CME - Measurement of disease activity in the office setting
Which disease measurement scale do you recommend that would not require laboratory testing and that could be done easily within an office visit?
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CME - Treatment of an RA patient who has herpes and lupus
I have an RA patient who also has genital herpes and has had lupus for 25 years. The patient is currently taking acyclovir (400 mg) twice daily and has not had an outbreak since starting on acyclovir ...
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CME - Treatment of RA in a patient with a family history of multiple sclerosis
My patient, a 59-year-old male with a 3-year history of RA, has had low disease activity for the past 14 months on adalimumab. At his last follow-up he reported that his younger sister was diagnosed w...
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CME - Treatment alternatives to methotrexate for an RA patient considering pregnancy
What suggestions do you have for a 38-year-old female patient with moderately active rheumatoid arthritis for 8 months that has been managed with methotrexate (MTX) 20 mg/wk but notes that she is cons...
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CME - Diagnosis and management of recurrent effusions of the knees
What is the most common cause of recurrent effusion of knee joints and its optimal treatment?
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CME - Altering or discontinuing drugs in a combination therapy regimen
I have a patient who has been in remission on methotrexate (MTX) and infliximab; should I reduce or stop the infliximab?
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CME - Use of tumor necrosis factor inhibitors in a patient with breast cancer
I have a 48-year-old female patient with rheumatoid arthritis whose disease has been controlled for the past 3 years with etanercept and methotrexate (DAS28 =2.2). She was diagnosed with breast cancer...
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CME - Options after treatment failure with methotrexate + etanercept
What is your advice for a patient with moderate rheumatoid arthritis for 18 months who has an inadequate response to combination therapy with methotrexate and etanercept? Do you suggest trying another...
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MRI prescreening before the use of rituximab
With recent reports of progressive multifocal leukoencephalopathy (PML) developing in patients treated with rituximab (thus far confined to patients with systemic lupus erythematosus), would it be pru...
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Biologic agents in combination with leflunomide and prednisone in a patient with a prior malignancy
What biologic agent, if any, would you use in a patient with severely deforming, very active rheumatoid arthritis who is currently on leflunomide and prednisone? I have a male patient of this descript...
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Defining inadequate response.
How should I define inadequate response?
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Differences in clinical and radiographic responses between methotrexate and anti-TNF agents
Why is it that the clinical and radiographic responses with methotrexate do not always correlate with one another, but when using anti-TNF agents they do?
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