In a study, researchers found extracellular vesicles may contribute to the greater disease severity typically seen in patients with seropositive rheumatoid arthritis (RA). Specifically, in these patients, extracellular vesicles can activate mononuclear phagocytes and induce proinflammatory cytokines in vitro…
The Effects of Early RA Treatment on CVD
New research exploring the effects of etanercept on cardiovascular disease in treatment-naive, early RA patients suggests a treatment advantage with etanercept, a TNF inhibitor and methotrexate over treatment with methotrexate and a conventional synthetic disease-modifying anti-rheumatic drug…
The Latest Data on Cancer Immunotherapy’s Interaction with Autoimmunity
CHICAGO—The body of literature on immunosuppressive drugs used to treat cancer and autoimmune diseases is growing, helping bring some clarity to their effects on the immune system and how well they work in patients. This has helped refine the questions that further research must answer, said an expert at the 2018 ACR/ARHP Annual Meeting. The…
The Tortured Path to the Cortisone Discovery
CHICAGO—The path to the discovery of cortisone—a top-selling, important drug, with dozens of indications—was complicated by failure, false moves, desperation and obsession. The tale, recounted in the Philip Hench, MD, Memorial Lecture: Crossroads of History & Hope: Discovery & First Use of Cortisone for RA at the 2018 ACR/ARHP Annual Meeting in October, is an…
Why & How Our Biologic Drug Discussion with Patients Should Evolve
As we turn the corner on the second decade of biologic use for rheumatic disorders, a reappraisal of approach in our communication with patients is due. In practice, the impact these agents have on patients’ lives justifies the friction rheumatologists face when connecting patients to them. You can understand why older rheumatologists who apprenticed on…
B Cell-Directed Therapy May Delay RA Development in High-Risk Patients
New evidence from a clinical trial of rituximab has identified the pathogenetic role of B cells in the earliest, pre-arthritis stage of autoantibody-positive RA…
RA Effectiveness Differs Among Non-TNF Inhibitors
NEW YORK (Reuters Health)—Rheumatoid arthritis (RA) outcomes are better with some non-TNF inhibitors than with others, according to French registry data. “Previously, indirect comparisons (meta-analyses) did not show any difference between biologics in terms of effectiveness,” Dr. Jacques-Eric Gottenberg from Strasbourg University Hospital, France, tells Reuters Health by email. “Our direct comparison using observational data…
Rheumatoid Arthritis Prevention, Remission & Treatment De-Escalation
CHICAGO—With an ever-strengthening foundation beneath the pathophysiology and prediction of rheumatoid arthritis (RA), the field may soon focus more intently on prevention, an expert said at the 2018 ACR/ARHP Annual Meeting. The session also covered the latest in remission targets and therapy de-escalation. RA Prevention Kevin Deane, MD, PhD, associate professor of medicine and principal…
Reminder: How to Handle Part D Prior Authorization Requests
Note: Although originally posted in January 2018, the advice below remains valid. We see this issue recur each year. As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B,…
Ultrasound as RA Treat-to-Target Strategy Doesn’t Improve Long-Term Outcomes
An analysis of treat-to-target therapy assessing two ultrasound definitions of remission for patients with early rheumatoid arthritis (RA) has concluded that using ultrasound remission as a target was not associated with better long-term outcomes for RA patients.1 Compared with MRI, ultrasound costs less, is more accessible and offers the ability to scan more joints in…
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