The RheumNow Week in Review – 28 July 2017

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Dr. Jack Cush reviews the news and articles from the past week on RheumNow.com:

Biosimilar Pricing Wars Have Begun

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Despite the approval of four anti-TNF biosimilars in 12 months, their introduction into the U.S. market has been slow and - until now - with paultry discounts compared to their introduction throughout Europe, where discounts averaged 50% and were as high as 70% (compared to the price of Remicade).

Baricitinib Derailed by FDA Review

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Eli Lilly and Co disclosed today that upon further discussions with the US Food and Drug Administration (FDA) there would be a delay in further regulatory decisions regarding baricitinib, a JAK inhibitor, that is being developed for use in rheumatoid arthritis (RA).  

Rheumatologists and Patients Concerns over Biosimilars - RheumNow “Live Vote” Results

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The RheumNow “Live Vote” on the use, uptake and safety of biosimilars contrasts rheumatologist and patient views. Despite FDA approval and looming introduction, there is considerable concern, knowledge gaps and hesitancy regarding their uptake in the US. The survey's primary question demonstrates that less than one-third of US rheumatologists are prepared to adopt biosimilars when they are available.

Inflammatory and Autoimmune Diseases are Not Rare in HIV Patients

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HIV infection and AIDs has been associated with numerous complications, presumably resulting from impaired immunity from infection.  Sporadic cases and small cohorts of patients with rheumatic and autoimmune syndromes have been described but epidemiology data on the prevalence is scarce.

Acute Coronary Syndrome Increased in Early Rheumatoid Arthritis

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It does not come as a surprise to anyone anymore that Acute Coronary Syndrome (ACS) is one of the major causes of morbidity and preterm mortality in RA. What we don’t know is what measures need to be taken to modify the risk and how effective such measures are.

Curbside Consults - July 2017

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Curbside Consults are cases submitted by our rheumatology colleagues as challenging therapeutic or safety issues. Answers are based on experience, with added evidence from the medical literature and published guidelines. Here are four new cases. 

The RheumNow Week in Review – 14 July 2017

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Dr. Jack Cush reviews highlights from the past week on RheumNow.com:

Withdrawal of TNF Inibitors Fails in Most RA Patients

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The 12 month POET study analyzed 817 rheumatoid arthritis (RA) patients who achieved remission or low disease activity (LDAS) for ≥6 months and then randomized 2:1 to stopping or continuing their TNF inhibitor.

Alendronate Use in Steroid Treated Patients Lowers the Risk of Hip Fracture

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Among older patients using medium to high doses of the anti-inflammatory steroid prednisolone, treatment with the osteoporosis drug alendronate was associated with a significantly lower risk of hip fracture, according to a study published by JAMA.

Linkage Between Gut and Joint Immunity in Rheumatoid Arthritis

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Pianta, et al have published their findings in the Journal of Clinical Investigation showing that two novel autoantigens, GNS and FLNA, are highly expressed in synovium and share a sequence homology with gut microbesa; thereby providing a potential link between gut mucosal and joint immunity in rheumatoid arthritis. 

ACR/AAHKS Guidelines on Perioperative Management

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The American College of Rheumatology has partnered with the American Association of Hip and Knee Surgeons to develop consensus-based guidelines for perioperative management of antirheumatic therapies for patients with rheumatic diseases who plan to undergo total joint replacement.

EULAR 2017 – Day 4 Highlights

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Saturday was a day of big posters and special seminars at EULAR in Madrid.  In the morning, I passed on an interesting session on nailfold capillaroscopy led by Dr. M Cutolo and went to a JIA outcomes session.

EULAR 2017 – Day 3 Highlights

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Friday was a mega-day in Madrid as this day all the late-breaking abstracts were presented, in addition to the bulk of high-impact podium presentations in several areas.

Here are the major presentations from several clinical areas.

Lancet Launches EULAR 2017 and "A Platinum Age of Rheumatology"

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The current Lancet edition for 10 June 2017 is a rheumatology rich collection.  

Supreme Court Decision Favors Earlier Biosimilar Adoption

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On Monday June 11th, the US Supreme Court unanimously ruled that biosimilar manufacturers can bring their drugs to market faster by eliminating the provision that the biosimar manufacturer had to give the innovator company 180 days notice before launching the new biosimilar.

FDA Approves Abatacept for Pediatric Use

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Subcutaneous (SC) abatacept (Orencia) is now available for use in patients 2 years of age and older with moderately to severely active polyarticular Juvenile Idiopathic (JIA) according to Bristol-Myers Squibb.

Suspending Methotrexate for Influenza Vaccination

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Vaccinating our rheumatoid arthritis patients against influenza every year is a safety priorty. However immunosuppressive therapies pose a challenge to vaccine administration as their use can hamper vaccine immunogenicity.