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,…
Can IL-6 Predict Sarilumab Response?
Recent post-hoc analyses of two Phase 3 clinical trials show that RA patients with high interleukin 6 levels taking sarilumab experienced improved symptoms and less joint damage than those using other treatments…
Initial Sjögren’s Manifestations Can Go Beyond Dry Eyes & Mouth
Primary Sjögren’s syndrome is a systemic autoimmune condition noted for findings of xerostomia, keratoconjunctivitis sicca and focal lymphocyte infiltrate in salivary glands.1 In the initial publications regarding keratoconjunctivitis sicca, Henrik Sjögren, a Swedish ophthalmologist, described a group of 19 women with dry eyes, some of whom had other organ dryness and inflammatory infiltrates.2,3 The syndrome…
Upadacitinib Monotherapy Proves Promising; Plus FDA Approves Tocilizumab Autoinjector
In a study, RA patients taking upadactinib monotherapy experienced less pain and morning joint stiffness than methotrexate-treated patients…
Case Report: The Hairdresser Who Couldn’t Comb Her Hair
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition characterized by pain and morning stiffness at the neck, shoulders and hip girdle. It can be associated with giant cell arteritis (GCA); in fact, the two disorders may represent a continuum of the same disease process. This case describes a patient who initially refused treatment for PMR…
Study Suggests Tocilizumab Monotherapy May Work for Some RA Patients
For patients with rheumatoid arthritis (RA) who respond to subcutaneous tocilizumab, discontinuing methotrexate may be an option and offer an alternative to patients who cannot tolerate or prefer not to take methotrexate. “This is one of the first studies showing that methotrexate may be discontinued in a cohort of patients with a biologic agent without…
The FDA Approved Several New Rheumatology Drugs in 2017
SAN DIEGO—In a session at the 2017 ACR/ARHP Annual Meeting, Kam Nola, PharmD, MS, professor in the College of Pharmacy and vice chair in the Department of Pharmacy Practice at Lipscomb University in Nashville, Tenn., updated participants on new medications and new indications for rheumatology treatments and safety labeling changes approved by the U.S. Food…
How to Avoid Insurance Denials for Prescribing a Biologic Without MTX in Concert
The Insurance Subcommittee (ISC) of the ACR’s Committee on Rheumatologic Care (CORC) has recently received a number of reports from members regarding denials for biologics for patients not on methotrexate. To help avoid an often-lengthy appeals process, the ACR/ARHP recommends that members document a patient’s history of methotrexate intolerance or contraindication at every visit. What…
E6011 & Tocilizumab Monotherapy Studies Show Promising Results for RA Patients
New RA Antibody Treatment SAN DIEGO—A recent study examined the pharmacokinetics, safety and efficacy of E6011, an anti-fractalkine monoclonal antibody designed to treat rheumatoid arthritis (RA).1 Researchers presented the results of this first 52-week trial of E6011 at the 2017 ACR/ARHP Annual Meeting in November. Fractalkine (CX3CL1/FKN) is a chemokine that regulates chemotaxis and adhesion…
Tocilizumab Monotherapy May Sustain Low Disease Activity in RA Patients
New research demonstrates that subcutaneous tocilizumab monotherapy may preserve disease control in RA patients who have discontinued methotrexate…
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