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This retrospective review is drawn from the authors collection of the most impactful publications, research and news that occurred in 2017. In no particular order, here are my top rheumatology advances, news and research reports for calendar year 2017:
- Explosion of Psoriatic Drugs – Three IL-17 inhibitors, 4 anti-TNF biosimilars, and tofacitinib all have become FDA approved in the last 20 months. Will these many new and diverse treatments fortify psoriatic management by rheumatologists and dermatologists? Will their introduction and marketing create more disease awareness and grow the number of patients treated? Or will these additions be a commercial annoyance? Some rheumatologists have complained they have more new psoriatic arthritis drugs than they have patients for. Nevertheless, psoriatic disease has several well documented unmet needs, including the under diagnosis of psoriatic arthritis and the under treatment of psoriasis (https://buff.ly/2oE863O).
- Opioid Tragedy - This “crisis” has been building for years, probably before the FDA removal of propoxyphene from the market in 2010 (for cardiac concerns). But clearly the news, reports and awareness of this tragedy was loud and clear in 2017. The public health and economic toll is tremendous, but the individual consequences have been tragic, especially for the many suffering in pain with fewer options and no priority while the “crisis” reports continue. Here are but a few of the staggering headlines and facts from 2017
- The amount of opioids prescribed in the United States peaked in 2010 and then decreased each year through 2015. Despite reductions, the amount of opioids prescribed remains approximately three times as high as in 1999
- In 2015 alone, opioid medications, both legal and illegal, caused over 30,000 fatalities, triple the number of overdoses reported the entire 15 years prior.
- Annals of Internal Medicine reported that more than one third of U.S. adults were prescribed opioids in 2015. ( http://buff.ly/2vkd8au)
- U.S. drug overdose deaths exceeded 60,000 in 2016 and were partially driven by a fivefold increase in overdose deaths involving synthetic opioids (excluding methadone), up 28% from 2015. At same time, deaths from synthetic opioids (e.g., fentanyl and tramadol), more than doubled to 19,413.
- Opioid prescriptions have fallen in 49 states since 2013, according to IMS, with some of the sharpest decreases coming in West Virginia, the state considered the center of the opioid epidemic, and in Texas and Oklahoma.
- By July 2017 opioid overdose deaths have dropped in 14 states. Lead by a decline in prescription opioids like OxyContin, Percocet and Vicodin. Yet there are significant rises in overdoses from prescription and illicit fentanyl and heroin.
- More than 100 Americans die daily from opioid related overdoses, according to the CDC.