Overmedication of America

Save

Recent research from the Lown Institute reports that 750 older Americans are hospitalized daily because of serious side effects from and the core problem is that of polypharmacy, especially in the elderly. 

DMARD Inertia by Registry Rheumatologists

Save

A registry study of metric use (primarily RAPID3 and CDAI) in the treatment of rheumatoid arthritis (RA) patients shows that, even in the face of moderate or high disease activity, treatment changes by rheumatologists were relatively low (35.6–54.6%).

Limited Advantage to Very Early vs. Delayed Etanercept in RA

Save

The VEDERA study sought to confirm whether the very early introduction of first-line etanercept+methotrexate (ETN+MTX) was superior to treat-to-target MTX (MTX-TT) in patients with early RA.

Half of Opioids Rx Come from 1% of MDs

Save

The BMJ reports that while most US providers are cautious in their prescribing, half of opioid prescriptions are written by 1% of providers.

Between 2003 and 2017, there was an annual average of 669495 providers prescribing 8.9 million opioid prescriptions.

Knee Replacements Last 25 Years

Save

UK registry reports that greater than 80% of total knee replacements can last for 25 years.

The outcomes regarding the duration and durability of knee arthroplasties is sketchy, with many orthopedists projecting a 15 to 20 year survivial. Hence the need for an appraisal of the data.

Book Review: “Great Health Care Value: Chronic Diseases, Practice Teams and Population Management”

Save

The US healthcare market has evolved into an incredibly expensive system that often does not deliver good medical outcomes. While most of us know these problems exist, we rarely have up-to-date data or can offer alternatives to the way we manage care, especially to the chronically ill who consume much of our health care dollars. In their book, authors Tim Harrington, MD and Andrew Johnson, MS, MBA offer insights, evidence and experience on how we may do our part to improve the management of chronic rheumatic/orthopedic issues.

Biosimilars for Rheum Disease: Failure to Launch

Save

The availability of biologic biosimilars has thus far had negligible impact on prescribing practices in the United States, in stark contrast to what has been observed in some European countries, researchers reported.

QD Clinic - Dealing with Non-adherence

Save

QD Clinic - Lessons from the clinic. Today’s clinic topic: Dealing with Non-Adherence in the Clinic.

Rheumatologists Ranked #1 in Happiness (Again)

Save

Medscape has reported the results of its 2020 annual physician survey, This year rheumatologists (60%), general surgeons (60%), public health and preventive medicine physicians, and allergists/immunologists are the "happiest" outside of work compared to other specialists, according to Medscap

RheumNow Podcast- Knee Pain Knockout (1.10.20)

Save

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. The podcast covers: best therapies for dactylitis and enthesitis; we have a new knockout for knee pain in OA; and are you on the naughty or nice list when it comes to the new ACR-AF guidelines for arthritis? This and more. Tune in.

Best Practice Recommendations in Musculoskeletal Care

Save

A group of Western Australian clinicians have set out to assess current practices and proved guidance recommendations for high-quality care for the most common musculoskeletal (MSK) pain scenarios encountered by clinicians in emergency and primary care.

Best of 2019 - War on RA - Part 1: Walk on the Moon

Save

It’s a great time to be a rheumatologist and to manage RA. But, if you keep doing what you’re doing, you’re going to keep getting what you’ve got.

Best of 2019 - War on RA - Part 3: Useless Drugs

Save

We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.

Best of 2019 - The Shame Behind Adalimumab Biosimilars

Save

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).

Best of 2019 - New EULAR/ACR Classification Criteria for SLE

Save

The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) have jointly developed new classification criteria for systemic lupus erythematosus (SLE); prompted by the need for criteria that were both highly sensitive and specific. The net result is improved sensitivity and specificity, but the use of positive ANA requirement along with a longer list of weighted criteria ensures its utility in SLE research (including early or latent SLE), but not clinical practice.

Gilead Submits Filgotinib NDA to the FDA

Save

Gilead has submitted a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for filgotinib, an investigational, oral, selective JAK1 inhibitor for the treatment of adults who are living with moderate-to-severe rheumatoid arthritis (RA).

Domestic Abuse Linked to Fibromyalgia and Chronic Fatigue

Save

Domestic violence was found to predispose to a higher risk of fibromyalgia and those developing chronic fatigue syndrome.

Variations in First Biologic Use in Rheumatoid Arthritis

Save

A Canadian analysis shows that rheumatoid arthritis (RA) patients are more likely to receive biologic DMARDs earlier if they are younger, female, and living in urban areas closer to prescribers.

BMS and Celgene Merge as Amgen Buys Otezla

Save

Bristol-Myers Squibb (BMS) has completed its $74 billion acquisition of Celgene. With the acquisition complete, Celgene is now a wholly-owned subsidiary of BMS. The combined companies have nine products with more than $1 billion in annual sales.

Mallinckrodt Receives SEC Subpoena

Save

Reuters reports that Mallinckrodt Plc has received a subpoena from the U.S. Securities and Exchange Commission for documents related to the drugmaker’s lawsuit against the U.S. Department of Health and Human Services (HHS).