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Book and Media Reviews
July 25, 2007

Current Diagnosis and Treatment in Rheumatology

JAMA. 2007;298(4):462-466. doi:10.1001/jama.298.4.463-b

The current practice of rheumatology is a fascinating mix of slowly evolving changes in diagnoses and rapidly changing treatment protocols. Since the approval of the first biological therapy in 1998, these drugs have led to a revolution in the treatment of several rheumatologic diseases. Prior to the introduction of the biologics, methotrexate therapy, the gold-standard treatment, could induce remissions in perhaps 10% of patients with rheumatoid arthritis. The entire severity curve has now shifted toward less severe disease, and combination treatment with a biologic along with methotrexate can induce remissions in as many as 30% of patients. Biologics were recently approved for ankylosing spondylitis and psoriatic arthritis. Biologics are currently being used for lupus and other rheumatologic diseases. With any new therapies come new adverse effects. Therefore, a textbook must be up to date with the latest treatments and their adverse effects, as well as detailed enough to cover the numerous diagnoses within this subspecialty.

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