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Herndon S, Kimball J, Ross L, Homann S, Faison MN, Lee YLA, Marks A, Weinmann SC, Maheswaranathan M, Leverenz D, Jones CA. Top Ten Tips Palliative Care Clinicians Should Know About Rheumatology. J Palliat Med 2025. [PMID: 39841504 DOI: 10.1089/jpm.2024.0520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2025] Open
Abstract
Systemic autoimmune rheumatic diseases (SARDs) consist of a broad range of immune-mediated multisystem diseases. They are chronic, incurable illnesses that often present in early to mid-life and can be associated with a high symptom burden, disability, and early mortality. Treatment guidelines for similar chronic, life-limiting conditions with uncertain disease courses now recommend palliative care (PC) assessment at the time of diagnosis. Recently, the first rheumatology treatment guidelines to recommend PC were also published. Integration of PC into rheumatology offers an opportunity to improve quality of life and deliver better goal-concordant care for people with severe rheumatic disease. This article provides 10 tips to guide PC clinicians when caring for people with rheumatic diseases.
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Affiliation(s)
- Shannon Herndon
- Department of Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jack Kimball
- Department of Medicine, Division of Geriatrics and Palliative Care, Duke University Health System, Durham, North Carolina, USA
| | - Laura Ross
- Department of Medicine, University of Melbourne, Parkville, Australia
- Department of Rheumatology, St Vincent's Hospital, Melbourne, Australia
| | - Sarah Homann
- Department of Medicine, Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Medicine, Division of General Internal Medicine, Section of Palliative Care, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA
| | - Maya N Faison
- Departments of Medicine and Pediatrics, Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Yu-Lin Amy Lee
- Departments of Medicine and Pediatrics, Division of Palliative Care, Duke University School of Medicine, Durham, North Carolina, USA
| | - Adam Marks
- Department of Medicine, Division of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Sophia C Weinmann
- Department of Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mithu Maheswaranathan
- Department of Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, North Carolina, USA
| | - David Leverenz
- Department of Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Christopher A Jones
- Department of Medicine, Division of Geriatrics and Palliative Care, Duke University School of Medicine, Durham, North Carolina, USA
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Liew DFL, Mackie SL, Tison A, Sattui SE, Yates M, Buchanan RRC, Owen CE. Immune Checkpoint Inhibitor-induced Polymyalgia Rheumatica. Rheum Dis Clin North Am 2024; 50:255-267. [PMID: 38670724 DOI: 10.1016/j.rdc.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Polymyalgia rheumatica (PMR) immune-related adverse events (ICI-PMRs) represent a novel, distinct entity, despite many clinical, laboratory, and imaging similarities to classical PMR. Important questions remain in differentiating ICI-PMR from classical PMR, as well as other immune-related adverse events and PMR mimics. Despite this, ICI-PMR currently takes treatment cues from classical PMR, albeit with considerations relevant to cancer immunotherapy. Comparisons between ICI-PMR and classical PMR may provide further bidirectional insights, especially given that important questions remain unanswered about both diseases. The cause of classical PMR remains poorly understood, and ICI-PMR may represent a model of induced PMR, with important therapeutic implications.
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Affiliation(s)
- David F L Liew
- Department of Rheumatology, Austin Health, Heidelberg West VIC 3081, Australia; Department of Clinical Pharmacology and Therapeutics, Austin Health, Heidelberg VIC 3084, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria 3052, Australia.
| | - Sarah L Mackie
- Division of Rheumatic and Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Worsley Building, Leeds, West Yorkshire LS2 9NL, England
| | - Alice Tison
- LBAI UMR1227, Univ Brest, Inserm, Brest, France; Department of Rheumatology, CHU Brest, France Boulevard TANGUY PRIGENT, Brest, Brittany 29609, France
| | - Sebastian E Sattui
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, BST S723, 3500 Terrace Street, Pittsburgh, PA 15261, USA
| | - Max Yates
- Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Russell R C Buchanan
- Department of Rheumatology, Austin Health, Heidelberg West VIC 3081, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Claire E Owen
- Department of Rheumatology, Austin Health, Heidelberg West VIC 3081, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria 3052, Australia
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