Highlights from the 2017 EULAR Congress MADRID—The anti-IL6 “nanobody,” vobarilizumab, produced mixed results when used with methotrexate (MTX), compared with MTX and placebo, according to results of a 24-week, double-blind Phase 2b study of patients with rheumatoid arthritis (RA), which were presented in an abstract session at the Annual European Congress of Rheumatology (EULAR). The…
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A Stiff Man: A Case Study in Ankylosing Spondylitis
First Appearances I watched the old man, his back painfully bent, shuffle toward the scale. A blocky rigidity draped over him. His feet seemed stuck to the floor. His head hung heavily over his chest. Observing him from the end of the hallway, instead of a face, I saw only a mound of shaggy, matted…

FDA Responds to New Drug Application for Baricitinib
Oxycodone Tablets Submitted to FDA Filings for oxycodone tablets (Oxaydo) in both 10 and 15 mg doses have been accepted by the U.S. Food and Drug Administration (FDA).1 The submission is based on a pharmacokinetic study demonstrating bioequivalence to the reference drug, oxycodone hydrochloride (Roxicodone) tablets at a 15 mg dose. The product is an…

More Effective Antifibrotic Therapies for Systemic Sclerosis in Development; Adverse Events A Concern
Systemic sclerosis (SSc) is a rare disease affecting about 49,000 U.S. adults, and it is strongly associated with high levels of morbidity and mortality.1 Of the few available antifibrotic therapies, none is targeted for SSc. However, reason for optimism exists for antifibrotic treatments in early development and clinical trials, says Jörg H.W. Distler, MD, Heisenberg Professor…

Somatic Mosaicism Can Complicate Diagnosis of Autoimmune Disease
New methods of gene sequencing have resulted in improved identification of mutations in patients and increased availability of genetic testing in rare diseases. Despite these exciting advances, a majority of patients lack identifiable mutations and the underlying disease etiology remains an enigma. Somatic mosaicism (SM) may be an explanation for some of these clinically challenging…
Sanofi to Invest Further in Biologics
PARIS (Reuters)—Sanofi announced plans to invest 600 million euros ($673 million) annually over the next two to three years in the field of biologics production, an area of strong growth potential. In contrast to most drugs that are chemically synthesized, many biologics are produced using living cells. They are seen as a promising answer in…
U.S. Supreme Court Speeds Copycat Biologic Drugs to Market
WASHINGTON (Reuters)—The U.S. Supreme Court on Monday cut the time it will take for copycat versions of biologic drugs to get to the market in a pivotal ruling about an expensive class of medicines that can yield billions of dollars in sales for drug companies. The justices, in a 9–0 ruling, overturned a lower court…
Rheumatology Coding Corner Answer: Infusion Services for Skilled Nursing Facility Patient
Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…
Rheumatology Coding Corner Question: Infusion Services for Skilled Nursing Facility Patient
An 83-year-old established female patient who resides in a skilled nursing facility (SNF) and is diagnosed with rheumatoid arthritis with rheumatoid factor in multiple joints returns to the office for her first infliximab infusion. She denies fevers, cough, dyspnea or concurrent illness, but has joint pain and swelling in both elbows and her left wrist….
Pfizer Hikes U.S. Prices of 91 Drugs by Average 20% in 2017
(Reuters)—Pfizer Inc. has hiked the price of nearly a hundred drugs by an average of 20 percent so far this year in the U.S., the Financial Times reported on Friday. The U.S. drug maker raised the list price of 91 medicines—including that of its erectile dysfunction treatment, Viagra, and its pain drug, Lyrica—on June 1…
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