Over the past decade, physicians, patients and policy makers have expressed increasing concern about the high frequency of opioids being prescribed and the association between opioid use and poor outcomes. Rates of opioid prescriptions in the general population rose considerably from the 1990s through 2010, with a plateau in the early 2010s. In 2015, 38%…

More Data for Treat to Target: Post-Hoc Analysis of Large RA Clinical Trials Supports Treat-to-Target Recommendations
A post-hoc analysis of data from two large clinical trials supports treat-to-target recommendations for patients with rheumatoid arthritis. The research found baseline disease activity was the strongest predictor of a patient’s insufficient response to initial therapy at six months…

Galectin-3 May Be a Biomarker for Cardiovascular Disease in RA
Galectin-3 may have potential as a biomarker for the early onset of cardiovascular disease in RA patients, potentially enabling early intervention and deferring the cardiovascular risks associated with RA…

MRI-Guided Therapy Offers No Improvement Over Conventional Treat to Target for RA
New research does not support the use of a magnetic resonance imaging (MRI)-guided strategy for treating RA patients. The study found that among RA patients in remission, an MRI-guided treat-to-target strategy compared with a conventional treat-to-target strategy did not result in improved disease activity remission rates or reduced radiographic progression…
Rheumatoid Arthritis Risk Lower Among Smokers Who Quit
(Reuters Health)—Adults who quit smoking decades ago may have a lower risk of rheumatoid arthritis (RA) than people who gave up cigarettes more recently, a U.S. study suggests. Smoking has long been linked to an increased risk of RA, and quitting can reduce this risk. But the new study offers fresh evidence that years of…

Upadacitinib at the FDA
Upadacitinib is an investigational, oral, small molecule JAK1-selective inhibitor, which recently completed phase 3 clinical trials for treating patients with moderate to severe rheumatoid arthritis (RA). In late 2018, AbbVie Inc. submitted a New Drug Application to the U.S. Food and Drug Administration, as well as a marketing authorization application to the European Medicines Agency,…

The Effects of Early RA Treatment on CVD
New research exploring the effects of etanercept on cardiovascular disease in treatment-naive, early RA patients suggests a treatment advantage with etanercept, a TNF inhibitor and methotrexate over treatment with methotrexate and a conventional synthetic disease-modifying anti-rheumatic drug…

B Cell-Directed Therapy May Delay RA Development in High-Risk Patients
New evidence from a clinical trial of rituximab has identified the pathogenetic role of B cells in the earliest, pre-arthritis stage of autoantibody-positive RA…
RA Effectiveness Differs Among Non-TNF Inhibitors
NEW YORK (Reuters Health)—Rheumatoid arthritis (RA) outcomes are better with some non-TNF inhibitors than with others, according to French registry data. “Previously, indirect comparisons (meta-analyses) did not show any difference between biologics in terms of effectiveness,” Dr. Jacques-Eric Gottenberg from Strasbourg University Hospital, France, tells Reuters Health by email. “Our direct comparison using observational data…
Reminder: How to Handle Part D Prior Authorization Requests
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,…
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