Pregnancy and Immune Modulating Therapies
Whether lupus activity is ameliorated by end-stage renal disease (ESRD) or transplantation has been debated. A recent report from Mexico City assessed the frequency and risks for extrarenal flare in SLE patients after renal transplant. A retrospective, case–control study studied 38 SLE cases (who experienced 50 extrarenal flares) and 50 controls seen between 1993 to 2014.
The good news: in 2015 the FDA approved a record number of new drugs (n=45).
The bad news: most new drugs entering the market today have an exorbitantly high price tag.
Update on Ankylosing Spondylitis and Spondyloarthritis
A prospective cohort of RA first-degree relatives were prospectively studied for genetic and environmental factors (smoking, body mass index, education, and parity) and RA-related autoantibodies that may influence future development of inflammatory joint symptoms over a 2 year follow-up period.
The paradigm for DMARD use in rheumatoid arthritis (RA) begins with DMARD monotherapy and then escalates to combination therapy with either DMARDs or a combination of conventional DMARD plus a biologic DMARD (bDMARD). Recent data suggests equal efficacy for triple DMARD therapy when compared to methotrexate (MTX) plus a TNF inhibitor.
Recent Developments in Osteoarthritis, Osteoporosis and Gout
Drs. Orin Troum and Martin Bergman reviewed the literature and news from 2015 for advances in OA, OP and gout. Hydroxychloroquine has been shown to have no effect in hand OA based on a RCT in 196 patients - no significant change in pain or function (this has also been shown for inflammatory OA in the past).
Overall survival and survival free of end-stage renal disease (ESRD) have both improved significantly over time in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), but the risk of relapse has not.
The Rheumatology Winter Clinical Symposia launched its 9th annual conference yesterday in Maui. Highlights of this meeting will be covered by RheumNow from Wednesday 2/10 till Saturday 2/13.
Rheumatoid Arthritis Year in Review
Day one sessions began with the “Year in Review” by Drs. Artie Kavanaugh and Jack Cush. Highlights from this review included the following:
Once the clock runs out on teriparatide (TPTD or Forteo), what is the next best option?
It’s somewhat bizarre that a designer drug from over 65 years ago would become the cornerstone of treatment for rheumatoid arthritis in the 21st century. When Sidney Farber designed a molecule that would interfere with folate metabolism in the middle of the 20th century, he was looking for a ubiquitous antimetabolite to treat cancer. Farber was actually quite concerned with the potential side effects of a drug that competitively inhibits folate
The mantra of rheumatologists worldwide is to treat rheumatoid arthritis (RA) earlier and more aggressively. While referral of early RA patients has improved, there is little data demonstrating that more aggressive treatment works or is cost effective.
On Tuesday February 9th Celltrion presented its biosimilar developmental data to the FDA as they sought approval for their CT-P13 (called Inflectra), a biosimilar of infliximab (Remicade). The panel included over 20 members comprised of the Arthritis Advisory Committee with additional representation from adult and pediatric rheumatologists, dermatologists, gastroenterologists, statisticians, pharmacists and protein chemists.
The arthritis advisory committee of the Food and Drug Administration (FDA) is scheduled to meet today, February 9th to review the efficacy and safety of Celltrion's biosimilar form of infliximab (Remicade) that is currently marketed in other countries.
Juvenile idiopathic arthritis (JIA) is commonly managed with methotrexate (MTX), with many pediatric rheumatologists preferring to use parenteral MTX for compliance and absorption reasons.
A cross-sectional study of 179 JIA patients on MTX was performed to examine the relationship between dosing and MTX intolerance (using the validated Methotrexate Intolerance Severity Score questionnaire).
