The Overpricing of Drugs (1.14.2022) Save

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. This week we discuss amputations, a $57 billion RA market, an FDA approved drug for Cat arthritis and drug that works in Sjogren's.

1. Study 126 rheumatic disease (RMD) patients showed that post-vaccination flares of RMD are rare. Despite being on DMARDs, biologics, immunosuppressives, the rate of RMD reactivation was 0.007 person/mo. 5 mild articular flares in 3 women  https://bit.ly/3zZXVLg

2. Patients on biologics are NOT at higher risk for COVID-19 infx. Retrospective matched cohort study compared 7631 Biologic Rx pts to 74910 matched cohort with equal Infx & death rates. COVID infx assoc w/ age, minorities, more comorbidities https://t.co/GxmgWIbgSo

3. JAMA study shows that, compared with usual care, colchicine did not significantly reduce mechanical ventilation or 28-day mortality in patients hospitalized with COVID-19 pneumonia (HR 0.83; 95% CI, 0.67-1.02; P = .08). https://t.co/6dRd6gnkjc

4. JAMA cohort study of 5.9 million VA pts and with & without gout (556521)-gout pts had higher rates of lower extremity amputation (HR 1.59), than those without gout. This was assoc w/ poor uric acid control (>7), but not urate lowering therapy. https://t.co/KiM3IBCCp4

5. Global Burden of Disease Study shows that globally, from 1990 to 2019, the age-standardized incidence rate (ASIR) of hip osteoarthritis increased from 17.02 per 100,000 persons to 18.70 per 100,000 persons https://t.co/OJOnkAw1Dy

6. Duloxetine added to usual analgesics failed to improve pain in 132 hip or knee OA pts by WOMAC pain scores: 1) Dulox + usual care vs 2) Usual care showed no diff in pain at 3 mos or 12 mos. https://t.co/9gR2PNVrPl

7. FDA has approved an NGF inhibitor for arthritis in cats...yes CATS!  Presumably for OA, Solensia (frunevetmab) is a cat-specific MAb that binds nerve growth factor (NGF). In humans several NGF MAbs have failed (tanezumab in 2021) https://bit.ly/3zXxMwv

8. Biomarker study of 21 systemic juvenile idiopathic arthritis (sJIA) shows you can differentiate between active & inactive disease. From 69 biomarkers, these were predictive: IL-6, MMP1, S100A12 (p < 0.0001), HMGB1; but IL-18 elevated in both groups! https://t.co/m2yXTITzwY

9. Single center comparison of pts with MAS vs malignancy assoc. HLH (mHLH) - overall MAS had less hepatomegaly (0 v 25%), double platelet #s (50 v 29Kµ/L), but lower sIL-2R (6814 vs. 27,972.0) and less mortality (22 v 44%, p=0.18).https://t.co/NGIaPTU0yT

10. RheumNow Live, March 19-20, 2022. Attend onsite or virtually.  Registration is free for fellows and NPs/PAs  https://t.co/fYyV75vAWm&nbsp;

11. Study of subcutaneous ianalumab in patients with primary Sjögren's syndrome met primary objective, showing dose-related decrease in disease activity (ESSDAI) at week 24: randomised, double-blind, placebo-controlled trial. https://t.co/NqdDWqpX2g&nbsp;

12. In Mouse Model of Lupus, when the gut microbiome of NZM2410 mice colonized w/ SFB, glomerulonephritis worsened & was assoc. w/ incr in TH17, MCP-1 and CXCL1, & more microbial abundance & biodiversity (dysbiosis) https://t.co/bLxrJZKTDZ

13. NICE (UK) has recommended upadacitinib for use in active Psoriatic Arthritis, 15 mg qd +/- MTX, in pts not responding to DMARDS. UPA can now be used in England Wales and Scotland https://t.co/JFxMrgjrUe

14. Cosentyx (secukinumab) was FDA approved for use in pediatric psoriatic arthritis & enthesitis-related arthritis, based on results of the ph III JUNIPERA study. Dosing based on weight (SEC 75 mg sc if 15-50kg; SEC 150 mg sc if 50 kg or more) https://t.co/1nv3iJ7EJ3

15. Study of biologic/ts DMARD switching in 8,398 axial spondyloarthritis pts from 5 Nordic registries showed a low rate of multiple switches (refractory?) over 3 years; ≥3 DMARDs (8%), ≥4 (3%) & ≥ 5 (1%); more w/ women, comorbiditiy & psoriasis https://t.co/ZQDvl6AaZz

16. KEEPSaKe-1 Trial in Psoriatic Arthritis - IL-23 Inhibition is Effective
17. BEAT LUPUS - Belimumab after Rituximab in SLE
18. COVID-19 in Pregnant Rheumatic Women
19. The global rheumatoid arthritis drugs market size was valued at $57,929 million in 2019, and is projected to reach $62,935 million by 2027. https://t.co/hQTDc0ajdN
20. Why Are Physicians Silent About Outrageous Drug Prices?