LEF-WASH is a transparent clinical heuristic for reproductive-safety triage when leflunomide is active, recently stopped, or being cleared before conception in rheumatic and autoimmune disease. The bedside problem is not whether the drug was merely discontinued, but whether cholestyramine washout occurred, whether teriflunomide clearance below 0.
ANIFRO-HZ is an executable, transparent clinical decision-support skill for stratifying herpes zoster concern in systemic lupus erythematosus during or soon after anifrolumab exposure. The bedside problem is not only knowing that zoster risk exists, but recognizing when glucocorticoids, lymphopenia, nephritis-level co-immunosuppression, absent recombinant zoster vaccination, and early symptom patterns create a treatment context that should alter monitoring or escalation.
## Abstract Anticoagulation in antiphospholipid syndrome (APS) remains clinically contentious because the convenience of direct oral anticoagulants (DOACs) is not matched by uniform safety across APS phenotypes. The central bedside problem is not whether DOACs are ever usable, but whether a given patient sits in a high-risk phenotype where DOAC exposure is especially unfavorable.
Denosumab discontinuation creates a distinctive clinical hazard: vertebral-fracture risk can rebound rapidly when treatment is delayed or stopped without sequential antiresorptive therapy. This problem is especially relevant in rheumatology and glucocorticoid-treated osteoporosis, where missed injections may go unnoticed until new back pain or clustered vertebral fractures emerge.
RA-MODEL is an executable Python skill that consolidates standard rheumatoid arthritis disease-activity and function indices into one transparent longitudinal workflow. It computes DAS28-CRP, DAS28-ESR, CDAI, SDAI, Boolean remission, HAQ-DI, RAPID3, and a treat-to-target summary across serial visits.
Visual ischemic complications of giant cell arteritis (GCA) are among the most time-sensitive emergencies in rheumatology and ophthalmology because permanent vision loss can occur before diagnostic certainty is complete. GCA-VISION is an executable dependency-free Python skill that converts this bedside problem into a transparent 0-100 ocular ischemia risk-context score.
HCQ-QT is an executable Python skill for transparent QT-prolongation risk-context stratification before or during hydroxychloroquine therapy in rheumatic and autoimmune disease. It weights baseline QTc, sex-age context, kidney function, potassium and magnesium status, structural and arrhythmic cardiac history, bradycardia, concomitant QT-prolonging drugs, hydroxychloroquine dose intensity, and syncope or palpitations into a 0-100 concern score.
Osteonecrosis is a clinically meaningful but often underrecognized complication of systemic lupus erythematosus (SLE), especially after repeated pulse methylprednisolone exposure or sustained high cumulative glucocorticoid burden. The diagnostic problem is practical: early hip or groin pain may be normalized until structural injury is advanced, while the real risk context was created earlier by nephritis, steroid intensity, vascular-metabolic factors, and thrombosis biology.
Occult Strongyloides stercoralis infection is an under-recognized safety problem in rheumatology and autoimmune care because clinically silent infection may accelerate into hyperinfection after glucocorticoids or other potent immunosuppression. STRONGY-GUARD is an executable Python skill that converts this bedside problem into a transparent 0-100 risk-context score using endemic exposure, eosinophilia, positive serology, positive stool/larvae, glucocorticoid intensity and duration, pulse methylprednisolone, rituximab/cyclophosphamide exposure, HTLV-1, compatible symptoms, gram-negative sepsis, current immunosuppression, and recent ivermectin treatment.
Vaccination planning around rituximab is a recurring clinical problem in rheumatic and autoimmune disease because clinicians must balance infection-prevention urgency against expected vaccine blunting after B-cell depletion. RTX-VAX is an executable Python skill for transparent readiness stratification before non-live vaccination.
Pegloticase can produce major improvement in uncontrolled gout, but safe use depends on recognizing G6PD deficiency, urate rebound, prior infusion reactions, weak monitoring setups, and danger symptoms before harm occurs. We present PEGLOTI-GUARD, an executable Python skill for transparent pegloticase infusion-safety risk-context stratification.
Medication-related osteonecrosis of the jaw (MRONJ) is uncommon in routine osteoporosis care, but when it occurs it is clinically disruptive, difficult to reverse, and often amplified by avoidable dental and host-level cofactors. ONJ-GUARD is an executable Python skill for transparent MRONJ risk-context stratification that integrates antiresorptive exposure type, therapy duration, invasive dental procedures, periodontal disease, oral trauma, glucocorticoids or immunosuppression, diabetes, smoking, prior MRONJ or exposed nonhealing bone, and active jaw symptoms.
We present ALLO-SAFE, a transparent executable clinical skill for relative risk stratification before or during very early allopurinol initiation. The model integrates HLA-B*58:01 status, ancestry-linked pretest concern, chronic kidney disease, planned starting dose, thiazide exposure, prior rash history, age, chronic liver disease, urgency pressure to start therapy, and baseline monitoring readiness.
# COLCHI-MYO: Transparent Colchicine-Associated Neuromyopathy Risk-Context Stratification Before or During Therapy **Authors:** Dr. Erick Zamora-Tehozol, DNAI, RheumaAI **ORCID:** 0000-0002-7888-3961 ## Abstract Colchicine remains an important anti-inflammatory drug in gout, calcium pyrophosphate disease, pericarditis, and selected autoinflammatory disorders, but clinically meaningful toxicity can emerge when exposure rises because of renal failure, dialysis, interacting drugs, or prolonged treatment.
ALLO-SCAR is an executable clinical skill for transparent allopurinol severe cutaneous adverse reaction risk-context stratification before initiation or during early toxicity assessment. The model integrates HLA-B*58:01 status, ancestry context, chronic kidney disease, allopurinol dose, diuretic exposure, cardiovascular comorbidity or hypertension, prior rash, timing since start, and early warning signs including fever, facial edema, mucosal involvement, eosinophilia, transaminitis, and creatinine rise.
Febuxostat is an important urate-lowering option when allopurinol is not tolerated, contraindicated, or ineffective, but cardiovascular safety remains a real bedside concern in patients with gout and high cardiac comorbidity. We present **FEBUX-CV**, a transparent executable skill for cardiovascular risk-context stratification before or during febuxostat exposure.
TNF-HF is an executable Python clinical skill for transparent heart-failure decompensation risk stratification before or during TNF inhibitor therapy in rheumatic and autoimmune disease. The model integrates TNF agent, NYHA class, left ventricular ejection fraction, prior heart-failure hospitalization, NT-proBNP, loop diuretic use, ischemic heart disease, uncontrolled hypertension, chronic kidney disease, diabetes, congestion symptoms, and recent TNF start or escalation timing.
MTX-PNEUMO is an executable Python clinical skill for transparent methotrexate-associated pneumonitis risk stratification in rheumatic and autoimmune disease. The model integrates age, time since methotrexate initiation, weekly dose, pre-existing ILD/fibrosis, abnormal baseline chest imaging, prior DMARD lung toxicity, diabetes, hypoalbuminemia, CKD, dyspnea, dry cough, fever, hypoxemia, eosinophilia, diffuse interstitial or ground-glass imaging pattern, and whether infection has been excluded.
We present CYCLO-OVA, an executable Python skill for transparent ovarian-failure risk stratification before or during cyclophosphamide exposure in rheumatic and autoimmune disease. The model integrates age, planned cumulative dose, oral daily versus pulse exposure, prior cyclophosphamide exposure, baseline low ovarian reserve or prior amenorrhea, expectation of repeated treatment cycles, other gonadotoxic exposures, fertility goals, GnRH agonist mitigation planning, and availability of less gonadotoxic alternatives.
Leflunomide-associated interstitial lung toxicity is uncommon but clinically important because presentations can be abrupt, severe, and difficult to separate from rheumatoid arthritis-associated interstitial lung disease or pulmonary infection. The bedside problem is not merely whether the adverse event is rare.