Rheumnow Podcast Cases & Guidelines
22 snips
Dec 10, 2025 
Join Audrey Gibson, a physician assistant in rheumatology, Benjamin A. Smith, also a physician assistant, and Emma Babbage, a rheumatology nurse from Tasmania, as they tackle complex cases in psoriatic arthritis and rheumatoid arthritis. They discuss treatment decisions, including the challenges of methotrexate and switching to JAK inhibitors. The conversation dives into practical clinic strategies, patient preferences, and the importance of adherence. They also share insights on steroid management and holistic care, providing valuable tips for healthcare professionals.
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Stop Methotrexate If Toxicity Emerges
- If methotrexate causes toxicity or fails, consider switching to a biologic or JAK rather than persisting with harmful DMARDs.
- Monitor labs closely and choose therapy that controls both skin and joint disease.
Adapt To Funding And Guideline Limits
- Follow local funding/rules: Australia requires two DMARD trials before biologics.
- If funding allows, still individualize choice by severity and contraindications.
Act Fast In Early Erosive RA
- Early erosive, seropositive RA warrants rapid escalation beyond methotrexate to prevent damage.
- Guidelines differ, but aggressive disease should prompt biologic or JAK consideration.