M. Alexander Otto

San Diego – Preemptive levothyroxine seems to help prevent hypothyroidism after radioactive iodine treatment for Graves’ disease, according to an interim analysis of an ongoing randomized, placebo-controlled trial at the Mayo Clinic in Rochester, Minn.

Following iodine treatment, the team is randomizing adult patients to levothyroxine 25 mcg/day or placebo at 4 weeks, then increasing the levothyroxine dose to 50 mcg/day at 6 weeks. The enrollment goal is 60 patients; the team presented results for the first 17 at the Endocrine Society annual meeting.

At 8 weeks, six of 11 (54.5%) levothyroxine patients – but four of the six (66.7%) placebo patients – had overt hypothyroidism.

Hyperthyroidism is the main concern with preemptive levothyroxine, but that hasn’t been a problem so far; in fact, the levothyroxine group has had lower rates of hyperthyroidism (18.2%) than the placebo group (33.3%). Quality of life indicators haven’t separated much; at 8 weeks, thyroid Specific Questionnaire scores were about 12 in both groups, and levothyroxine patients did slightly worse on the hypothyroid–Health Related Quality of Life survey (46 vs. 36).

Given the low numbers, you can’t put too much stock in the findings yet, but the prevention trends are moving in the right direction, said lead investigator Dr. Spyridoula Maraka, a Mayo endocrinology fellow.

“As expected, none of the analyses reached statistical significance given that the sample size is 25% of the planned population,” but “it is reassuring that initiating low-dose levothyroxine 4 weeks after [Graves’ treatment] appears safe, without an increased prevalence of hyperthyroidism. There is an encouraging trend for prevention of overt hypothyroidism .... Accordingly, we plan to continue the trial to completion,” she said.

The work is important because, in many places, the first follow-up visit after Graves’ treatment is at 2 or even 3 months. By then, the majority of patients are hypothyroid, and may even have new or worsened Graves’ orbitopathy. The hope is that pre-emptive levothyroxine will counter the problem.

The fact that more than half of the levothyroxine subjects developed hypothryroidism suggests that “maybe we need a higher dose,” Dr. Maraka said.

If nothing else, the findings argue for earlier follow-up after radioactive iodine treatment, when there’s still a chance of catching nascent hypothyroidism before symptoms set in. “Try to see your patients earlier than week 8.” Six weeks might be a good goal, Dr. Maraka said.

There were no significant baseline differences between the placebo and levothyroxine arms of the study. In both, patients were in their mid-50s, on average, with thyroids of about 30 grams; about two-thirds of patients in both arms were women.

There’s been one adverse event so far; a levothyroxine patient with a history of atrial fibrillation had heart palpitations after quitting her beta-blocker, and dropped out of the study.

Pre-emptive levothyroxine has been studied before, but only retrospectively.

Dr. Maraka has no disclosures, and there was no outside funding for the work.

[email protected]

San Diego – Preemptive levothyroxine seems to help prevent hypothyroidism after radioactive iodine treatment for Graves’ disease, according to an interim analysis of an ongoing randomized, placebo-controlled trial at the Mayo Clinic in Rochester, Minn.

Following iodine treatment, the team is randomizing adult patients to levothyroxine 25 mcg/day or placebo at 4 weeks, then increasing the levothyroxine dose to 50 mcg/day at 6 weeks. The enrollment goal is 60 patients; the team presented results for the first 17 at the Endocrine Society annual meeting.

At 8 weeks, six of 11 (54.5%) levothyroxine patients – but four of the six (66.7%) placebo patients – had overt hypothyroidism.

Hyperthyroidism is the main concern with preemptive levothyroxine, but that hasn’t been a problem so far; in fact, the levothyroxine group has had lower rates of hyperthyroidism (18.2%) than the placebo group (33.3%). Quality of life indicators haven’t separated much; at 8 weeks, thyroid Specific Questionnaire scores were about 12 in both groups, and levothyroxine patients did slightly worse on the hypothyroid–Health Related Quality of Life survey (46 vs. 36).

Given the low numbers, you can’t put too much stock in the findings yet, but the prevention trends are moving in the right direction, said lead investigator Dr. Spyridoula Maraka, a Mayo endocrinology fellow.

“As expected, none of the analyses reached statistical significance given that the sample size is 25% of the planned population,” but “it is reassuring that initiating low-dose levothyroxine 4 weeks after [Graves’ treatment] appears safe, without an increased prevalence of hyperthyroidism. There is an encouraging trend for prevention of overt hypothyroidism .... Accordingly, we plan to continue the trial to completion,” she said.

The work is important because, in many places, the first follow-up visit after Graves’ treatment is at 2 or even 3 months. By then, the majority of patients are hypothyroid, and may even have new or worsened Graves’ orbitopathy. The hope is that pre-emptive levothyroxine will counter the problem.

The fact that more than half of the levothyroxine subjects developed hypothryroidism suggests that “maybe we need a higher dose,” Dr. Maraka said.

If nothing else, the findings argue for earlier follow-up after radioactive iodine treatment, when there’s still a chance of catching nascent hypothyroidism before symptoms set in. “Try to see your patients earlier than week 8.” Six weeks might be a good goal, Dr. Maraka said.

There were no significant baseline differences between the placebo and levothyroxine arms of the study. In both, patients were in their mid-50s, on average, with thyroids of about 30 grams; about two-thirds of patients in both arms were women.

There’s been one adverse event so far; a levothyroxine patient with a history of atrial fibrillation had heart palpitations after quitting her beta-blocker, and dropped out of the study.

Pre-emptive levothyroxine has been studied before, but only retrospectively.

Dr. Maraka has no disclosures, and there was no outside funding for the work.

[email protected]

San Diego – Preemptive levothyroxine seems to help prevent hypothyroidism after radioactive iodine treatment for Graves’ disease, according to an interim analysis of an ongoing randomized, placebo-controlled trial at the Mayo Clinic in Rochester, Minn.

Following iodine treatment, the team is randomizing adult patients to levothyroxine 25 mcg/day or placebo at 4 weeks, then increasing the levothyroxine dose to 50 mcg/day at 6 weeks. The enrollment goal is 60 patients; the team presented results for the first 17 at the Endocrine Society annual meeting.

At 8 weeks, six of 11 (54.5%) levothyroxine patients – but four of the six (66.7%) placebo patients – had overt hypothyroidism.

Hyperthyroidism is the main concern with preemptive levothyroxine, but that hasn’t been a problem so far; in fact, the levothyroxine group has had lower rates of hyperthyroidism (18.2%) than the placebo group (33.3%). Quality of life indicators haven’t separated much; at 8 weeks, thyroid Specific Questionnaire scores were about 12 in both groups, and levothyroxine patients did slightly worse on the hypothyroid–Health Related Quality of Life survey (46 vs. 36).

Given the low numbers, you can’t put too much stock in the findings yet, but the prevention trends are moving in the right direction, said lead investigator Dr. Spyridoula Maraka, a Mayo endocrinology fellow.

“As expected, none of the analyses reached statistical significance given that the sample size is 25% of the planned population,” but “it is reassuring that initiating low-dose levothyroxine 4 weeks after [Graves’ treatment] appears safe, without an increased prevalence of hyperthyroidism. There is an encouraging trend for prevention of overt hypothyroidism .... Accordingly, we plan to continue the trial to completion,” she said.

The work is important because, in many places, the first follow-up visit after Graves’ treatment is at 2 or even 3 months. By then, the majority of patients are hypothyroid, and may even have new or worsened Graves’ orbitopathy. The hope is that pre-emptive levothyroxine will counter the problem.

The fact that more than half of the levothyroxine subjects developed hypothryroidism suggests that “maybe we need a higher dose,” Dr. Maraka said.

If nothing else, the findings argue for earlier follow-up after radioactive iodine treatment, when there’s still a chance of catching nascent hypothyroidism before symptoms set in. “Try to see your patients earlier than week 8.” Six weeks might be a good goal, Dr. Maraka said.

There were no significant baseline differences between the placebo and levothyroxine arms of the study. In both, patients were in their mid-50s, on average, with thyroids of about 30 grams; about two-thirds of patients in both arms were women.

There’s been one adverse event so far; a levothyroxine patient with a history of atrial fibrillation had heart palpitations after quitting her beta-blocker, and dropped out of the study.

Pre-emptive levothyroxine has been studied before, but only retrospectively.

Dr. Maraka has no disclosures, and there was no outside funding for the work.

[email protected]

SAN DIEGO – Encourage teens with metabolic syndrome to snack on nuts; it just might improve their health.

Investigators from the University of Texas Southwestern Medical Center, in Dallas, found that children who ate 12.9 g of nuts per day – the equivalent of a small handful of peanuts, almonds, walnuts, and the like 3 times a week – had less than half the risk of metabolic syndrome, compared with those who did not, when age, sex, race, household income, and daily intake of sugar, fruits, and vegetables were controlled for (odds ratio, 0.43; 95% confidence interval, 0.20-0.92). The benefit persisted up to about 50 g/day, then tapered off, perhaps because the extra calories offset the metabolic benefit.

Adolescents who ate nuts a few times a week also had lower body mass index z scores, smaller waists, lower systolic blood pressure, and higher HDL cholesterol levels. Similar benefits have been found in adults.

The data come from the 2003-2010 National Health and Nutrition Examination Survey (NHANES) of 2,233 12- to 19-year-olds; nut consumption was self-reported.

Pediatrician and lead investigator Dr. Roy Kim stressed that the correlations don’t prove cause and effect. Still, he said he now encourages his patients to eat nuts. He explained why in an interview at a meeting of the Endocrine Society.

[email protected]

SAN DIEGO – Encourage teens with metabolic syndrome to snack on nuts; it just might improve their health.

Investigators from the University of Texas Southwestern Medical Center, in Dallas, found that children who ate 12.9 g of nuts per day – the equivalent of a small handful of peanuts, almonds, walnuts, and the like 3 times a week – had less than half the risk of metabolic syndrome, compared with those who did not, when age, sex, race, household income, and daily intake of sugar, fruits, and vegetables were controlled for (odds ratio, 0.43; 95% confidence interval, 0.20-0.92). The benefit persisted up to about 50 g/day, then tapered off, perhaps because the extra calories offset the metabolic benefit.

Adolescents who ate nuts a few times a week also had lower body mass index z scores, smaller waists, lower systolic blood pressure, and higher HDL cholesterol levels. Similar benefits have been found in adults.

The data come from the 2003-2010 National Health and Nutrition Examination Survey (NHANES) of 2,233 12- to 19-year-olds; nut consumption was self-reported.

Pediatrician and lead investigator Dr. Roy Kim stressed that the correlations don’t prove cause and effect. Still, he said he now encourages his patients to eat nuts. He explained why in an interview at a meeting of the Endocrine Society.

[email protected]

SAN DIEGO – Encourage teens with metabolic syndrome to snack on nuts; it just might improve their health.

Investigators from the University of Texas Southwestern Medical Center, in Dallas, found that children who ate 12.9 g of nuts per day – the equivalent of a small handful of peanuts, almonds, walnuts, and the like 3 times a week – had less than half the risk of metabolic syndrome, compared with those who did not, when age, sex, race, household income, and daily intake of sugar, fruits, and vegetables were controlled for (odds ratio, 0.43; 95% confidence interval, 0.20-0.92). The benefit persisted up to about 50 g/day, then tapered off, perhaps because the extra calories offset the metabolic benefit.

Adolescents who ate nuts a few times a week also had lower body mass index z scores, smaller waists, lower systolic blood pressure, and higher HDL cholesterol levels. Similar benefits have been found in adults.

The data come from the 2003-2010 National Health and Nutrition Examination Survey (NHANES) of 2,233 12- to 19-year-olds; nut consumption was self-reported.

Pediatrician and lead investigator Dr. Roy Kim stressed that the correlations don’t prove cause and effect. Still, he said he now encourages his patients to eat nuts. He explained why in an interview at a meeting of the Endocrine Society.

[email protected]

MAUI, Hawaii – Do not diagnose systemic lupus erythematosus based on vague clinical symptoms and an elevated antinuclear antibody blood test.

As incredible as it seems, Dr. Alvin Wells, director of the Rheumatology and Immunotherapy Center in Franklin, Wis., said he sees doctors doing that all the time in his practice.

SLE is a serious and tricky diagnosis that has long-standing consequences for patients, he said.

Even road rage before an appointment can throw off blood tests. Also, SLE doesn’t seem to be one disease, so drugs have to be picked based on manifestations. Belimumab is a good example of that. Dr. Wells explained those and other insights at the Rheumatology Winter Clinical Symposium.

[email protected]

MAUI, Hawaii – Do not diagnose systemic lupus erythematosus based on vague clinical symptoms and an elevated antinuclear antibody blood test.

As incredible as it seems, Dr. Alvin Wells, director of the Rheumatology and Immunotherapy Center in Franklin, Wis., said he sees doctors doing that all the time in his practice.

SLE is a serious and tricky diagnosis that has long-standing consequences for patients, he said.

Even road rage before an appointment can throw off blood tests. Also, SLE doesn’t seem to be one disease, so drugs have to be picked based on manifestations. Belimumab is a good example of that. Dr. Wells explained those and other insights at the Rheumatology Winter Clinical Symposium.

[email protected]

MAUI, Hawaii – Do not diagnose systemic lupus erythematosus based on vague clinical symptoms and an elevated antinuclear antibody blood test.

As incredible as it seems, Dr. Alvin Wells, director of the Rheumatology and Immunotherapy Center in Franklin, Wis., said he sees doctors doing that all the time in his practice.

SLE is a serious and tricky diagnosis that has long-standing consequences for patients, he said.

Even road rage before an appointment can throw off blood tests. Also, SLE doesn’t seem to be one disease, so drugs have to be picked based on manifestations. Belimumab is a good example of that. Dr. Wells explained those and other insights at the Rheumatology Winter Clinical Symposium.

[email protected]

MAUI, HAWAII– Discontinuing medications when rheumatoid arthritis patients are doing well is a hot topic in rheumatology lately, but it’s tricky.

The idea is to give patients a break from the costs and side effects of steroids, methotrexate, and biologics. Whether or not doing so is a good idea has a lot to do with how you define remission, and the odds of recapturing patients if they flare.

Advice from Dr. Roy Fleischmann, a clinical professor of rheumatology at the University of Texas Southwestern Medical Center in Dallas, might help. At the 2015 Rheumatology Winter Clinical Symposium, he shared his know-how about tapering and discontinuing treatments, culled from his professional experience and the literature on the subject in a video interview.

[email protected]

MAUI, HAWAII– Discontinuing medications when rheumatoid arthritis patients are doing well is a hot topic in rheumatology lately, but it’s tricky.

The idea is to give patients a break from the costs and side effects of steroids, methotrexate, and biologics. Whether or not doing so is a good idea has a lot to do with how you define remission, and the odds of recapturing patients if they flare.

Advice from Dr. Roy Fleischmann, a clinical professor of rheumatology at the University of Texas Southwestern Medical Center in Dallas, might help. At the 2015 Rheumatology Winter Clinical Symposium, he shared his know-how about tapering and discontinuing treatments, culled from his professional experience and the literature on the subject in a video interview.

[email protected]

MAUI, HAWAII– Discontinuing medications when rheumatoid arthritis patients are doing well is a hot topic in rheumatology lately, but it’s tricky.

The idea is to give patients a break from the costs and side effects of steroids, methotrexate, and biologics. Whether or not doing so is a good idea has a lot to do with how you define remission, and the odds of recapturing patients if they flare.

Advice from Dr. Roy Fleischmann, a clinical professor of rheumatology at the University of Texas Southwestern Medical Center in Dallas, might help. At the 2015 Rheumatology Winter Clinical Symposium, he shared his know-how about tapering and discontinuing treatments, culled from his professional experience and the literature on the subject in a video interview.

[email protected]

MAUI, HAWAII – Two homeopathic injectables, as well as the familiar combination of glucosamine and chondroitin, showed promise in two studies of alternative treatments for osteoarthritis.

In an interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Martin J. Bergman, of the department of rheumatology at Drexel University in Philadelphia, shared the recent results from the two investigations.

The first pitted intra-articular injections of two homeopathic products, Traumeel and Zeel, against placebo saline injections for knee osteoarthritis; the work was sponsored by the products’ German maker, Biologische Heilmittel Heel.

In the second trial, glucosamine and chondroitin sulfate went head to head against celecoxib (Celebrex), also for knee OA. The work was sponsored by Bioibérica, a Spanish company that makes chondroitin and glucosamine, and the investigators reported financial ties to the company.

Traumeel and Zeel may sound exotic, but they aren’t unknown in the rheumatology world – some U.S. rheumatologists are using them, Dr. Bergman, also chief of rheumatology at Taylor Hospital in Ridley Park, Pa., said.

Dr. Bergman disclosed that he has served as an advisor, speaker, or consultant for AbbVie, Amgen, Celgene, and Roche, and holds shares in Bristol-Myers Squibb, Johnson & Johnson, and Pfizer.

[email protected]

MAUI, HAWAII – Two homeopathic injectables, as well as the familiar combination of glucosamine and chondroitin, showed promise in two studies of alternative treatments for osteoarthritis.

In an interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Martin J. Bergman, of the department of rheumatology at Drexel University in Philadelphia, shared the recent results from the two investigations.

The first pitted intra-articular injections of two homeopathic products, Traumeel and Zeel, against placebo saline injections for knee osteoarthritis; the work was sponsored by the products’ German maker, Biologische Heilmittel Heel.

In the second trial, glucosamine and chondroitin sulfate went head to head against celecoxib (Celebrex), also for knee OA. The work was sponsored by Bioibérica, a Spanish company that makes chondroitin and glucosamine, and the investigators reported financial ties to the company.

Traumeel and Zeel may sound exotic, but they aren’t unknown in the rheumatology world – some U.S. rheumatologists are using them, Dr. Bergman, also chief of rheumatology at Taylor Hospital in Ridley Park, Pa., said.

Dr. Bergman disclosed that he has served as an advisor, speaker, or consultant for AbbVie, Amgen, Celgene, and Roche, and holds shares in Bristol-Myers Squibb, Johnson & Johnson, and Pfizer.

[email protected]

MAUI, HAWAII – Two homeopathic injectables, as well as the familiar combination of glucosamine and chondroitin, showed promise in two studies of alternative treatments for osteoarthritis.

In an interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Martin J. Bergman, of the department of rheumatology at Drexel University in Philadelphia, shared the recent results from the two investigations.

The first pitted intra-articular injections of two homeopathic products, Traumeel and Zeel, against placebo saline injections for knee osteoarthritis; the work was sponsored by the products’ German maker, Biologische Heilmittel Heel.

In the second trial, glucosamine and chondroitin sulfate went head to head against celecoxib (Celebrex), also for knee OA. The work was sponsored by Bioibérica, a Spanish company that makes chondroitin and glucosamine, and the investigators reported financial ties to the company.

Traumeel and Zeel may sound exotic, but they aren’t unknown in the rheumatology world – some U.S. rheumatologists are using them, Dr. Bergman, also chief of rheumatology at Taylor Hospital in Ridley Park, Pa., said.

Dr. Bergman disclosed that he has served as an advisor, speaker, or consultant for AbbVie, Amgen, Celgene, and Roche, and holds shares in Bristol-Myers Squibb, Johnson & Johnson, and Pfizer.

[email protected]

MAUI, HAWAII – There’s been fairly brisk uptake of biosimilar infliximab in Europe, both for new patients and as a possible switch from Remicade.

That biosimilar infliximab, Remsima, was submitted for U.S. approval in 2014, and a Food and Drug Administration advisory panel recently recommended approval of a biosimilar for filgrastim (Neupogen).

The agents are in the vanguard of what is sure to be an expanding market in the United States as biologics come off patent. Additional infliximab replacements are in the works, as well as biosimilars for etanercept, adalimumab, rituximab, and others.

For rheumatologists, that could mean less expensive treatments for patients, but it’s also likely to make treatment more complicated. Given the complexity of the molecules, the differences between biosimilars and familiar brands could be a bit more marked than those between small-molecule generics and their branded counterparts.

In a video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Arthur F. Kavanaugh, a rheumatology professor at the University of California, San Diego, outlined the latest developments and shared his thoughts on the rapidly evolving field.

[email protected]


MAUI, HAWAII – There’s been fairly brisk uptake of biosimilar infliximab in Europe, both for new patients and as a possible switch from Remicade.

That biosimilar infliximab, Remsima, was submitted for U.S. approval in 2014, and a Food and Drug Administration advisory panel recently recommended approval of a biosimilar for filgrastim (Neupogen).

The agents are in the vanguard of what is sure to be an expanding market in the United States as biologics come off patent. Additional infliximab replacements are in the works, as well as biosimilars for etanercept, adalimumab, rituximab, and others.

For rheumatologists, that could mean less expensive treatments for patients, but it’s also likely to make treatment more complicated. Given the complexity of the molecules, the differences between biosimilars and familiar brands could be a bit more marked than those between small-molecule generics and their branded counterparts.

In a video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Arthur F. Kavanaugh, a rheumatology professor at the University of California, San Diego, outlined the latest developments and shared his thoughts on the rapidly evolving field.

[email protected]


MAUI, HAWAII – There’s been fairly brisk uptake of biosimilar infliximab in Europe, both for new patients and as a possible switch from Remicade.

That biosimilar infliximab, Remsima, was submitted for U.S. approval in 2014, and a Food and Drug Administration advisory panel recently recommended approval of a biosimilar for filgrastim (Neupogen).

The agents are in the vanguard of what is sure to be an expanding market in the United States as biologics come off patent. Additional infliximab replacements are in the works, as well as biosimilars for etanercept, adalimumab, rituximab, and others.

For rheumatologists, that could mean less expensive treatments for patients, but it’s also likely to make treatment more complicated. Given the complexity of the molecules, the differences between biosimilars and familiar brands could be a bit more marked than those between small-molecule generics and their branded counterparts.

In a video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. Arthur F. Kavanaugh, a rheumatology professor at the University of California, San Diego, outlined the latest developments and shared his thoughts on the rapidly evolving field.

[email protected]


MAUI, HAWAII – Though costly, newer biologics increase 1-year survival with metastatic melanoma from perhaps 40% to more than 70%.

Among the latest are nivolumab and pembrolizumab, antibodies against PD-1 (programmed cell death) cell surface receptors that were approved in 2014 for unresectable melanoma no longer responding to other drugs; another anti-PD-1 is in development.

In this video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. George Martin of the Dermatology and Laser Center of Maui explains the latest developments and shares his excitement about them.

MAUI, HAWAII – Though costly, newer biologics increase 1-year survival with metastatic melanoma from perhaps 40% to more than 70%.

Among the latest are nivolumab and pembrolizumab, antibodies against PD-1 (programmed cell death) cell surface receptors that were approved in 2014 for unresectable melanoma no longer responding to other drugs; another anti-PD-1 is in development.

In this video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. George Martin of the Dermatology and Laser Center of Maui explains the latest developments and shares his excitement about them.

MAUI, HAWAII – Though costly, newer biologics increase 1-year survival with metastatic melanoma from perhaps 40% to more than 70%.

Among the latest are nivolumab and pembrolizumab, antibodies against PD-1 (programmed cell death) cell surface receptors that were approved in 2014 for unresectable melanoma no longer responding to other drugs; another anti-PD-1 is in development.

In this video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. George Martin of the Dermatology and Laser Center of Maui explains the latest developments and shares his excitement about them.

MAUI, HAWAII – Though costly, newer biologics increase 1-year survival with metastatic melanoma from perhaps 40% to more than 70%.

Among the latest are nivolumab and pembrolizumab, antibodies against PD-1 (programmed cell death) cell surface receptors that were approved in 2014 for unresectable melanoma no longer responding to other drugs; another anti-PD-1 is in development.

In this video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. George Martin of the Dermatology and Laser Center of Maui explains the latest developments and shares his excitement about them.

[email protected]

MAUI, HAWAII – Though costly, newer biologics increase 1-year survival with metastatic melanoma from perhaps 40% to more than 70%.

Among the latest are nivolumab and pembrolizumab, antibodies against PD-1 (programmed cell death) cell surface receptors that were approved in 2014 for unresectable melanoma no longer responding to other drugs; another anti-PD-1 is in development.

In this video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. George Martin of the Dermatology and Laser Center of Maui explains the latest developments and shares his excitement about them.

[email protected]

MAUI, HAWAII – Though costly, newer biologics increase 1-year survival with metastatic melanoma from perhaps 40% to more than 70%.

Among the latest are nivolumab and pembrolizumab, antibodies against PD-1 (programmed cell death) cell surface receptors that were approved in 2014 for unresectable melanoma no longer responding to other drugs; another anti-PD-1 is in development.

In this video interview at the 2015 Rheumatology Winter Clinical Symposium, Dr. George Martin of the Dermatology and Laser Center of Maui explains the latest developments and shares his excitement about them.

[email protected]