Although the cause is not clear, women who have weight loss surgery have a higher risk of thinning bones (osteoporosis) and fractures over time, according to a new analysis of a Swedish study. Women, but not men, had a 3-fold higher risk of developing osteoporosis and more fractures.
25% of Medicare beneficiaries with rheumatoid arthritis use high-cost biologics. Yazdany and coworkers have analyzed a national cohort of beneficiaries and compared Medicare part D plans. Nearly all Part D plans cover at least 1 biologic DMARD, but the vast majority require cost sharing that is sufficiently high to risk significant financial burden to patients.
52.5 million US adults (22.7%) have arthritis with half of these claiming activity limitation because of arthritis and pain. Many arthritis patients have comorbid conditions including heart disease (49%), diabetes (47%) and obesity (31%).
Clinical decision-making, occurring at the intersection of the ’art’ and the ’science’ of medicine, remains enigmatic and controversial.
This retrospective highlights several of the most impactful publications, trends, research and news that occurred in 2014.
IL-17 inhibitors are being developed for treatment of psoriasis, psoriatic arthritis and axial spondyloarthritis. Broadalumab has been in phase II & III trials and been developed by a partnership between Amgen and Astra-Zeneca. Amgen announced Friday (5/22/15) it was no longer going to pursue approval on broadalumab, citing concerns over suicidal ideation and behavioral issues that may lead to restrictive labeling.
A prospective study of sildenafil was conducted in 25 centers that included 83 patients and 192 digital ulcers at entry. The odds of healing ulcers was less, but not significant, for sildenafil. Although the primary endpoint of the trial was not met, the mean number of digital ulcers was significantly lower at week 8 and 12 for those on sildenafil.
Three phase III studies of sarilumab (SARIL-RA-TARGET, -EASY and -ASCERTAIN), a fully-human IL6 receptor antibody, have been reported and met primary end points in these pivotal clinical trials. In the TARGET trial, 546 RA patients with an inadequate response to TNF inhibition received 2 doses sarilumab or placebo and showed an ACR20 response rate of 56-61% (35% in placebo).
Fibromyalgia is a noninflammatory disorder. However, there are patients with prolonged morning stiffness, subjective joint swelling and many with modest-to-moderate elevations of acute-phase reactants. Arkfeld and colleagues analyzed such a cohort and found no new autoimmune disease over time. They question the appropriateness of ACR classification criteria that fails to address this.
A US Preventive Services Task Force recommends DEXA screening in women >65 yrs and only in women 65 yrs if there is a significan risk of fracture. Amarnath and coworkers studied 50,995 women in primary care, aged 40-85 years, between 2006-2012. They found that DXA screening was underused in women at increased fracture risk, including women aged ≥ 65 years.
The manufacturers of the 2 best selling TNF inhibitors, Enbrel and Humira, have announced a 9.9% price increase of May 1st. The current average price of Enbrel is $42,000 per annum.
The population prevalence of Sjogrens syndrome is 0.2%, with an incidence of 4 cases per 100,000 per year. Sjogrens is 20 times more common in females than males.
Carl Schoellhammerhas just won the Lemelson-MIT National Collegiate Student Prize for his invention - the microneedle pill. This capsule is covered in tiny needles coated in a “pH responsive coating” that makes it easier to swallow. The mechanics are such that it will deliver the injectable biologic in the gut when conditions are optimal for effect. Might this be a boom for biologic delivery?
To many of my colleagues (admitted Luddites) the mere mention of Twitter results in the “omi-god 360” eye roll with an accompanying snide comment.
