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Biologics Lead the Way in Drug Price Increases
Reuters has reported the results of a recent Institute for Clinical and Economic Review (ICER) analysis showing that biologics, especially Humira and Rituxan, are leading the way in the cost of drugs in the USA.
All told, Humira and Rituxan topped a list of seven treatments whose combined 2017 and 2018 price hikes accounted for a $5.1 billion increase in U.S. drug spending. ICER said their analysis points to price hikes that were more than twice the rate of medical inflation and were not warranted by any new clinical evidence.
FDA Approves Rituximab for Children with GPA
The U.S. Food and Drug Administration has approved Rituxan (rituximab) for the treatment of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) in children 2 years of age and older in combination with glucocorticoids.
This is the first approved treatment for children with vasculitis.
Anakinra Shows Benefits in Cytokine Storm
The interleukin (IL)-1 receptor antagonist anakinra (Kineret) showed promise in critically ill children who develop the often-lethal condition known as secondary hemophagocytic lymphohistiocytosis (sHLH)/macrophage activation syndrome (MAS), a retrospective single-center study found.
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RheumNow Podcast – The End of Arthritis (9.13.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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RheumNow Podcast – Upadacitinib FDA Approved for RA (8.23.19)
Dr. Jack Cush reports on the news and journal reports from the past week on RheumNow.com, including: how your genetics may shape your microbiome; GERD as a risk factor for TMJ?; how can MDA-5+ dermatomyositis be any worse; new drug happenings; StillsNow.com; and more.
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Analysis of 128 Pediatric Rheum pts (JIA, FMF, etc) analzyed for reactions to 8 different biologics during 32,494 infusions/injections - the frequency of anaphylaxis (from TCZ or RTX) was 3.9% in children. https://t.co/GzvcR0R7Bv
Links:
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Good Pregnancy Outcomes for DMARD Exposed JIA Patients
A study of pregnancy outcomes in 98 women with juvenile idiopathic arthritis (JIA) who were exposed to DMARDs shows no increased risk of major adverse pregnancy outcomes.
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Increasing Lung Disease in Systemic JIA
A single-center cohort analysis shows that lung disease is increasingly seen in children with systemic juvenile idiopathic arthritis (SJIA), especially those complicated by macrophage activation syndrome.
Prior to 2013, reports of pulmonary disease in SJIA were rare, but since there have been increasing reports of alveolar hypertension, interstitial lung disease and pulmonary alveolar proteinosis; often with a high mortality rate.
As such, since 2014, the Cincinnati Children’s Hospital Medical Center has seen an increase in lung disease and severe lung disease in SJIA.
RheumNow Podcast – More Than a Spot of Tea (8.2.19)
Dr. Jack Cush reviews the journal articles and news reports from the past week on RheumNow.com:
MMP-7 and Myositis-ILD; Post-surgical gout attacks; CV events and testosterone; and a Boxed warning for tofacitinib.
EULAR 2019 - Day 1 Report
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. Here are a few of the highlights from day 1 EULAR in Madrid, including another IL-23 inhibitor, BTK inhibition, abatacept in Sjogren's syndrome, don't repeat the ANA, and drug free remission in systemic JIA.
Management of Hemophagocytic Lymphohistiocytosis (HLH) in Adults
Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome induced by activated macrophages and cytotoxic T cells. HLH manifests recurrent fever, cytopenia, liver dysfunction, and a sepsis-like syndrome that may complicated by multiple organ failure.
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RheumNow Podcast – Rituximab Monitoring (5.31.19)
Dr. Jack Cush presents the news and best of rheumatology and medicine from the past week on RheumNow.com
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Lupus Outcomes Influenced by Race/Ethnicity
A lupus registry from San Francisco County analyzed racial/ethnic differences in lupus manifestations and found significant differences in SLE manifestations among racial/ethnic groups. Researchers found that Blacks, Asians/Pacific Islanders (API), and Hispanics are more likely to develop severe manifestations following a diagnosis of SLE.
From their database, they identified 724 SLE patients, and identified specific features in different subgroups.
New ACR/AF Guidelines on JIA Polyarthritis and Uveitis
The American College of Rheumatology (ACR) and the Arthritis Foundation (AF) have released two guidelines on management of juvenile idiopathic arthritis (JIA).
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EULAR 2019 Update to Lupus Management
The goal of SLE treatment is remission or low disease activity and flare prevention. Hydroxychloroquine is recommended in all patients with lupus, at a dose not exceeding 5 mg/kg real body weight. Glucocorticoids (GC) should be minimised to less than 7.5 mg/day (prednisone equivalent). Appropriate initiation of immunomodulatory agents (methotrexate, azathioprine, mycophenolate) can be tailored to the clinical scenarios and may allow for tapering or discontinuation of GC.
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Best of 2019 - Ups and Downs with Abatacept
Two recent studies have examined the effect of starting abatacept upon the risk of serious hospitalized infections or cancer, showing divergent results from claims data analyses.
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Cyclosporin and IVIG Effective in Kawasaki's Disease
A Lancet study has shown that adding cyclosporin to intravenous immunoglobulin (IVIG) Kawasaki disease patients, who were predicted to be resistant to IVIG, was both safe and effective in averting severe coronary artery outcomes.
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First Line IL-1 Inhibition in Systemic JIA
First-line treatment of systemic juvenile idiopathic arthritis (JIA) with anakinra (Kineret) was highly effective as monotherapy, minimizing the need for glucocorticoids, a single-center prospective study found.
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Congenital Heart Block: Dangers Ahead
Children of autoantibody-positive mothers who were born with congenital heart block were at high risk for developing later cardiovascular and autoimmune disorders, as were their siblings, Swedish researchers reported.
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