“You have effectively given me my life and hope back, and for that I will be immensely and eternally grateful.” – A.B.
When we see a patient who is not feeling well, we listen to them very carefully, discuss, diagnose their condition, and together as “partners”, choose treatment options. Dialogue is important to achieve the best outcome.
Main Line Rheumatology is very proud to announce that Cheryl Wieczeroek, CRNP, MSN, has been nominated for the Association of Rheumatology Health Professionals (ARHP) Master Education Award. Cheryl is a dedicated health team member at Main Line Rheumatology, and an asset to our practice and patients.
TV commercials about medication and risks can be very confusing.
By Gary V. Gordon, MD, FACP, FACR
Every day when we watch television, we’re bombarded with commercials for all kinds of medications. As a rheumatologist, I have great concern when I see medication commercials that patients take for psoriatic or rheumatoid arthritis. We are frightened by the lengthy list of potentially terrible side effects from taking medications for psoriatic arthritis. I often think anyone in their right mind would not take any advertised medications where death, or some serious or lingering infection could be the outcome. Exchange one bad problem for another? No doubt, the pharmaceutical companies have done marketing studies that show TV drug advertising increases the rise in drug sales, with the bottom line – “if you advertise, they will come.” After watching these ads, some patients will run right to their doctor and ask, “Why are you not prescribing these drugs for me?” or in some cases, “Why are you?”
I think most physicians probably would say “No” to television drug commercials. There are frequently mixed messages with the commercials’ optics, and narrative. Some medication information can really frighten or confuse viewers, scaring them away from taking medications which might be really helpful in their treatment. At the end of these commercials, there is the rapidly announced list of terrible, potential drug side effects but in reality, most of them are extremely unlikely. For example, the biologic drugs, Humira, Enbrel and Remicade, as well as the newer medications such as Xeljanz, can, in theory, cause viral hepatitis or tuberculosis. However, of the hundreds of patients I have treated with these types of drugs, I have yet to see one case of tuberculosis or hepatitis. Why are these potential side effects listed? The listing is a Federal Drug Administration (FDA) mandate, and it is hard to argue with the FDA that’s just trying to protect the public. However, it is difficult for somebody watching TV drug commercials to know the likelihood of these possible side effects. If the consequence of untreated rheumatoid or psoriatic arthritis is that a patient may be crippled and unable to work, a small 3% chance of infection may be a worthwhile risk. Medical providers are risk averse; we want patients as healthy as possible, and living a good, quality of life! But an everyday reality is when you get out of bed, you could be exposed to a potential hazard; driving your car to run an errand, getting on a train or plane, or even just walking to the mailbox. Medical treatment with medications is also about weighing the risks against the benefits. With professional medical guidance, we all aim for the right decision. Having a complete and honest discussion with your rheumatologist about the benefits and risks of your prescribed medicines, is the reasonable approach.
As far as these TV drug commercials, next time just hit the MUTE button on your remote control!
https://www.nytimes.com/2019/04/09/health/osteoporosis-evenity-bone-amgen.html
The Food and Drug Administration on Tuesday approved an osteoporosis drug, romosozumab (brand name Evenity), that restores bone without breaking it down, according to the findings of two large clinical trials. This breakthrough represents the first new treatment approach in nearly two decades, developed by Amgen, in collaboration with the Belgian drug company UCB. Read more!
Any questions or to speak to one of our doctors, please call 610-896-8400
The practice of Main Line Rheumatology is proud to announce that Healthgrades™ has awarded Gary V. Gordon, MD, FACP, FACR and Thomas Harder MD, the distinction of 2019 HONOR ROLL doctors in the category of Rheumatology, Pennsylvania.
Healthgrades is an online database of doctors, dentists, and hospitals that has over 100 million users and has amassed data on more than three million U.S. healthcare providers. is an online database of doctors, dentists, and hospitals that has over 100 million users and has amassed data on more than three million U.S. healthcare providers. In a recent study, Healthgrades and Yelp proved to be the two most important sites for healthcare professionals.
Systemic Lupus Erythematosus (SLE) or Lupus can be associated with gestational hypertension (maternal high blood pressure), preterm birth, intrauterine growth restriction and fetal death. Lupus patients may have abnormal placentation (attachment), which is a major contributor of many pregnancy complications due to reduction in maternal blood flow to the fetus. Despite potential risks, women with SLE can have healthy pregnancies. Women with SLE should have low disease activity for the 6 months prior to conception for the best chance of a successful, healthy pregnancy. The PROMISSE Study was a large multicenter prospective study of pregnant and postpartum SLE patients. The study showed that 26 % of patients had a flare (worsening) during pregnancy, and 24.4% had a flare in the postpartum period. Most of the flares were mild and infrequently required therapy. Only 6.3% of the patients had severe flares during pregnancy and 1.7% had severe postpartum flares.
Data suggests that the drug, Plaquenil, used during pregnancy was associated with fewer preterm births and less intrauterine growth restriction. Findings also suggest that discontinuation of Plaquenil is associated with higher lupus disease activity during pregnancy.
For SLE patients not looking to conceive, IUDs are considered safe and effective. Other acceptable contraceptive options, when used appropriately, include condoms, progestin (only oral contraceptives) or depo-provera injections. Estrogen-containing contraceptives are contraindicated in the setting of active lupus, as they may flare the disease.
Main Line Rheumatology’s Amy L. Lundholm, DO, is board certified in both rheumatology and internal medicine. Dr. Lundholm holds current membership in the Pennsylvania Osteopathic Medical Association and the American College of Rheumatology. She was chosen as a rheumatology Top Doctor 2018 Main Line Today magazine. To read more about Dr. Lundholm, go to Our Staff.
https://www.healthgrades.com/quality/americas-best-hospitals-for-2019
The doctors at Main Line Rheumatology are honored to be affiliated with Lankenau Medical Center as one of America’s 50 Best Hospitals™. Just announced, Lankenau received recognition in the top 1% of hospitals in the nation for consistently providing overall clinical excellence across a broad spectrum of conditions and procedures year over year. The premier distinction rewards hospitals that consistently exhibit exceptional, comprehensive quality care, and according to statistics, patients are more likely to have a successful treatment without major complications—and have a lower chance of dying—at America’s Best Hospitals.
Have you been vaccinated against getting the flu? If not, it is still not too late to get a flu shot! This week’s report from the PA Department of Health https://www.health.pa.gov/topics/disease/Flu/Pages/Flu.aspx states that flu is widespread in PA and The Centers for Disease Control and Prevention (CDC) can provide valuable information and updated PA flu activity at https://www.cdc.gov/flu/about/disease/65over.htm
It has been recognized for many years that people 65 years and older are at greater risk of serious complications from the flu compared with young, healthy adults, because human immune defenses become weaker with age. People 65 years and older bear the greatest burden of severe flu disease. In recent years, it’s estimated that between about 70 and 90 percent of seasonal flu-related deaths have occurred in people 65 years and older.
If you are an adult with an immunosuppressed system (from recent sickness, chronic disease, medications or chemotherapy) you are at greater risk for flu and complications that could include bronchitis, pneumonia, ear infections, sinus infections, encephalitis, and pregnancy complications.
Flu viruses are very contagious and are spread from person to person when an infected person coughs or sneezes spreading virus-laden droplets up to three feet through the air. Flu also can be spread when droplets from a cough or sneeze are on hands, or land on objects like a doorknob, light switch, refrigerator door, bathroom or sink handles. If you touch an object and then touch your own or someone else’s mouth, nose or eyes before washing hands, the virus is spread.
You can pass the flu on to someone else both before you feel sick (no symptoms) and up to 5-7 days after becoming sick. If you suffer from a suppressed immune system (or autoimmune disease) you are far more susceptible to contracting the flu. See your rheumatologist or family doctor and get a flu shot.
Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea. People may be infected with the flu and have respiratory symptoms without a fever. Emergency signs of the flu include: difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, flu-like symptoms that improve but then return with fever and worse cough.
In addition to getting the flu shot, people 65 years and older and the immunosupressed, should take the same everyday preventive actions CDC recommends of everyone, including covering coughs, washing hands often, and avoiding people who are sick.
Where can you get your flu shot today? Your doctor’s office, Urgent Care, pharmacy or drug store, clinics, health department, medical center and even some retail stores. For more information regarding flu vaccine availability for High Risk Individuals, please call 1-877-PA-HEALTH
