Services

Our Services

What We Offer

Evaluation, Diagnosis & Treatment

At AOC, we harness the latest medical technology and evidence-based practice to provide you with the very best assessment, diagnosis, and treatment available. We attempt to be ambassadors along each patient’s individual journey to health. We are of the belief that “fast food Rheumatology” does not exist. We favor a methodical approach which primarily relies on old fashioned medicine: a detailed history and exam, followed by appropriate lab testing and imaging. Because we understand the pitfalls of “shotgun testing” or “pan-laboratory testing” we prefer a more targeted diagnostic testing approach. Our providers have the unique training and experience to put these puzzle pieces of information together and formulate a diagnosis.

Once a diagnosis is confirmed, we help patients fully understand their illness. Our experience suggests that well-informed patients are better able to make decisions about their health. Before treatment options are discussed, we attempt to understand our patients’ needs, concerns and expectations. We strongly feel listening to patients, encouraging them to ask questions, and always including them in the decision-making process empowers them in their wellness journey. We believe in thinking broadly and holistically about our patients. Whenever possible we incorporate non-pharmacologic treatments (e.g. mindfulness, certain high-quality supplements, physical therapy, lifestyle modification) into the treatment plan. Many of these treatments can be of significant adjunctive benefit alongside more conventional pharmacologic treatments. Rheumatology has been blessed with a variety of highly effective medical treatments which can put some of our chronic diseases in a remission state. These same treatments have been proven to avoid disability and preserve physical function over a lifetime. Cutting edge treatments will certainly be offered but we don’t ignore older medications that can be very effective especially in combination with newer treatments. The immune system is very complex and varies from patient to patient. While a particular treatment can be highly effective for one patient, another patient may not respond at all. For this reason, our treatment plans are not “one size fits all” and are rather tailored to the individual.

State of the Art Infusion Center

At AOC, we are fortunate to have a state-of-the-art infusion center. Unlike some general infusion centers and hospital infusion centers, our facility focuses on Rheumatology, Osteoporosis, and other specialized treatments. To enhance safety of our patient population, none of the patients in our infusion space will have chronic infections and/or require Intravenous antibiotics. Advantages of Intravenous treatments are several including 1. higher bioavailability of the medication (drug levels higher translating to more efficacious treatments), 2. lack of preservative (most subcutaneously self- administered biologics contain preservatives which can lead to injection site reactions) 3. ability to adjust or tailor dose to the size of an individual (subcutaneously self- administered biologics are “one size fits all” where all patients despite size differences get the same dose of the drug). 4. Treatments are typically spaced over longer intervals (often 8 week) so patients aren’t dosing weekly/every 2 weeks. Listed below are the treatments we offer at our facility. If the biologic drug prescribed for you is not listed on this page, we still may offer infusions of it. Talk to your rheumatologist or call our office and ask. The below descriptions are brief and only an overview; more details about each medicine can be found on each drug’s website which is hyperlinked.

REMICADE® (infliximab)

Remicade is classified as a tumor necrosis factor (TNF)-inhibitor and when used with methotrexate to treat rheumatoid arthritis (RA), infusions of Remicade can reduce signs and symptoms, help prevent further joint damage, and improve physical function for patients with moderately to severe RA. Remicade is also used to treat:

Psoriatic Arthritis (PsA)
Ankylosing Spondylitis (AS)
Plaque Psoriasis

Remicade is given by intravenous (IV) infusion in our offices. If you are prescribed Remicade, after your first three doses, you will most likely return every 6-8 weeks. Each infusion takes up to 2 hours.

ORENCIA® (abatacept)

ORENCIA is used in adults to reduce signs and symptoms of moderate to severe rheumatoid arthritis (RA). It may prevent further bone and joint damage and improve physical function. ORENCIA may be used alone or with other RA treatments. If you are prescribed ORENCIA, after your first three doses, you will come to the office for an intravenous (IV) infusion every 4 weeks. Each infusion takes 30 minutes. Orencia is also used to treat:

Psoriatic Arthritis (PsA)

RITUXAN® (rituximab)

Rituxan is used with methotrexate to treat adult patients who have moderately to severely active rheumatoid arthritis (RA). It is often used for patients who have not responded well to other RA treatments. Rituxan reduces signs and symptoms of RA and can slow progression of joint and bone damage. Patients who receive infusions of Rituxan often see improvements that can last through six months. The drug is also approved to treat Granulomatosis with polyangilitis (formerly known as Wegener’s). If you are prescribed Rituxan, you will come to the office for IV infusions at a frequency determined by your doctor based on your diagnosis.

ACTEMRA® (tocilizumab)

ACTEMRA is a prescription medicine called an interleukin-6 (IL-6) receptor inhibitor.

It is used to treat adults with moderately to severely active rheumatoid arthritis (RA). ACTEMRA blocks a substance in the body called interleukin-6 which is overproduced by people with RA. Improvements of RA symptoms have been reported within a few weeks after starting treatment. If you are prescribed ACTEMRA, you’ll receive an intravenous (IV) infusion given over 1 hour every 4 weeks. Actemra is also approved to treat Giant Cell Arteritis (GCA).

CIMZIA® (certolizumab pegol)

CIMZIA is a medicine used to treat adults with active rheumatoid arthritis (RA). It is referred to as an “anti-TNF therapy.” By blocking tumor necrosis factor (TNF)-alpha, CIMZIA helps reduce the inflammation, stiffness and joint damage RA causes. In clinical trials, CIMZIA has been shown to reduce RA pain, stiffness, and fatigue in as fast as 1 to 2 weeks. There is data showing safety associated with the use of Cimzia in pregnant and lactating females. If you are prescribed CIMZIA, you’ll come to our offices to receive an injection under the skin. After your first 3 doses, you’ll need a new injection every 4 weeks. Cimzia is also used to treat:

Psoriatic Arthritis (PsA)
Ankylosing Spondylitis (AS)
Plaque Psoriasis

SIMPONI ARIA® (golimumab)

SIMPONI ARIA is used in combination with methotrexate for adults with moderate to severe rheumatoid arthritis (RA). Different patients see different results but, in general, this medicine has been proven to help:

relieve the pain, stiffness, and swelling of RA
stop further joint damage
improve your ability to perform every day activities with less difficulty

If you are prescribed SIMPONI ARIA, you will come to our offices to receive an infusion through a needle placed in your vein, usually in your arm. After two starter doses, 4 weeks apart, you will return for an infusion once every 8 weeks. Each infusion takes about 30 minutes. SIMPONI ARIA is also used to treat:

Psoriatic Arthritis (PsA)
Ankylosing Spondylitis (AS)

Lupus Treatment

BENLYSTA® (belimumab)

BENLYSTA is a prescription medication used to treat adults with active systemic lupus erythematous (SLE or lupus), who are receiving other lupus medicines. BENLYSTA is a biologic therapy that works by reducing certain cells in your immune system that can make lupus active. If you are prescribed BENLYSTA, you will come to the office for an intravenous (IV) infusion given over 1 hour every 4 weeks. For the first three infusions, you’ll need an infusion every two weeks. After the first three, you’ll come in every 4 weeks for an infusion.

SAPHNELO® (anifronlumab-fnia)

SAPHNELO is a prescription medication used to treat adults with Lupus. SAPHNELO is a biologic medication administered intravenously every 4 weeks.

Osteoporosis Treatments

EVENITY®

Evenity is a prescription medication for the treatment of osteoporosis in postmenopausal women who have an increased risk for fractures. By leveraging a unique mechanism, this is one of the few Osteoporosis drugs that actually “builds new bone.” The drug can help reduce fracture risk and strengthen your bones. If you are prescribed Evenity, you will come to the office to receive two subcutaneous (just under the skin) injections of the drug once every month for total of 12 months.

PROLIA® (denosumab)

Prolia is a prescription medication for the treatment of osteoporosis in postmenopausal women who have an increased risk for fractures. The drug can help reduce fracture risk and strengthen your bones. Prolia is also used to increase bone mass in men with osteoporosis who have a high risk for bone fracture. It is also used to treat patients who have not benefitted from or are unable to tolerate other available osteoporosis treatments. If you are prescribed Prolia, you will come to the office to receive subcutaneous (just under the skin) injections of the drug once every 6 months.

RECLAST® (Zoledronic acid)

Reclast is the only FDA-approved once-a-year osteoporosis treatment. Reclast, along with daily calcium and vitamin D, helps to increase bone density, protecting and strengthening your bones. Reclast is approved for:

Treatment and prevention of osteoporosis in postmenopausal women
Reducing the incidence of new bone fractures in patients at high risk of fractures (those with recent low-trauma hip fracture)
Treatment to increase bone mass in men with osteoporosis
Treatment of Paget’s disease of the bone for both men and women

If you are prescribed Reclast, you will come to our office to receive one dose through intravenous (IV) infusion treatment once a year. The infusion takes at least 15 minutes to administer.

Gout Treatment

KRYSTEXXA® (pegloticase)

KRYSTEXXA is used as a treatment of chronic gout in adults. It is usually given after other gout medications have been tried without success. Gout is caused by a build up of uric acid in your blood. KRYSTEXXA is an enzyme that breaks down uric acid so that it can be eliminated from the body in urine. If you are prescribed KRYSTEXXA, you will receive it through intravenous (IV) infusion at a frequency of every 2 weeks. Each infusion takes about 2 hours.

Injection Services

Our providers can perform needle-based injections to ease pain associated with joints and/or tendons. Joint and soft tissue injections are often performed with medications, such as corticosteroids. A steroid medication (sometimes called “cortisone”) is injected into or around a joint/muscle/tendon. The steroid treats the inflammation leading to decreased swelling and pain. Sometimes joint fluid is removed before the steroid is injected into the joint (aspiration). Drainage of a large amount of fluid from a joint can provide pain relief and improved mobility. In addition to standard forms of “cortisone” (triamcinolone/depo-medrol) our providers offer ZILRETTA® is an extended release corticosteroid injection indicated for Osteoarthritis of the knee.

Musculoskeletal Ultrasound

Musculoskeletal ultrasound is a non-invasive, radiation-free procedure that uses sound waves to produce images of joints, tendons, soft tissues. It can be a very reliable way to diagnose and monitor inflammatory arthritic syndromes like Rheumatoid Arthritis and Psoriatic Arthritis.

Bone Density Testing (DEXA Scan)

A DEXA scan is a type of medical imaging test that uses very low levels of x-rays to measure the mineral content of bone in certain areas of the skeleton to help determine the density of bone. After menopause and with aging our skeleton loses bone density and this increases the risk of fractures. DEXA scan testing is considered the gold standard for diagnosing Osteoporosis.

Clinical Research Trials Services

Our providers do participate in clinical research studies and have served as principal investigators and sub-investigators on a number of studies . In clinical research studies, also known as clinical trials, researchers evaluate investigational medications under carefully controlled conditions. The FDA only approves medications if they are found to be safe and effective during the clinical research process. It takes a team of healthcare professionals to conduct a research study. Besides the main physician (principal investigator) who oversees the study, the research team may include other doctors, nurses, study coordinators and other healthcare professionals. Our office partners with Stat Research with all of our trials.

Why participate in a clinical research study?

Receive related medical care and potentially state of the art study medication, which often includes exams and other tests to monitor your condition, at no cost to you
Receive the attention and support of the study physician and staff
Learn more about your condition and your overall health
Advances medical knowledge of the condition which could benefit people who have the same condition in the future

Qualifying for a research study

All research studies have specific requirements for participation. This ensures that the study is right for you and that the researchers collect quality study data.

Your safety comes first

All study plans, also called protocols, and participant materials are reviewed and approved by an independent ethics committee, called an Institutional Review Board. This ensures that the research study is ethical and that participants’ rights are protected.
Study protocols have detailed instructions for doctors to follow your health while you are participating in the study. There are even doctors outside the study who help oversee study’s progress and ensure your safety comes first.

Learn more about clinical trials at www.clinicaltrials.gov

Natural Nutritional Supplements

We offer access to high quality supplements. Oasis Health’s line of Premium Products was formulated by Rheumatologists to provide patients a natural, preventative approach as part of their overall wellness plan. All products are third party tested for purity with verified sourcing and are manufactured in the USA. All Oasis products are organic, and free of both gluten and GMOs. Many other supplements on the open market do not follow strict testing guidelines, which leaves room for under-dosed products and inaccuracy in delivery. By third party testing individual ingredients and the finish blend each time, Oasis ensures potency for every batch of its products

Synovial Fluid Analysis

Rheumatologists often use a polarized light microscope to analyze fluid removed from inflamed joints to help determine which arthritis is causing the swelling. Using this technology, our providers are often more accurately able to confirm crystalline forms of arthritis like gout or pseudogout.

Laboratory Services

At AOC we have partnered with LabCorp for a convenient in-house laboratory for drawing blood to help with diagnosis of disease and medication monitoring.