Rheumatologist OnCall

Rheumatologist OnCall Rheumatologist OnCall is a telemedicine practice actively seeing patients in multiple US states

Rheumatologist OnCall provides people with convenient and accessible access to specialized rheumatology care. With the goal of addressing the unique needs of patients dealing with rheumatic conditions, this innovative platform offers a range of benefits:

👨‍⚕️ Expert Consultations: Rheumatologist OnCall connects patients with experienced rheumatologists who specialize in diagnosing and treating co

nditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and other autoimmune disorders.

📱 Telehealth Convenience: Patients can access consultations from the comfort of their homes, eliminating the need for time-consuming and potentially challenging in-person visits.

🌐 Accessible Anywhere: Whether you reside in a rural area or a bustling city, Rheumatologist OnCall ensures that expert care is available to you, regardless of your location. Check out the states where we are licensed!

🔒 Secure and Private: The platform prioritizes patient privacy and data security, adhering to strict confidentiality standards.

📋 Comprehensive Care: Rheumatologist OnCall offers a comprehensive approach to managing rheumatic conditions, from diagnosis to ongoing treatment and support.

⏰ Timely Assistance: Patients can schedule appointments at their convenience, reducing waiting times and ensuring prompt attention to their healthcare needs.

💼 Collaborative Care: The platform encourages collaboration between patients and physcians, fostering a patient-centered approach to managing rheumatic conditions.

📊 Education and Resources: Rheumatologist OnCall strives to empower patients with information and resources to better understand and manage their conditions.

04/13/2026

The way we treat autoimmune disease is about to change forever. 🧬
And we're not talking 10 years from now.
Some of these breakthroughs are happening RIGHT NOW
⚡1. VAGUS NERVE STIMULATION — FDA APPROVED 2025 This is not experimental. The SetPoint System — a jellybean-sized implantable device — received FDA approval for Rheumatoid Arthritis in July 2025. Here's how it works: RA is driven by an overactive inflammatory reflex. The vagus nerve is the body's natural "off switch" for that reflex. This device stimulates the vagus nerve for just 1 minute a day — calming the immune system without suppressing it.
Currently approved for moderate-to-severe RA patients who have failed biologics. Rollout expanding across the US in 2026.
🧬 2. CAR-T CELL THERAPY — IN CLINICAL TRIALS, BREAKTHROUGH RESULTS
CAR-T therapy — already transforming blood cancers — is now showing remarkable results in autoimmune disease.
Here's the concept: your own T cells are extracted, genetically reprogrammed to target autoreactive B cells (the immune cells driving your disease), and reinfused. The result? A deep immune system reset. ⚠️ Important: CAR-T for autoimmune disease is still in clinical trials. It is NOT yet broadly FDA-approved for RA or lupus outside specialized research centers. This is the frontier — but the data is extraordinary.
🔬 3. GENE THERAPY — Gene therapy for autoimmune disease aims to correct the underlying genetic dysfunction driving immune dysregulation — not just suppress it. Early-stage research is underway targeting HLA gene variants, cytokine regulation, and immune tolerance restoration.
🩺 WHAT THIS MEANS FOR YOU TODAY:
These therapies represent hope — especially for patients who have failed multiple biologics or are struggling with treatment-resistant disease.
They also represent why staying connected to a rheumatologist who follows the cutting edge of this science matters. 💙
At Rheumatologist OnCall®, we follow every major development— so that when these therapies become available, our patients are the first to know.

📲 Book a consultation — 20 states:
🌐 rheumatologistoncall.com/book | 📞 (650) 525-4404

Save this. The future of autoimmune disease treatment is being written right now — and you deserve to know what's coming.

04/12/2026

Rheumatoid Arthritis doesn't live only in your joints.
It lives in your immune system.
Your gut. Your hormones. Your stress levels. Your sleep. Your plate.
So why is most RA treatment just a prescription and a 7-minute follow-up? 🤔
At Rheumatologist OnCall®, we do it differently.

Here's what a complete RA treatment plan looks like with Dr. Diana Girnita & Dr. Vishnuteja Devalla:

THE ADVANCED MEDICINE:
✅ DMARDs — Methotrexate, Hydroxychloroquine, Leflunomide
✅ Biologics — TNF inhibitors (Humira, Enbrel), IL-6 inhibitors (Actemra), IL-17, abatacept
✅ JAK inhibitors — Rinvoq, Xeljanz, Olumiant (oral pills, no injections)
✅ Biosimilars — same efficacy, dramatically lower cost
✅ Precision medicine & extended autoimmune lab panels
✅ 80% discounts on labs and imaging

🌿 THE HOLISTIC LAYER:
✅ Mediterranean anti-inflammatory nutrition — online course + live coaching
✅ Gut microbiome support — because leaky gut and RA are directly connected
✅ Science-backed supplements — omega-3 EPA, curcumin phytosome, Vitamin D
✅ Low-impact exercise guidance — swimming, yoga, physical therapy protocols
✅ Stress management & mindfulness — chronic stress triggers RA flares

And Dr. Girnita literally wrote the book on it:
"Thriving with Rheumatoid Arthritis" — where conventional medicine meets whole-body healing.

THE EXPERIENCE:
→ 60-minute new patient appointment (vs 7–15 min nationally)
→ Up to 2 hours of medical record review BEFORE your visit
→ No referral needed
→ 1–2 week wait (vs 4–6 months nationally)
→ Telehealth across 20 states

RA remission is possible. But it requires more than a prescription. 💙

📲 Book your consultation:
🌐 rheumatologistoncall.com/book | 📞 (650) 525-4404
Save this and share with any RA patient who feels undertreated or stuck.

04/11/2026

"I hate injections. Is there a pill for my Rheumatoid Arthritis?"

Yes. And it's one of the most exciting advances in RA treatment in years.

Meet JAK inhibitors — the oral "small molecule" medications that are changing how RA is treated.

WHAT ARE JAK INHIBITORS?

Unlike biologics (which are injected), JAK inhibitors are daily pills that work by blocking the JAK-STAT pathway — the internal signaling route that tells your immune system to attack your joints.

They're called "small molecules" because they're chemically synthesized (not made from living cells like biologics) — which means they're:

✅ Taken orally — no injections, no infusion center
✅ Faster acting — shorter half-life means quicker adjustments
✅ Equally powerful — efficacy comparable or superior to biologics in clinical trials
✅ FDA-approved for moderate-to-severe RA

THE THREE FDA-APPROVED JAK INHIBITORS FOR RA:
🔹 Tofacitinib (Xeljanz) — approved 2012, first in class
🔹 Baricitinib (Olumiant) — approved 2018, JAK1/JAK2 selective
🔹 Upadacitinib (Rinvoq) — approved 2019, highly selective JAK1

🔬 WHAT THE SCIENCE SAYS:

JAK inhibitors are effective and well-tolerated. Real-world evidence from US studies confirms benefits in clinical outcomes, treatment adherence, and patient-reported quality of life.

⚠️ THE HONEST NUANCE:
JAK inhibitors are not for everyone. Patients over 65 with cardiovascular risk factors require careful evaluation before starting. The decision should always be made with a rheumatologist who knows your complete health picture.
Have questions about whether a JAK inhibitor is right for YOU?

Dr. Diana Girnita & Dr. Vishnuteja Devalla at Rheumatologist OnCall® are here to help — via telehealth across 20 states.

📲 Book your consultation:
🌐 rheumatologistoncall.com/book | 📞 (650) 525-4404
Save this and share with any RA patient who's been struggling with injections.

04/10/2026

Your doctor just mentioned a "biosimilar" and you nodded along — but had no idea what they meant.

You're not alone. And you deserve a real explanation.

Here's what every Rheumatoid Arthritis, Psoriatic Arthritis, and Ankylosing Spondylitis patient needs to know:

🧬 WHAT IS A BIOLOGIC?

Biologics are complex medicines made from living cells — designed to target the exact immune pathways driving your inflammation. Think Humira (adalimumab), Enbrel (etanercept), Remicade (infliximab), Cosentyx, Taltz. They transformed autoimmune disease care. They are also expensive — sometimes $100,000+ per year.

💊 WHAT IS A BIOSIMILAR?

A biosimilar is NOT a generic drug. It is a highly similar — but not identical — copy of a reference biologic, approved by the FDA only after rigorous testing to confirm:

✅ Same mechanism of action
✅ Same safety profile
✅ Same clinical efficacy
✅ Same dosage and delivery method

Think of it like this: a generic drug is an exact chemical copy. A biosimilar is the closest possible copy of an incredibly complex biological molecule — proven equivalent through years of clinical trials.

💰 WHY DOES THIS MATTER FOR YOU?
Biosimilars can cost less than the original biologic.
That means:
→ Insurance coverage that was denied may now be approved
→ More patients can access life-changing treatment

For RA, Psoriatic Arthritis, and Ankylosing Spondylitis — the most common biosimilars you may encounter include:
🔹 Adalimumab biosimilars (Humira alternatives): Amjevita, Hadlima, Hyrimoz, 🔹 Infliximab biosimilars (Remicade alternatives): Inflectra, Renflexis
Still have questions? That's exactly what we're here for.

👉 Dr. Diana Girnita & Dr. Vishnuteja Devalla at Rheumatologist OnCall® specialize in guiding patients through these exact decisions — with expert, personalized care via telehealth across 20 states.

📲 Book your consultation:
🌐 rheumatologistoncall.com/book
📞 (650) 525-4404

Save this and share it with anyone who's been switched to a biosimilar and has no idea what it means.

04/09/2026

for rheumatoid arthritis have changed how we treat this disease.

If NSAIDs and steroids calm inflammation temporarily, biologic medications target the immune system more precisely.

arthritis is an — which means the immune system is driving joint inflammation.

Biologic drugs for rheumatoid arthritis are designed to block specific inflammatory pathways.
Common biologics used in rheumatoid arthritis include:

• TNF inhibitors
– Adalimumab (Humira)
– Etanercept (Enbrel)
– Infliximab (Remicade)
– Certolizumab (Cimzia)
– Golimumab (Simponi)

• IL-6 inhibitors
– Tocilizumab (Actemra)
– Sarilumab (Kevzara)

• T-cell co-stimulation blocker
– Abatacept (Orencia)

• B-cell therapy
– Rituximab (Rituxan)

Biologics are often used when traditional DMARDs (like methotrexate) are not enough.

They are not “stronger pain medications:, BUT......There is no one-size-fits-all biologic for rheumatoid arthritis. Treatment is individualized and closely monitored.

If you’ve been told you may need a biologic and you’re unsure what that means, comment “BIOLOGIC” below and we’ll continue explaining your options.



Dr. Vishnuteja Devalla, Dr. Diana Girnita, and Dr. Mirela Titianu are board-certified physicians who tell the truth.

📞 (650) 525-4404
🌐 RheumatologistOnCall.com

04/07/2026

Rheumatoid arthritis treatment should start early — not after joint damage has already occurred.
If you’ve been diagnosed with rheumatoid arthritis (RA), timing matters.
Early treatment of rheumatoid arthritis can:
• Reduce joint damage
• Lower long-term disability risk
• Improve quality of life
• Help control inflammation before it becomes destructive

The first step in managing rheumatoid arthritis often includes:
• NSAIDs (nonsteroidal anti-inflammatory drugs) to reduce pain and inflammation
• Short-term corticosteroids (steroids) to quickly calm immune-driven inflammation
These medications help control symptoms — but they are not the full long-term solution.
Rheumatoid arthritis is an autoimmune disease.
That means we must address the immune system itself.

And that’s where treatment strategy becomes more important.
Tomorrow, we’ll explain:
• DMARDs
• Biologics
• When to escalate therapy
If you or someone you love has RA, comment “RA” below so we know to keep creating this content.

Early treatment changes outcomes.



Dr. Vishnuteja Devalla, Dr. Diana Girnita, and Dr. Mirela Titianu are board-certified physicians who tell the truth.

📞 (650) 525-4404
🌐 RheumatologistOnCall.com

04/06/2026

Rheumatoid doesn’t start the way you think it does — and you might already be feeling the early signs.

You wake up stiff for more than 30–60 minutes.
Your hands feel swollen.
Both wrists ache at the same time.
You’re exhausted — and no one can explain why.
You’ve been told:
“It’s stress.”
“It’s aging.”
“Your labs are normal.”
But early arthritis symptoms often begin quietly — before obvious joint damage, and sometimes before blood tests clearly show it.

If your body is telling you something is wrong, listen to it.

Early diagnosis of can make a significant difference in long-term joint health and quality of life.

You deserve clarity — not dismissal.



Dr. Vishnuteja Devalla, Dr. Diana Girnita, and Dr. Mirela Titianu are board-certified physicians who tell the truth.

📞 (650) 525-4404
🌐 RheumatologistOnCall.com

04/05/2026

Rheumatoid arthritis is NOT diagnosed by a single blood test.
And yes, you can have rheumatoid arthritis even if your labs are negative.
Many patients are told:
“Your rheumatoid factor is negative.”
“Your labs are normal.”
“So it’s not RA.”
That is not how the diagnosis works.
Rheumatoid arthritis is a clinical diagnosis.
Up to 20–30% of patients have **seronegative rheumatoid arthritis**, meaning their rheumatoid factor and anti-CCP can be negative — especially early on.

If your symptoms are real, but your labs are negative, you still deserve evaluation — not dismissal.

Early diagnosis of rheumatoid arthritis protects joints and improves long-term outcomes.

Normal labs do not automatically mean normal joints.



Dr. Vishnuteja Devalla, Dr. Diana Girnita, and Dr. Mirela Titianu are board-certified physicians who tell the truth.

📞 (650) 525-4404
🌐 RheumatologistOnCall.com

04/04/2026

"The old school me? I prefer telemedicine now."

Those are the exact words of one of our patients — in her 70s — after her first few visits with Dr. Diana Girnita at Rheumatologist OnCall®.

Before telehealth, here's what a rheumatology appointment looked like for her:

Wake up early, fight morning stiffness just to get dressed
30-minute drive each way on the freeway — painful with joint inflammation
30–60 minutes in a waiting room
10-15-minute visit
Drive home exhausted, symptoms flaring from the stress of it all

Now?
☕ She makes her coffee
💻 Opens her laptop
👨⚕️ Sees her rheumatologist

Same board-certified specialist.
Same expert care.
Same prescriptions and follow-up.
Zero freeway.
Zero waiting room.
Zero exhaustion.

And here's what surprises most people: it's not just younger patients who love it.

Our elderly patients — many managing multiple conditions, many who don't drive at night, many who live far from a specialist — are some of our biggest telehealth advocates.

Because for them, the barrier to getting expert rheumatology care wasn't knowledge or motivation.
It was the trip.
We removed the trip.

Have YOU tried telemedicine for arthritis or an autoimmune disease?

Drop a ✅ in the comments if you have — or a ❓ if you're curious but haven't tried it yet.

📲 Book a telehealth consultation with Dr. Girnita or Dr. Devalla:
🌐 rheumatologistoncall.com/book
📞 (650) 525-4404
📍 Available in 20 states |

04/03/2026

"I don't want to start biologics. I'm scared of getting infections. Or cancer."
If this sounds like you — you are not alone.

And your fear deserves a real, science-backed answer. Not reassurance.

Facts. 🔬

Here's what the research actually says:
🦠 THE INFECTION RISK — REAL, BUT MANAGEABLE:
Yes, biologics modulate your immune system. That means your infection risk increases — particularly for respiratory infections and, more rarely, serious infections like TB.
BUT — here's what most patients aren't told:
→ Before starting biologics, your rheumatologist screens you for TB, hepatitis B, and other latent infections
→ Research tracking AS patients on biologics found that serious infection rates were low and manageable with proper screening and follow-up

The risk is real. It is also known, tracked, and mitigated when you work with the right specialist.

🔴 THE CANCER RISK — THIS ONE SURPRISES PEOPLE:
→ Overall cancer risk in AS patients was NOT significantly different from the general population
→ Biologics (TNF inhibitors) did not significantly increase overall cancer risk in AS patients
→ The inflammation from UNTREATED AS may itself contribute to certain cancer risks — particularly hematologic malignancies

In other words: the disease process without treatment carries its own risks.

Biologics, used correctly, do not dramatically add to them.

⚖️ THE REAL RISK EQUATION:
Untreated AS = progressive joint destruction + spinal fusion + increased cardiovascular disease + systemic inflammation that strains every organ

Treated AS with biologics = managed inflammation + preserved function + quality of life + monitored, low absolute risk of side effects

Your rheumatologist's job is to help you weigh that equation for YOUR specific situation.

🎙️ Dr. Devalla breaks this down on the Thriving with Arthritis Podcast:
https://podcasts.apple.com/us/podcast/ankylosing-spondylitis-what-patients-and-doctors/id1733575518?i=1000756756699

📲 Telehealth | 20 states → rheumatologistoncall.com | (650) 525-4404

Save this for anyone who is afraid to start their biologic medication.

04/02/2026

If you're under 45 and your back hurts — please watch this.

Most back pain is mechanical. A pulled muscle. A bad mattress. Poor posture.

But there's a type of back pain that's completely different — and it's one of the most missed diagnoses in medicine.

It's called inflammatory back pain. And it's the hallmark of Ankylosing Spondylitis (AS).

Here are the RED FLAGS that separate AS from ordinary back pain:

🔴 Age under 45 — especially under 35 — with NO injury or trauma
🔴 Morning stiffness lasting MORE than 30–45 minutes
🔴 Pain that gets BETTER when you move, WORSE when you rest
🔴 Night pain so bad it wakes you up — especially in the second half of the night
🔴 Pain in the buttocks or sacroiliac joints (where your spine meets your pelvis)
🔴 Improvement with ibuprofen or naproxen within 24–48 hours
🔴 Family history of AS, psoriasis, IBD, or uveitis

❗ The danger: most people — and many doctors — assume back pain in young people is "muscle strain." So AS goes undetected for an average of 7–10 years while inflammation silently causes irreversible joint damage.

If 3 or more of these sound familiar — this is your sign to ask for a rheumatology referral. Today.

🎙️ Full episode → Thriving with Arthritis Podcast:
https://podcasts.apple.com/us/podcast/ankylosing-spondylitis-what-patients-and-doctors/id1733575518?i=1000756756699

📲 Telehealth | 20 states → rheumatologistoncall.com | (650) 525-4404

Save this. You may not need it now — but someone you know does.

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19712 MacArthur Bldv
Irvine, CA
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