A recent Deloitte analysis of the biosimilar market in the USA suggests there are defined obstacles to biosimilar use that must be dealt with, especially as the current administration is seeking to lower drug prices and reduce out-of-pocket costs for US consumers.

Preclinical rheumatoid arthritis (RA) is a hot new area wherein at risk individuals (seropositive, first degree relatives of RA patients, etc.) are being studied to assess the triggers that lead to progression to RA or whether therapies can be used to avert the onset of RA.

Dr. Jack Cush reviews EULAR 2018 and the past week's news and reports from RheumNow.com, including DMARDs in OA, the price of Penicillamine, Infections when ANCA+, CV outcomes in gout, NSAIDs in Pregnancy and Seropostive vs. Seronegative Outcomes.

A study from the American Journal of Obstetrics & Gynecology analyzed pregnant women from the Kaiser Permanente healthcare system and compared newly pregnant women who took non-steroidal anti-inflammatory drugs or acetaminophen or neither showed that using NSAIDs around conception carried a more than four-fold higher risk of early miscarriage. (Citation source: http://bit.ly/2tqNWN6)

"Can stresss be the cause of my autoimmune disease?" is an often launched question met with shrugs of uncertainty or strongly held beliefs rooted in bias moreso than fact.

Swedish investigators have analyzed a large registry cohort and shown that exposure to stress-related disorders yields a significantly increased risk of autoimmune disease. They analyzed 106,464 patients with stress-related disorders, with 126,652 full siblings, and over a million non-stressed matched controls to assess a future risk of autoimmune disease.

A cohort study of 241 DMARD-naive rheumatoid arthritis (RA) patients, meeting either 1987 ACR or the 2010 ACR/EULAR  classification criteria for RA, compared the baseline status and long term outcomes of seronegative (SNRA) and seropositive (SPRA).

The EULAR 2018 wound down on Saturday with fewer oral presentations but many posters.  In my last report I put together a collection of impressions and some thematic highlights not covered in previous reports.

Our colleagues in gastroenterology measure drug levels with certain biologics used in inflammatory bowel disease in order to increase the dose for optimal benefit if the patient has a low trough level (i.e. targeting drug level).

We are supposed to treat to a target (T2T) in RA. In other words, measure many components of the disease and its activity and calculate a score and if the patient is not in remission (or a low state if remission is not achievable) we are to make a treatment change.

There were many presentations at EULAR 2018 in Amsterdam about the mortality of RA.

I was delighted to see that investigators presenting work at EULAR 2018 haven’t lost interest in our old friend methotrexate, with a number of abstracts examining issues of safety, dose and route of administration.

Highlights from Day 2 of the EULAR meeting in Amsterdam include high MBDA scores in ACPA negative RA predicts remission; characterization of difficult RA; and gender differences in psoriatic responses to TNF inhibitors. 

Biosimilars are here, and more are being registered all the time, so I was really interested in the biosimilar data at the meeting.

Abbvie press releases feature the results from 3 new trials to be presented during the Annual European Congress of Rheumatology (EULAR 2018) in Amsterdam from three Phase 3 trials evaluating upadacitinib, an investigational, once-daily oral JAK1-selective inhibitor, in adult patients with moderat

Highlights from the first day at EULAR include: canakinumab prevents acute gout; AS uveitis benefits from most TNFi; MRI does not improve T2Tor X-ray outcomes; baracitinib wins in SLE - maybe?; new lupus criteria; and lost survival in RA. Here's the RheumNow recap. 

Recent shifts in the cancer treatment paradigm towards immune therapies has led to wide implementation of the novel immune check point inhibitors (ICI) in the treatment of multiple types of advanced cancer.

Beloved by gastroenterologist for treatment of inflammatory bowel disease (IBD), α4β7 integrin receptor vedolizumab (VDZ) has probably caught attention of many rheumatologist since the time it entered the market; largely for what it won't do for inflammatory arthritis.

Dr. Jack Cush discusses the past week's news and journal articles featured on RheumNow.com - including reports on advance practice clinicians, baricitinib, gout, disease activity, hypomagnesemia and upadacitinib.

An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices.  By 2016, 28% of all specialty practices employed APCs.

The US Food and Drug Administration has approved baricitinib (Olumiant) for use in adults in moderate-to-severe active rheumatoid arthritis (RA) who have had an inadequate response to TNF inhibitors (TNFi). It is not approved for use, nor has it been studied, in children.