NEW YORK (Reuters Health)—Temporarily withholding methotrexate (MTX) can improve the efficacy of seasonal influenza vaccination in patients with rheumatoid arthritis (RA), according to a new randomized clinical trial. Response was strongest in patients who discontinued MTX for two weeks before and two weeks after receiving the flu shot, Dr. Eun Bong Lee of Seoul National…
FDA Approves Oral Methotrexate; Plus Restrictions for 2 Analgesics in Children
The FDA has approved a new formulation of methotrexate designed as an oral solution for pediatric patients. The agency has also recently introduced age restrictions for codeine and tramadol for children under age 12, citing their risks for slowed or difficult breathing and death…
RA Prevention: A Trial of Methotrexate Vs. Placebo in Patients with Undifferentiated Arthritis
Disease outcomes in rheumatoid arthritis (RA) have improved dramatically since the introduction of biologic agents and improved treatment strategies. Nevertheless, the majority of patients still require prolonged, if not lifelong, therapy. Therefore, the ultimate goal would be to prevent RA. This study analyzed the effect of a one-year course of methotrexate in high-risk UA patients (studied in a previous trial) after post-randomization exclusion of patients without a high risk of developing RA…
Tocilizumab Effectively Treats Early RA for Up to Two Years
NEW YORK (Reuters Health)—Patients with early rheumatoid arthritis (RA) treated with IV tocilizumab alone or with methotrexate maintained clinical benefits during their second year of treatment, researchers say. Sophie Dimonaco of Roche Products Ltd. in Welwyn Garden City, UK and colleagues sought to determine whether the efficacy and safety of IV tocilizumab, as demonstrated in…
Moderate Alcohol Use Could Be Safe with Methotrexate for RA
NEW YORK (Reuters Health)—In patients taking methotrexate for rheumatoid arthritis (RA), moderate alcohol consumption – that is, no higher than existing U.K. guidelines for the general population – was not associated with an increased risk of transaminitis, researchers say. The study is both the largest to examine alcohol and methotrexate (MTX) and the first to…
Paternal Methotrexate Exposure Not Tied to Adverse Pregnancy Outcomes
NEW YORK (Reuters Health)—A father’s exposure to methotrexate 90 days or less before conception “should not be of major concern,” researchers say. Prepregnancy paternal methotrexate exposure appears to confer no increased risk of major or minor congenital malformation, stillbirth or preterm birth in his offspring, their study found. Methotrexate is a first-line therapy for rheumatoid…
Reminder: How to Handle Part D Prior Authorization Requests
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, but when it’s used as an oral agent for rheumatoid arthritis, it’s covered by Part D. Early in the…
Baricitinib Is Effective in Patients Treated with DMARDs & Methotrexate
A recent analysis has examined the effectiveness of baricitinib in treating RA patients who suffer from comorbidities and the effect of concomitant use of steroids. Baricitinib proved effective, particularly in patients who had exposure to cDMARDs and corticosteroids…
FDA Update: FDA Delays Baricitinib Review & Removes Bupropion & Varenicline Warnings
FDA Review of Baricitinib Delayed The U.S. Food and Drug Administration (FDA) has extended the review period for baricitinib, an investigational medication for treating moderate to severe rheumatoid arthritis (RA).1 Baricitinib is a once-daily oral Janus kinase (JAK) inhibitor currently in clinical studies for inflammatory and autoimmune diseases. The New Drug Application (NDA) for baricitinib…
TNF Inhibitor Tied to Lower Cardiovascular Risk in Psoriasis
NEW YORK (Reuters Health)—Psoriasis patients treated with tumor necrosis factor-alpha (TNF) inhibitors may have a lower risk of major cardiovascular (CV) events than those treated with methotrexate (MTX), according to a new study. “The findings do not surprise me. TNF inhibitors control inflammation better than methotrexate,” lead author Dr. Jashin J. Wu of Kaiser Permanente…
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