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By Jeffrey S. Peller, MD Dr Peller is Practicing Rheumatologist at Harbin Clinic/Rheumatology in Rome, GA I had my first experience with clinical research during my fellowship 30 years ago. The new drug isotretinoin (Accutane) was being used to treat acne, and the concern was that it triggered spondyloarthritis. Rheumatologists were therefore asked to evaluate young patients who were being treated with that drug, and I was one of those rheumatologists.
Stelara a new treatment option for this patient population By Phoebe Starr Madrid, Spain—One-year open-label follow-up of the phase 3 PSUMMIT 2 trial showed that the early improvement that was achieved by week 24 with ustekinumab (Stelara), an interleukin (IL)-2 and IL-23 antagonist, was sustained at week 52 in patients with psoriatic arthritis who had previously received as well as those who had not previously received an anti–tumor necrosis factor (TNF) inhibitor, said lead investigator Christopher T. Ritchlin, MD, MPH, Chief, Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, NY, at the 2013 European League Against Rheumatism annual meeting.
Canakinumab, rilonacept, and tocilizumab considered for the first time By Rosemary Frei, MSc New recommendations from the American College of Rheumatology for the treatment of patients with systemic juvenile idiopathic arthritis (JIA) have been published simultaneously in the October 2013 issues of Arthritis Care & Research (Hoboken) (Ringold S, et al. 2013;65:1551-1563) and Arthritis & Rheumatism (Ringold S, et al. 2013;65:2499-2512).
In a recent guest blog on the Harvard Business Review website, Toby Cosgrove, MD, President and CEO of the Cleveland Clinic in Ohio, suggested that value-based care represents a life-saving “breakthrough” by focusing on lowering costs and improving quality of care and outcomes as its main goals. According to Dr Cosgrove, value-based care “is being slowed by criticism, misunderstanding, and a reluctance to do things differently,” but it is inevitable, and it will change the way medicine is being practiced in this country.
An inflammatory signaling pathway has been identified that involves key signaling proteins in the inflammatory process that are responsible for many inflammatory diseases, including rheumatoid arthritis (RA) and psoriasis. The proteins were identified by researchers from The Scripps Research Institute (TSRI), and may suggest potential new treatments for these inflammatory diseases.
In a new study, PREDICTS, which was supported by the Lupus Research Institute, the Alliance for Lupus Research, the American College of Rheumatology Research and Education Foundation, the National Institutes of Health, the Arthritis Foundation, the Iris Cantor Women’s Health Foundation, the Arthritis National Research Foundation, and a Kirkland Award, a panel of 6 biomarkers was shown able to predict which female patients with systemic lupus erythematosus (SLE) are at increased risk for cardiovascular events as confirmed by carotid artery ultrasound examinations.
The US Food and Drug Administration (FDA) approved the first anti–interleukin (IL)-12 and anti–IL-23, ustekinumab (Stelara; Janssen Biotech), alone or in combination with methotrexate, for the treatment of adult patients aged ≥18 years with active psoriatic arthritis.
By Rosemary Frei, MSc A new multicenter study confirms that there is an independent association between gout and gout-related characteristics on the one hand and functional impairment and quality of life on the other. For example, polyarticular joint involvement is significantly associated with increased disability and with poorer overall quality of life for this patient population (Scirè CA, et al. Arthritis Res Ther. 2013;15:R101).
By John Kolstoe, MD Dr Kolstoe is in private practice at Kolstoe Rheumatology: Musculoskeletal Medicine, East Lansing, MI, and an editorial board member of Value-Based Care in Rheumatology The August 2013 issue of Value-­Based Care in Rheumatology devoted 3 articles to systemic lupus erythematosus (SLE). Two of the articles pertained to refining the clinical “state” of SLE through newer laboratory criteria (“New Biomarkers and Biomarker Panels Show Promise for Diagnosing and Monitoring Patients with Lupus”)1 or through available clinical criteria (“New Diagnostic Algorithm for SLE Can Facilitate Early Treatment, Improve Outcomes”)2; the third article reviewed the effect of treatment with vitamin D (“Increasing Vitamin D Intake in Patients with Lupus Provides Modest Benefit”).3 All 3 articles will assist the clinician’s decision on how and when to treat the individual patient with SLE.
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.
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