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…
New Research into Rheumatoid Arthritis, Gout Includes Updates on Methotrexate, Biologics, Ultrasound
LONDON—From optimizing responses to methotrexate, to the efficacy of biologics, to the need for imaging in assessing remission, the literature, as ever, has been lively with explorations of pressing topics in the treatment and management of rheumatoid arthritis. Josef Smolen, MD, chair of rheumatology at the Medical University of Vienna, reviewed many of the highlights…
Methotrexate with Step-Down Glucocorticoid Remission Induction Works in Early RA
NEW YORK (Reuters Health)—Methotrexate with step-down glucocorticoid remission induction (COBRA Slim) is an effective, safe and feasible initial treatment strategy for patients with early rheumatoid arthritis (RA), researchers from Belgium report. Patients with early RA should be treated rapidly, intensively and to target, according to current guidelines, they note in a paper online July 18…
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