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…

Certolizumab Pegol Combination Therapy Better than Methotrexate Monotherapy in DMARD-Naive Patients with RA
A recent study found that certolizumab pegol plus methotrexate is effective in achieving sustained remission and low disease activity in patients with early active RA…
Certolizumab Combo Helps Curb RA Damage
NEW YORK (Reuters Health)—Certolizumab pegol (Cimzia, UCB Pharma) in combination with methotrexate does better than methotrexate alone in certain patients with early rheumatoid arthritis (RA), according to one-year results from a new trial. As Dr. Paul Emery of the University of Leeds, UK, explains in an email to Reuters Health, “This study used a unique…
Triple Therapy with Methotrexate Effective, Cheaper in RA
NEW YORK (Reuters Health)—The combination of methotrexate, sulphasalazine and hydroxychloroquine is similar in effect as methotrexate plus biologic therapy for patients with rheumatoid arthritis (RA), according to a new network meta-analysis. “Thus, for most patients, this low-cost combination of medications should probably be tried before moving onto biologic therapy, either as initial treatment or as…
Cholesterol Levels in Patients with RA Starting Methotrexate
Although research regarding the increased cardiovascular (CV) morbidity and mortality in rheumatoid arthritis (RA) has burgeoned in recent years, the need remains for a better understanding of the effects of widely used DMARDs on CV risk and risk factors in RA patients. These authors set out to evaluate the long-term changes in cholesterol levels in patients with early RA. Decreases in RA disease activity over long-term follow-up were associated with increases in cholesterol levels in patients with early RA treated with either biologic or nonbiologic therapies…
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