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VBCR Perspectives

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory illness with significant potential for morbidity and disability. Although treatment options have significantly expanded in the past 15 years, we are still faced with patients who do not achieve full remission and have persistent symptoms.
In 2013, the National Vaccine Advisory Committee (NVAC) updated its Standards for Adult Immunization Practice.1 The new standards, recognizing the dismal rate of adult vaccination in the United States, emphasized the role of all providers to assess immunization status and recommend needed vaccines.
As healthcare reform continues to unfold, an increasing amount of pressure is being placed on payers, providers, and patients to address the rising cost of care. Greater attention is being paid to patients with inflammatory arthritis and other autoimmune conditions treated with chronic biologic therapies.
By Jeffrey S. Peller, MD Dr Peller is Practicing Rheumatologist at Harbin Clinic/Rheumatology in Rome, GA I had my first experience with clinical research during my fellowship 30 years ago. The new drug isotretinoin (Accutane) was being used to treat acne, and the concern was that it triggered spondyloarthritis. Rheumatologists were therefore asked to evaluate young patients who were being treated with that drug, and I was one of those rheumatologists.
By John Kolstoe, MD Dr Kolstoe is in private practice at Kolstoe Rheumatology: Musculoskeletal Medicine, East Lansing, MI, and an editorial board member of Value-Based Care in Rheumatology The August 2013 issue of Value-­Based Care in Rheumatology devoted 3 articles to systemic lupus erythematosus (SLE). Two of the articles pertained to refining the clinical “state” of SLE through newer laboratory criteria (“New Biomarkers and Biomarker Panels Show Promise for Diagnosing and Monitoring Patients with Lupus”)1 or through available clinical criteria (“New Diagnostic Algorithm for SLE Can Facilitate Early Treatment, Improve Outcomes”)2; the third article reviewed the effect of treatment with vitamin D (“Increasing Vitamin D Intake in Patients with Lupus Provides Modest Benefit”).3 All 3 articles will assist the clinician’s decision on how and when to treat the individual patient with SLE.

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