60 Minutes Drills Acthar - A Financially Crippling Drug

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Acthar is in the news again. Previously a New York Times article lambasted the drug as the "single most expensive drug per patient", based on it costing Medicare  $16,2371 per patient for nearly 3100 patients. Overall, costing Medicare a half-billion US dollars per year. 

Rising Need for Weight Loss Counseling in Arthritic Patients

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The CDC's May 4th MMWR reports that from 2002 to 2014, the prevalence of health care provider counseling for weight loss among adults with arthritis and overweight or obesity increased by 10% (from 35% to 45%).

Among the 54.4 million adults with doctor-diagnosed arthritis in the United States, 32.7% are overweight and 38.1% are obese. Moreover obesity is more prevalent among persons with arthritis than among those who do not have arthritis.

Bisphosphonate Drug Holidays May Result in Fractures

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A report in Endocrine Practice shows that drug holidays from bisphosphonates results in a 15% risk of fractures.  (Citation source: 

Targeting IL-17A: A Winner in PsA

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Psoriatic arthritis patients with inadequate response to tumor necrosis factor (TNF) inhibitors had improvements in their arthritis and psoriasis when treated with the interleukin (IL)-17A blocker ixekizumab (Taltz), according to a phase III study presented here at the

Tick, Mosquite-Borne Diseases Triple Since 2004

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The Centers for Disease Control and Prevention has a new report showing that from 2004 to 2016, the number of Americans infected by mosquitoes, ticks or fleas tripled from 27,388 in 2004, to 96,075 in 2016. 

From 2015 to 2016, these infections rose by 73 percent. This included new Zika and chikungunya virus infections, (41,680 in 2016), followed by Lyme disease (36,429 cases). This may be an underestimation as as many infections are not reported.

Comorbidities Undermine Clinical Outcomes in Psoriatic Arthritis

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Analysis of data from the DANBIO registry of psoriatic arthritis patients treated with tumor necrosis factor inhibitor therapy shows that comorbidities were associated with higher baseline disease activity, shorter TNFi persistence, and reduced clinical response rates to TNFi.

The RheumNow Week in Review – FDA Showdown for Baricitinib (4.27.18)

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Dr. Jack Cush reviews the news and FDA proceedings from the past week on RheumNow.com.

FDA Arthritis Panel Split on the Efficacy and Safety of Baricitinib in RA

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On Monday, April 23rd the FDA convened the Arthritis Advisory Committee (AAC) to evaluate Lilly’s resubmitted NDA for the approval of the JAK inhibitor baricitinib for use in rheumatoid arthritis (RA).

FDA Review: Take Two for Baricitinib

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FDA staff remain worried about the safety of baricitinib, an oral JAK inhibitor intended for treatment of rheumatoid arthritis, according to briefing documents prepared for an advisory committee meeting on Monday.

Will Aspirin Cotherapy Undermine Celecoxib’s Safety Effects?

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The PRECISION study took 11 years and 24,081 patients (90% OA; 10% RA).

The RheumNow Week in Review – Vitamin D Snark Report (4.20.18)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  A second life for Syk kinase, Vitamin D talk, VTE, regulatory hearings and the Lupus clinic edge.

USPSTF Recommendations on Vitamin D, Calcium Supplementation to Prevent Fractures

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The U.S. Preventive Services Task Force (USPSTF) concludes current scientific evidence is insufficient regarding the use of vitamin D and calcium, alone or in combination, to prevent fractures in men and premenopausal women. The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1,000 mg or less of calcium to prevent fractures in postmenopausal women. Current scientific evidence is insufficient regarding the use of vitamin D and calcium at doses greater than 400 IU of vitamin D and greater than 1,000 mg of calcium in postmenopausal women.

EMA to Review Methotrexate Overdose and Dosing Errors

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A recent meeting (April 9-12) of the European Medicines Agency’s (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) considered the problem of dosing errors with methotrexate (MTX), citing "continued reports of overdose." 

MMWR: Cannabis Use in the Colorado Workers

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MMWR reports that eight states, including Colorado, have legalized recreational marijuana for use by adults and that a study of use in Colorado has shown that nearly 15% of Colorado adult workers have used marijuana in the past 30 days.

Mayo and UAB Awarded $1 million Grant for Patient Research

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CreakyJoints and Pfizer have selected the Mayo Clinic and the University of Alabama at Birmingham (UAB) to each receive a $500K research award (funded by Pfizer Independent Grants) for Learning & Change.

"Breakthrough" Drug Designation by the FDA

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The current issue of the NEJM reviews the Food and Drug Administration (FDA) “breakthrough therapy” designation that was introduced in 2012 to expedite testing and approval of medications that were intended to treat serious or life-threatening conditions.  This status is granted when prelimi

Lancet Tackles the Global Challenge of Low Back Pain

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Lancet has several reports on low back pain (LBP) as a major problem worldwide, largely because of the aging population.

Low back pain is the leading cause of disability worldwide.

Cannabis Laws Lessen the Opioid Crisis

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Three reports from JAMA Internal Medicine demonstrate favorable trends with less opioid use when cannabis became legal.

Unmet Needs in Calcium Pyrophosphate Deposition Disease

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Abhishek et al have written on the results of an international survey of crystal arthritis experts and identified the unmet needs  regarding calcium pyrophosphate crystal deposition (CPPD) - research, classification, diagnosis and management.