Description

Medicine continues to develop at an ever-increasing rate. However, rheumatology is now moving to the forefront. We can at last see concrete results that stem from the investment in basic science research as new, more effective disease modifying agents, such as the anti-tumour necrosis factor alpha (TNFa) drugs, are licensed for use in rheumatoid arthritis. These developments emphasise the importance of maintaining an understanding of the progress of basic science, if we are to continue to keep up with clinical developments!

The advent of expensive anti-TNFa drugs in rheumatology has also provided the stimulus for rheumatologists to work closer together when approaching purchasers, in an attempt to avoid the “postcode-prescribing” of the past. The British Society for Rheumatology must be congratulated for taking the lead in establishing protocols to be adopted nationally, for the evaluation, usage and long-term follow-up by registry of patients taking these agents. We await the results of much negotiation with many purchasers to find out what resources will be made available to allow us to use these new drugs. The preliminary feedback is encouraging.

Unfortunately, there are other, more disturbing developments in medicine also occurring. These are exemplified by the media-led scrutiny of medical mistakes and malpractice in the United Kingdom, resulting in the general public perceiving doctors in a new and, for us, uncomfortable, light. It is easy to feel burdened that not only must we practice the best medicine – as we have been trained to do – but also ensure that we are both seen to be and also evaluated by our peers to be working to the highest standards. Predictably, the onset of Clinical Governance and formal peer review has not been accompanied by the provision of additional time in which we can perform these important endeavours – further adding to the stresses.

Within the context of the above, CPD Rheumatology is proving successful. The articles published in this Journal cover a range of common and rare rheumatology problems, from basic science to clinical aspects and provide a mechanism for the objective evaluation of what has been learnt. It is encouraging to see an ever-increasing number of MCQ’s submitted for marking. Moreover, the annual Horizons in Rheumatology conference, organised by the Board of this Journal, provides an additional forum where the aetiology of and practical issues in the management of rheumatological problems can be discussed in a more interactive manner. In this edition, there is a report on the second annual Horizons in Rheumatology, held at the Royal College of Pathologists in London, earlier this year.

This edition also includes the first of series of articles on vasculitis; and also on that dreaded complaint – back pain. There is also a review of lung disease in scleroderma – a major contributor to mortality – but something that we are very poor at both assessing and managing.

Finally, whilst rheumatologists of national and international standing provide the bulk of the articles in CPD Rheumatology, the Editorial Board also welcomes the submission of articles from other sources, such as trainees. If submitted articles are suitable and able to pass the strict peer review process, they may be published, both conventionally and on the Journal’s website, and cited on EMBASE and Excerpta Medica.