Rheumatology

Although early diagnosis of axial spondyloarthritis is crucial for patients to receive timely access to care and effective treatment, these patients experience a diagnostic delay of more than 7 years, on average.

Clinical trial result revealed that upadacitinib may be more effective in treating patients with rheumatoid arthritis than the gold standard of care, methotrexate.

Treatment options for psoriatic arthritis and axial spondyloarthritis are increasing, and with studies already identifying response predictors for tumor necrosis factor inhibitors, there is a need to predict response to the interleukin-17A inhibitor secukinumab.

The coronavirus disease 2019 (COVID-19) public health emergency has led to an increased use of telemedicine services as CMS instituted reimbursement parity with in-person services. In a new position statement, the American College of Rheumatology has stated support for continuing to use telemedicine once the COVID-19 emergency passes.

Among patients with rheumatic diseases, medication nonadherence remains a significant problem because of a lack of standardization and guidance on terminology, measurement, and outcome selection, according to an abstract presented at the European Congress of Rheumatology of the European League Against Rheumatism.

While biologics may have improved outcomes in rheumatoid arthritis (RA), they also have higher costs and adverse events, and patients are more likely to request dose reductions or drug holidays.

Despite advances in therapeutics and treatment strategies for rheumatoid arthritis (RA) that impact well-being, patients in clinical remission still report reduced well-being, according to an abstract presented at the European Congress of Rheumatology of the European League Against Rheumatism.

Based on the safety and efficacy outcomes from the PREVENT phase 3 study, the FDA has approved secukinumab (Cosentyx) from Novartis for the treatment of active nonradiographic axial spondyloarthritis.

Measuring disease activity is a key aspect of rheumatologic care, but the creation of tools designed specifically for disease areas of interest has resulted in fragmentation and multiple disease activity scores, sometimes even just for a single disease.

Two abstracts presented at the European Congress of Rheumatology of the European League Against Rheumatism reviewed long-term safety data and real-life effectiveness and safety of secukinumab for ankylosing spondylitis, psoriasis, and psoriatic arthritis.

Recommendations that patients with rheumatoid arthritis see an expert within 6 weeks of symptom onset can provide challenges for practices.

Drugs used to treat rheumatic conditions suppress the rogue immune system, but it has been unclear whether patients using immunosuppressants have an increased risk of a more severe course if they are infected with the coronavirus disease 2019 (COVID-19).

New therapies for autoimmune conditions like rheumatoid arthritis (RA) highlight the potential of metabolic targets. A recent study highlights some of the most promising targets.

Erin L. Arnold, MD, FACR, of Orthopaedics and Rheumatology of the North Shore in Skokie, IL, discusses evolving treatment strategies and the use of biologic therapies in the management of psoriatic disease.

Catching psoriatric arthritis (PsA) early has been a challenge even when the diagnosis is aided by sonography, according to the authors.

For patients with rheumatoid arthritis (RA), cost can play a role in patient adherence to medication, but the presence of comorbidities does not impact cost of care for patients, according to 2 abstracts presented at the Virtual 2020 International Society for Pharmacoeconomics and Outcomes Research meeting.

Jerry Bagel, MD, director of the Psoriasis Treatment Center of New Jersey, sheds light on the clinical utility of newer classes of biologic agents in the management of psoriasis and psoriatic arthritis.

Incremental cost-effectiveness ratios (ICERs) must be updated to reflect the fact that some patients discontinue biologics and swap in other products, the authors concluded.

Although patient-reported outcomes (PROs) are increasingly being used to understand treatment effectiveness, there is still a lot unknown about what measures patients find most important. Two abstracts presented at the American College of Rheumatology’s annual meeting evaluated PROs in rheumatology and how PRO measures can be used in clinical care.

Pain is common in patients with rheumatologic diseases, and 2 abstracts presented at the American College of Rheumatology’s annual meeting analyzed opioid use in these patients, examining patient features associated with chronic use and changing opioid use patterns in the wake of the opioid epidemic.

Exercise can be a potent therapy for patients with rheumatologic diseases and can result in improvements in inflammation, disease activity score, pain, stiffness, and fatigue. However, exercise needs to be modified for these patients to address the unique barriers they may have compared with the general population, said panelists during a session at the American College of Rheumatology’s annual meeting.

Patients with rheumatoid arthritis (RA) not only deal with functional impairment, but also pain, fatigue, and other symptoms driven by interleukin (IL)-6 levels. In a session at the American College of Rheumatology’s annual meeting, 2 speakers examined the role of IL-6 in RA and treatment using sarilumab (Kevzara) to target and block IL-6 signals.

New technologies that can monitor sleep, track itching patterns, or assist with pain are improving outcomes and quality of life for patients with rheumatologic conditions, according to panelists at the American College of Rheumatology’s annual meeting.

Monotherapy was a big topic of conversation at the American College of Rheumatology’s annual meeting, held November 8-13 in Atlanta, Georgia, and 2 abstracts highlight the efficacy of sarilumab as a monotherapy in patients with rheumatoid arthritis.

Since there are no cures for knee osteoarthritis (OA), exercise and weight loss remain the best first-line therapies to decrease pain and improve function, said Stephen P. Messier, PhD, professor and director of the J.B. Snow Biomechanics Laboratory at Wake Forest University.

Patients with rheumatoid arthritis receiving sarilumab have lower odds of unacceptable pain and are able to reduce their dose of oral glucocorticoid; they also have lower costs per responder than most other treatments, according to a trio of abstracts presented at the American College of Rheumatology/Association of Rheumatology Professionals 2019 Annual Meeting.

While biosimilars have brought down the cost of therapies, the savings are not quite as huge as providers may have been led to believe when biosimilars were initially under development, said Elaine Husni, MD, MPH, vice chair and director of the Arthritis and Musculoskeletal Center in the Orthopedic and Rheumatologic Institute at the Cleveland Clinic.

Patients with immunosuppressive conditions, particularly those being treated with tumor necrosis factor inhibitors, are vulnerable to infections, but rheumatologists have mostly been hesitant to use any live virus vaccines in these patients, said Jeffrey R. Curtis, MD, MS, MPH, professor of medicine in the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham.

Grouping patients into clusters based on shared characteristics, such as disease control and general health, may be helpful in understanding and predicting clinical outcomes in patients with rheumatoid arthritis (RA), according to an abstract presented at the 2019 ACR/ARP Annual Meeting, held November 8-13 in Atlanta, Georgia.

Disease activity assessments can help physicians treat to targets, but in some areas those targets have not been set yet, said Yusuf Yazici, MD, clinical associate professor in the Department of Medicine at NYU Langone Health.