By Wayne Kuznar San Diego, CA—The most appropriate choice to treat rheumatoid arthritis (RA) should incorporate value into the decision, said James R. O’Dell, MD, Professor of Medicine and Chief, Division of Rheumatology and Immunology, University of Nebraska Medical Center, Omaha. The 3 components to value are efficacy, toxicity, and cost, and in this regard, triple disease-modifying antirheumatic drug (DMARD) therapy beats treatment with a bio­logic response modifier, argued Dr O’Dell in a debate conducted at the 2013 American College of Rheumatology (ACR) annual meeting.
By Phoebe Starr San Diego, CA—Using a “treat-to-target” strategy (ie, tight control) was superior to the standard approach in reducing disease activity in the skin and joints of patients with newly diagnosed psoriatic arthritis in the randomized Tight Control of Psoriatic Arthritis (TICOPA) trial. Treat to target has been successful in controlling disease activity in patients with rheumatoid arthritis, and TICOPA provides evidence in support of this approach in psoriatic arthritis.
By Alice Goodman San Diego, CA—It was a Herculean task to review 2900 abstracts from the 2013 American College of Rheumatology (ACR) annual meeting to select the studies most likely to impact clinical practice, but Arthur F. Kava­naugh, MD, Director, Center for In­novative Therapy, University of California, San Diego, and John J. Cush, MD, Director of Clinical Rheumatology, Baylor Research Institute, Dallas, TX, took up the challenge. Following are some of their best “picks,” highlighting the prac­tical implications for patients with rheumatic diseases.
Impressive response rates seen with VX-509 By Wayne Kuznar San Diego, CA—An investigational oral selective Janus kinase (JAK) 3 inhibitor was superior to placebo in response rate and changes in disease activity in an ongoing phase 2b study in patients with rheumatoid arthritis (RA).
New Hepatitis C Therapy Can Help Some Patients with Rheumatic Disease A New Model for Value-Based Physician Reimbursement Physicians’ Role in Payment Reform Efficacy of Hyaluronic Acid Injections Similar to NSAIDs for Knee OA Mayo Clinic Moving from FFS to Value-Based Care
The US Food and Drug Administration (FDA) approved a subcutaneous delivery formulation of methotrex­ate (Otrexup; Antares Pharma) for once-weekly self-administration of the drug, with an easy-to-use, single-dose, disposable auto injector. This new subcutaneous formulation is indicated for adults with severe active rheumatoid arthritis (RA) whose disease has an inadequate response to or who are intolerant of an adequate trial of first-line therapy for RA, includ­ing nonsteroidal anti-inflammatory agents, as well as for children with active polyarticular juvenile idiopathic arthritis (pJIA). The FDA also approved Otrexup for adults for the symptomatic control of severe recalcitrant and disabling psoriasis that is not adequately responsive to other forms of therapy.
By Phoebe Starr San Diego, CA—Apremilast, a first-in-class oral targeted phosphodiesterase-4 inhibitor, achieved rapid, sustained clinically meaningful resolution of oral ulcers in patients with Behçet’s disease. Apremilast also reduced disease activity and improved patients’ quality of life (QOL) and pain compared with placebo.
Elevated plasmablast levels potential new diagnostic biomarker By Phoebe Starr San Diego, CA—The spectrum of immunoglobulin (Ig)G4-related disorders responds to treatment with rituximab, according to results of a new study, suggesting that elevated plasmablasts are a sensitive marker for these disorders. Lead investigator John H. Stone, MD, MPH, Director, Clinical Rheumatology, Massachusetts General Hospital, Boston, presented at the 2013 American College of Rheumatology meeting.
Easy on the prednisone, maximize immunomodulators, look for noncalcified plaque By Wayne Kuznar San Diego, CA—Expanded use of hydroxychloroquine and limited use of prednisone are 2 strategies in the management of patients with systemic lupus erythematosus (SLE), said Michelle A. Petri, MD, MPH, Professor of Medicine, Johns Hopkins University, Baltimore, MD, at the 2013 American College of Rheumatology meeting.
By Wayne Kuznar San Diego, CA—Inadequate lupus-specific education and a lack of autoimmune centers are leading to a delay in the diagnosis of lupus, especially among ethnic minorities, who are disproportionately affected by lupus.
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