By Rosemary Frei, MSc A Canadian pilot program that required patients with rheumatoid arthritis (RA) to use their private and/or public insurance to cover the costs of rituximab (Rituxan) for RA and switch its site of administration from in-hospital to a private clinic may provide a good example for the United States on moving infusion out of the hospital and saving costs in the management of patients with RA. This move from administering rituximab in the hospital to private clinics for patients with RA reduced the overall hospital’s rituximab-associated costs by a total of $323,825 over the 3-month span of the pilot program.
Rheumatoid arthritis (RA), a chronic inflammatory autoimmune disorder that affects the lining, or synovium, of the joints, affects 1.3 million people in the United States.
By Rosemary Frei, MSc Québec, Canada—The evidence is strong that exercise is beneficial for patients with lower-limb osteoarthritis (OA), particularly knee OA, according to a new analysis that was presented at the 2013 Cochrane Colloquium. Rheumatologists and primary care physicians should continue to advise patients with OA to stay active and to exercise, the investigators say.
Besides expensive and invasive joint replacement surgery for osteoarthritis (OA), the treatment options are limited. Better knowledge of the underlying pathogenesis of OA is crucial for the development of disease-modifying drugs. Chondrocytes are the single cell type that is responsible for maintaining the extracellular matrix of articular cartilage and repair of any damage. Whereas articular cartilage has evolved to facilitate joint mobilization, severe loading can induce cell death, which is associated with OA progression. To avoid apoptosis, chondrocytes synthesize heat-shock proteins (HSPs). A new study investigated the roles of Hsp70 and Hsp90, 2 of the major classes of HSPs involved in the regulation of cell stress, in biochemically induced OA, and the potential for Hsp90 inhibition in OA management (Siebelt M, et al. Arthritis Rheum. 2013;65:2102-2112).
A new randomized controlled trial is the first to investigate the efficacy and safety of creatine supplementation in patients with fibromyalgia (Alves CR, et al. Arthritis Care Res [Hoboken]. 2013;65:1449-1459). Creatine has a significant role in the rapid provision of energy during muscle contraction. Creatine supplementation recently has been recognized as a potential adjunct treatment in a broad spectrum of diseases, including those associated with muscle wasting and dysfunction, low bone mass, joint syndromes, and central nervous system disorders. Fibromyalgia is a chronic syndrome that is characterized by generalized pain, muscle dysfunction, fatigue, disability, and sleep and mood disturbances.
Rheumatoid arthritis (RA) leads to joint inflammation and damage, disability, diminished quality of life, and shorter life expectancy compared with the general population. Treating-to-target approaches in patients with early RA have been shown to be more effective at managing the disease progression than routine care. A new study sought to determine if the treat-to-target strategy also has better outcomes than routine care in patients with established active RA (Pope JE, et al. Arthritis Care Res [Hoboken]. 2013;65:1401-1409).
By Neil Canavan The new class of drugs called Bruton’s tyrosine kinase (BTK) inhibitors may hold the key to more effective treatment for systemic lupus erythematosus (SLE), according to the results of a study just published in the peer-reviewed journal Arthritis & Rheumatism (Mina-Osorio P, et al. 2013;65:2380-2391).
Assessing genetic risk can improve outcomes By Charles Bankhead The ability to predict who is at risk for developing rheumatoid arthritis (RA) improved significantly with a new model based on a combination of genetic risk scores, environmental factors, and gene–­environment interactions (GEIs), according to an analysis of 2 large cohort studies.
By Rosemary Frei, MSc Researchers from across the United States are collaborating to elucidate the details of the complex molecular mechanism that leads to autoimmunity in patients with rheumatoid arthritis (RA), as was outlined in a recent study (Khandpur R, et al. Sci Transl Med. 2013;5:178ra40).
By Rosemary Frei, MSc Patients with rheumatoid arthritis (RA) whose symptoms continue despite treatment with methotrexate benefit from the addition of golimumab (Simponi Aria). In July 2013, the US Food and Drug Administration approved golimumab for this indication (see article, page 24). The 1-year results from the Golimu­mab, an Anti-TNF-alpha Monoclonal Antibody, Administered Intravenously, in Subjects with Active Rheumatoid Arthritis Despite Methotrexate Therapy (GO-FURTHER) trial show that compared with placebo plus methotrexate, the combination of go­limumab and methotrexate is associated with significantly less structural damage and with sustained clinical improvement (Weinblatt ME, et al; for the GO-FURTHER Investigators. Ann Rheum Dis. Epub 2013 Sep 3).
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