Pub Date : 2022-04-30DOI: 10.1142/s2661341722720038
Varsha Sivalingam, Hillary Dinning, J. Fang, Y. Prasad, P. Jones, S. Senanayake
The causes of a pyrexia of unknown origin (PUO) are broadly spread across infectious, malignant, or inflammatory conditions. The authors report a case of a 43-year-old female who initially presented with hypoxia and fevers secondary to a presumed acute viral or bacterial infectious pulmonary insult. However, fevers persisted despite pulmonary imaging remaining normal. The case subsequently evolved into a PUO with multiple lines of investigation proving inconclusive. No definitive diagnosis was made at the time of discharge; however, cessation of hydralazine was noted to coincide with the last of the patient’s fevers. Following the discharge, her anti-histone antibodies returned a positive result, and the diagnosis of drug-induced lupus was made with hydralazine as the presumed trigger.
{"title":"Drug-Induced Lupus: A Forgotten Cause of Prolonged Pyrexia of Unknown Origin","authors":"Varsha Sivalingam, Hillary Dinning, J. Fang, Y. Prasad, P. Jones, S. Senanayake","doi":"10.1142/s2661341722720038","DOIUrl":"https://doi.org/10.1142/s2661341722720038","url":null,"abstract":"The causes of a pyrexia of unknown origin (PUO) are broadly spread across infectious, malignant, or inflammatory conditions. The authors report a case of a 43-year-old female who initially presented with hypoxia and fevers secondary to a presumed acute viral or bacterial infectious pulmonary insult. However, fevers persisted despite pulmonary imaging remaining normal. The case subsequently evolved into a PUO with multiple lines of investigation proving inconclusive. No definitive diagnosis was made at the time of discharge; however, cessation of hydralazine was noted to coincide with the last of the patient’s fevers. Following the discharge, her anti-histone antibodies returned a positive result, and the diagnosis of drug-induced lupus was made with hydralazine as the presumed trigger.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48287611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.1142/s2661341722300014
M. Lee, S. C. Chan
Pneumocystis jirovecii pneumonia (PJP) is an uncommon opportunistic infection in patients with rheumatic diseases with high mortality. Unlike other non-HIV conditions, international guideline for PJP prophylaxis in rheumatic diseases is currently lacking. Recent evidence regarding the risk of PJP and effectiveness of prophylaxis has been accumulating. This Review provides an update on the information about risk factors associated with PJP in patients with rheumatic diseases based on rheumatic diagnoses, use of immunosuppressive agents and other disease-related factors. The second part of the article summarizes evidence regarding the effectiveness of PJP prophylaxis by considering both disease-related and therapy-related factors. Finally, the Review outlined the currently available disease-specific recommendations and local guidelines, and appreciate the factors that influence physicians’ decision.
{"title":"Pneumocystis jirovecii Pneumonia in Patients with Rheumatic Diseases: Risk Assessment and Prophylaxis","authors":"M. Lee, S. C. Chan","doi":"10.1142/s2661341722300014","DOIUrl":"https://doi.org/10.1142/s2661341722300014","url":null,"abstract":"Pneumocystis jirovecii pneumonia (PJP) is an uncommon opportunistic infection in patients with rheumatic diseases with high mortality. Unlike other non-HIV conditions, international guideline for PJP prophylaxis in rheumatic diseases is currently lacking. Recent evidence regarding the risk of PJP and effectiveness of prophylaxis has been accumulating. This Review provides an update on the information about risk factors associated with PJP in patients with rheumatic diseases based on rheumatic diagnoses, use of immunosuppressive agents and other disease-related factors. The second part of the article summarizes evidence regarding the effectiveness of PJP prophylaxis by considering both disease-related and therapy-related factors. Finally, the Review outlined the currently available disease-specific recommendations and local guidelines, and appreciate the factors that influence physicians’ decision.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45658691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.1142/s2661341722500018
H. Chung, P. Wong, Kam-Ho Lee, N. Ciang, S. P. Wong, Peng Cao, S. C. Chan, V. Lau, B. Lo, Ryan K L Lee
The Hong Kong Society of Rheumatology (HKSR) has developed evidence-based position statements on the use of magnetic resonance imaging (MRI) in axial spondyloarthritis (axSpA). A special interest group (SIG) developed the statements based on the literature review of the following research questions: 1) In whom should SI joint MRI be done to diagnose axSpA? 2) Should spine MRI be performed for diagnosis of axSpA? 3) Should spine and SI joint MRI be used in the assessment and monitoring of disease activity? 4) Which MRI sequence(s) should be used in axSpA? These statements have at least 75% agreement from voting rheumatology fellows of HKSR, and are developed to serve as local practice guidelines for rheumatologists and musculoskeletal radiologists in the management of axSpA.
{"title":"MRI in Axial Spondyloarthritis: Position Statements from the Hong Kong Society of Rheumatology","authors":"H. Chung, P. Wong, Kam-Ho Lee, N. Ciang, S. P. Wong, Peng Cao, S. C. Chan, V. Lau, B. Lo, Ryan K L Lee","doi":"10.1142/s2661341722500018","DOIUrl":"https://doi.org/10.1142/s2661341722500018","url":null,"abstract":"The Hong Kong Society of Rheumatology (HKSR) has developed evidence-based position statements on the use of magnetic resonance imaging (MRI) in axial spondyloarthritis (axSpA). A special interest group (SIG) developed the statements based on the literature review of the following research questions: 1) In whom should SI joint MRI be done to diagnose axSpA? 2) Should spine MRI be performed for diagnosis of axSpA? 3) Should spine and SI joint MRI be used in the assessment and monitoring of disease activity? 4) Which MRI sequence(s) should be used in axSpA? These statements have at least 75% agreement from voting rheumatology fellows of HKSR, and are developed to serve as local practice guidelines for rheumatologists and musculoskeletal radiologists in the management of axSpA.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45495399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-24DOI: 10.1142/s2661341722720026
Y. Cho, Erik W Anderson, Sara Guevara, Santiago J. Miyara, Aqsa Iqbal, J. Aronsohn, E. Molmenti, James M. Mumford, B. Keber, Farideh Zonouzi-Zadeh, You-kyung Ha, P. Nikolinakos, Brent Flickinger
T-cell large granular lymphocyte (T-LGL) leukemia is a rare and indolent clonal disorder of LGLs, associated with rheumatoid arthritis and neutropenia. The authors present a case of a 62-year-old male with rheumatoid arthritis (RA) who was diagnosed with T-LGL leukemia, with predominant neutropenia, and a poor response to conventional treatment. Subsequently, tofacitinib (a Janus Kinase 1 and 3 inhibitor, [JAK1/3 inhibitor]) resulted in improvement of the patient’s RA symptoms and temporary improvement of the neutropenia. Ultimately, upadacitinib (a specific JAK1 inhibitor) resulted in further improvement of the neutropenia and control of his RA. To the best of our knowledge, this is the first case report of coexisting RA and LGL leukemia that was treated with upadacitinib and showed clinical improvement.
{"title":"Upadacitinib as Novel Treatment for Rheumatoid Arthritis with T-Cell Granular Lymphocytic Leukemia: A Case Report and Narrative Review","authors":"Y. Cho, Erik W Anderson, Sara Guevara, Santiago J. Miyara, Aqsa Iqbal, J. Aronsohn, E. Molmenti, James M. Mumford, B. Keber, Farideh Zonouzi-Zadeh, You-kyung Ha, P. Nikolinakos, Brent Flickinger","doi":"10.1142/s2661341722720026","DOIUrl":"https://doi.org/10.1142/s2661341722720026","url":null,"abstract":"T-cell large granular lymphocyte (T-LGL) leukemia is a rare and indolent clonal disorder of LGLs, associated with rheumatoid arthritis and neutropenia. The authors present a case of a 62-year-old male with rheumatoid arthritis (RA) who was diagnosed with T-LGL leukemia, with predominant neutropenia, and a poor response to conventional treatment. Subsequently, tofacitinib (a Janus Kinase 1 and 3 inhibitor, [JAK1/3 inhibitor]) resulted in improvement of the patient’s RA symptoms and temporary improvement of the neutropenia. Ultimately, upadacitinib (a specific JAK1 inhibitor) resulted in further improvement of the neutropenia and control of his RA. To the best of our knowledge, this is the first case report of coexisting RA and LGL leukemia that was treated with upadacitinib and showed clinical improvement.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42967968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-17DOI: 10.1142/s2661341722720014
Srividhya Karunanithi, S. Nallasivan, M. Murugan
Takayasu vasculitis (TAK) is a form of large vessel vasculitis clinically manifesting as pulseless disease or hypertension. It is more common in South East Asia and Japan, India, and Mexico [1]. It is increasingly being recognized due to increased awareness among medical fraternity and better imaging modalities. Undetected hypertension, pulselessness, and syncope are more common symptoms and presentation during pregnancy is unusual and can lead to bad obstetric outcomes. Recent evidences support the use of tocilizumab for inducing remission in Takayasu arteritis. We report this rare case of vasculitis presenting in pregnancy as malignant hypertension. A 20-year-old pregnant woman (45 days) presented with headache and nausea but no fever. She had a history of intermittent claudication of legs for the past 3 years but not evaluated. During examination, pulses were felt normally and blood pressure (BP) 180/110, no murmurs in cardiac auscultation, but she had abdominal bruit (renal vessels). Other systems were normal. Echocardiogram (ECHO) showed dilated ascending aorta. Doppler of renal vessels showed narrowing of renal arteries. Unfortunately, she had to undergo termination of pregnancy (high BP in spite of antihypertensives). Her computed tomography (CT) angiogram showed features of TAK with type 5 pattern–she had methylprednisolone infusion 500 mg daily for 3 days, followed by injection tocilizumab 400 mg monthly 3 doses. Once remission was achieved, she had recanalization by percutaneous transluminal angioplasty of right renal artery. She is currently maintained on aspirin and telmisartan. Awareness of causes of high BP, inputs by radiologist, cardiologist, and rheumatologist and understanding by the patient and family helped to achieve good outcome albeit the miscarriage.
{"title":"Tocilizumab and Renal Artery Stent—Therapeutic Strategy for Takayasu Arteritis","authors":"Srividhya Karunanithi, S. Nallasivan, M. Murugan","doi":"10.1142/s2661341722720014","DOIUrl":"https://doi.org/10.1142/s2661341722720014","url":null,"abstract":"Takayasu vasculitis (TAK) is a form of large vessel vasculitis clinically manifesting as pulseless disease or hypertension. It is more common in South East Asia and Japan, India, and Mexico [1]. It is increasingly being recognized due to increased awareness among medical fraternity and better imaging modalities. Undetected hypertension, pulselessness, and syncope are more common symptoms and presentation during pregnancy is unusual and can lead to bad obstetric outcomes. Recent evidences support the use of tocilizumab for inducing remission in Takayasu arteritis. We report this rare case of vasculitis presenting in pregnancy as malignant hypertension. A 20-year-old pregnant woman (45 days) presented with headache and nausea but no fever. She had a history of intermittent claudication of legs for the past 3 years but not evaluated. During examination, pulses were felt normally and blood pressure (BP) 180/110, no murmurs in cardiac auscultation, but she had abdominal bruit (renal vessels). Other systems were normal. Echocardiogram (ECHO) showed dilated ascending aorta. Doppler of renal vessels showed narrowing of renal arteries. Unfortunately, she had to undergo termination of pregnancy (high BP in spite of antihypertensives). Her computed tomography (CT) angiogram showed features of TAK with type 5 pattern–she had methylprednisolone infusion 500 mg daily for 3 days, followed by injection tocilizumab 400 mg monthly 3 doses. Once remission was achieved, she had recanalization by percutaneous transluminal angioplasty of right renal artery. She is currently maintained on aspirin and telmisartan. Awareness of causes of high BP, inputs by radiologist, cardiologist, and rheumatologist and understanding by the patient and family helped to achieve good outcome albeit the miscarriage.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45207535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-15DOI: 10.1142/s2661341721300068
Chloe Kwong Yee Cheung, Mandy O M Wong, C. K. M. Chan, H. Chung
Uveitis is the most common ophthalmological disorder in the field of rheumatology, accounting for a significant proportion of visual morbidity, both locally and internationally. Causative factors can be divided into infectious and noninfectious etiologies. The diagnosis of uveitis is a major challenge due to heterogeneity in presentation. The disease course may be acute monophasic, recurrent, or chronic relapsing. Complications include posterior synechiae, secondary cataract, ocular hypertension or glaucoma, macular edema, retinal vascular occlusion, epiretinal membrane, and so on, and ultimately visual loss. Antimicrobial therapy is indicated for infection, whereas noninfectious uveitis warrants a combination of steroids, immunosuppressives, and anti-inflammatory agents. With the advancement of biologics, treatment strategies in chronic, noninfectious uveitis have had multiple breakthroughs, particularly in treatment-resistant cases. This article provides a review of the diagnostic approach to uveitis based on symptomatology and ophthalmological findings, and discussion of relevant treatment modalities and strategies.
{"title":"Uveitis and Rheumatological Diseases","authors":"Chloe Kwong Yee Cheung, Mandy O M Wong, C. K. M. Chan, H. Chung","doi":"10.1142/s2661341721300068","DOIUrl":"https://doi.org/10.1142/s2661341721300068","url":null,"abstract":"Uveitis is the most common ophthalmological disorder in the field of rheumatology, accounting for a significant proportion of visual morbidity, both locally and internationally. Causative factors can be divided into infectious and noninfectious etiologies. The diagnosis of uveitis is a major challenge due to heterogeneity in presentation. The disease course may be acute monophasic, recurrent, or chronic relapsing. Complications include posterior synechiae, secondary cataract, ocular hypertension or glaucoma, macular edema, retinal vascular occlusion, epiretinal membrane, and so on, and ultimately visual loss. Antimicrobial therapy is indicated for infection, whereas noninfectious uveitis warrants a combination of steroids, immunosuppressives, and anti-inflammatory agents. With the advancement of biologics, treatment strategies in chronic, noninfectious uveitis have had multiple breakthroughs, particularly in treatment-resistant cases. This article provides a review of the diagnostic approach to uveitis based on symptomatology and ophthalmological findings, and discussion of relevant treatment modalities and strategies.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43018268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-15DOI: 10.1142/s2661341721300044
Chi Kit Au, T. L. Lai, C. Yim
Human parvovirus B19 infections are well reported to be associated with different autoimmune disorders. They can either mimic or trigger autoimmune diseases, such as systemic lupus erythematous (SLE), rheumatoid arthritis (RA), and vasculitis. A lack of awareness about this infection can result in delays in diagnosis and poor care. In this review, the basic biology and clinical aspects of the parvovirus, human immune response, and the pathogenesis in the rheumatic diseases are discussed.
{"title":"Association of Parvovirus B19 with Rheumatic Diseases","authors":"Chi Kit Au, T. L. Lai, C. Yim","doi":"10.1142/s2661341721300044","DOIUrl":"https://doi.org/10.1142/s2661341721300044","url":null,"abstract":"Human parvovirus B19 infections are well reported to be associated with different autoimmune disorders. They can either mimic or trigger autoimmune diseases, such as systemic lupus erythematous (SLE), rheumatoid arthritis (RA), and vasculitis. A lack of awareness about this infection can result in delays in diagnosis and poor care. In this review, the basic biology and clinical aspects of the parvovirus, human immune response, and the pathogenesis in the rheumatic diseases are discussed.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44701403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-22DOI: 10.1142/s2661341721200017
P. Padhan, D. Maikap
{"title":"A Rare Cause of Chronic Digital Pain","authors":"P. Padhan, D. Maikap","doi":"10.1142/s2661341721200017","DOIUrl":"https://doi.org/10.1142/s2661341721200017","url":null,"abstract":"","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42766932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-18DOI: 10.1142/s2661341721500012
Cecilia Kit Ying O’Young, K. Ho, Hoch So, T. Mok, C. Leung, C. Chau, C. Chan
Patients with immune-mediated inflammatory diseases on anti-tumor necrosis factor (TNF) agents are at increased risk of developing active tuberculosis (TB). Screening and treatment of latent tuberculosis infection (LTBI) with the use of a standard screening protocol is important in reducing the risk of TB reactivation during therapies with anti-TNF agents. The Latent Tuberculosis Infection Working Group under the Tuberculosis Control Coordinating Committee of the Department of Health and the Hospital Authority has reviewed and assessed local and international scientific evidence and formulated guideline statements on the management of LTBI in patients initiating anti-TNF biologics.
{"title":"Recommendations on Management of Latent Tuberculosis Infection in Patients Initiating Anti-tumor Necrosis Factor Biologics","authors":"Cecilia Kit Ying O’Young, K. Ho, Hoch So, T. Mok, C. Leung, C. Chau, C. Chan","doi":"10.1142/s2661341721500012","DOIUrl":"https://doi.org/10.1142/s2661341721500012","url":null,"abstract":"Patients with immune-mediated inflammatory diseases on anti-tumor necrosis factor (TNF) agents are at increased risk of developing active tuberculosis (TB). Screening and treatment of latent tuberculosis infection (LTBI) with the use of a standard screening protocol is important in reducing the risk of TB reactivation during therapies with anti-TNF agents. The Latent Tuberculosis Infection Working Group under the Tuberculosis Control Coordinating Committee of the Department of Health and the Hospital Authority has reviewed and assessed local and international scientific evidence and formulated guideline statements on the management of LTBI in patients initiating anti-TNF biologics.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47196935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-09DOI: 10.1142/s2661341721300056
Chuanhui Xu, K. Leong
Pharmacogenomics, the study of the effect of genetics on the variation in drug response, is designed to maximize drug efficacy and minimize adverse effects. It is assuming increasing importance in clinical practice. Rheumatologists, who manage patients with complex diseases with unpredictable outcomes over long periods of time, should embrace tools that help customize treatment for their patients. In this article, the basis for pharmacogenomics is presented, followed by description of the tests relevant to drugs encountered in rheumatology practice, concluding with ideas about implementation and future developments.
{"title":"Pharmacogenomics and Rheumatological Practice","authors":"Chuanhui Xu, K. Leong","doi":"10.1142/s2661341721300056","DOIUrl":"https://doi.org/10.1142/s2661341721300056","url":null,"abstract":"Pharmacogenomics, the study of the effect of genetics on the variation in drug response, is designed to maximize drug efficacy and minimize adverse effects. It is assuming increasing importance in clinical practice. Rheumatologists, who manage patients with complex diseases with unpredictable outcomes over long periods of time, should embrace tools that help customize treatment for their patients. In this article, the basis for pharmacogenomics is presented, followed by description of the tests relevant to drugs encountered in rheumatology practice, concluding with ideas about implementation and future developments.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47909774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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