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Sun-Kyeong Park, Seung-Hoo Park, Min-Young Lee, Ji-Hyun Park, Jae-Hong Jeong, Eui-Kyung Lee
PURPOSE: In south Korea, the price of biologics has been decreasing owing to patent expiration and the availability of biosimilars. This study evaluated the cost-effectiveness of a treatment strategy initiated with etanercept (ETN) compared with leflunomide (LFN) after a 30% reduction in the medication cost of ETN in patients with active rheumatoid arthritis (RA) with an inadequate response to methotrexate (MTX-IR). METHODS: A cohort-based Markov model was designed to evaluate the lifetime cost-effectiveness of treatment sequence initiated with ETN (A) compared with 2 sequences initiated with LFN: LFN-ETN sequence (B) and LFN sequence (C)...
October 19, 2016: Clinical Therapeutics
M J Santos, M Conde, A F Mourão, F O Ramos, M Cabral, I Brito, M P Ramos, R C Marques, S M Gomes, M Guedes, M J Gonçalves, P Estanqueiro, C Zilhão, M Rodrigues, C Henriques, M Salgado, H Canhão, J E Fonseca, J M Gomes
OBJECTIVE: To provide evidence-based guidance for the rational and safe prescription of biological therapies in children and adolescents with juvenile idiopathic arthritis (JIAs) considering the latest available evidence and the new licensed biologics. METHODS: Rheumatologists and Pediatricians with expertise in Pediatric Rheumatology updated the recommendations endorsed by the Portuguese Society of Rheumatology and the Portuguese Society of Pediatrics based on published evidence and expert opinion...
July 2016: Acta Reumatológica Portuguesa
Alessandro Consolaro, Esi M Morgan, Gabriella Giancane, Silvia Rosina, Stefano Lanni, Angelo Ravelli
Information technology in paediatric rheumatology has seen several exciting developments in recent years. The new multidimensional questionnaires for juvenile idiopathic arthritis, juvenile dermatomyositis, and juvenile autoinflammatory diseases integrate all major parent- and child-reported outcomes (PCROs) used in these diseases into a single tool, and provide an effective guide to manage, document change in health, assess effectiveness of therapeutic interventions, and verify the parent and child satisfaction with illness outcome...
September 2016: Clinical and Experimental Rheumatology
Luis Rodriguez-Rodriguez, Leticia Leon, Jose Ivorra-Cortes, Alejandro Gómez, Jose Ramon Lamas, Esperanza Pato, Juan Angel Jover, Lydia Abásolo
OBJECTIVES: To assess the mortality rate (MR) and the mortality risk of a rheumatoid arthritis (RA) inception cohort, with and without biologic agents (BAs). Other factors associated to mortality were also investigated. METHODS: Retrospective longitudinal study of RA patients, attending the rheumatology outpatient clinic of a tertiary Hospital (Madrid), collected over 5 years (2000-2004), and followed from the diagnosis of RA up to the patients' death, lost to follow-up or September 2013...
October 7, 2016: Clinical and Experimental Rheumatology
Mei Jiang, Feifeng Ren, Yaning Zheng, Ruyu Yan, Wenhan Huang, Ning Xia, Lei Luo, Jun Zhou, Lin Tang
OBJECTIVES: To evaluate the efficacy and safety of down-titration (dose reduction/tapering) strategies compared with continuation of biological disease-modifying anti-rheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) who achieved and maintained low disease activity or remission. METHODS: We searched the following electronic database up to March 2016: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and conference proceedings of the American College of Rheumatology (ACR) and European League against Rheumatism (EULAR)...
September 7, 2016: Clinical and Experimental Rheumatology
Vedat Hamuryudan, Haner Direskeneli, Ihsan Ertenli, Murat Inanc, Yasar Karaaslan, Fahrettin Oksel, Suleyman Ozbek, Salih Pay, Ender Terzioglu, Dilara Balkan Tezer, Basak Hacibedel, Nurullah Akkoc
OBJECTIVES: To estimate the annual cost of rheumatoid arthritis (RA) in Turkey by obtaining real-world data directly from patients. METHODS: In this cross-sectional study, RA patients from the rheumatology outpatient clinics of 10 university hospitals were interviewed with a standardised questionnaire on RA-related healthcare care costs. RESULTS: The study included 689 RA patients (565 females) with a mean age of 51.2±13.2 years and mean disease duration of 9...
September 18, 2016: Clinical and Experimental Rheumatology
Maddalena Napolitano, Nicola Balato, Francesco Caso, Luisa Costa, Matteo Megna, Teresa Cirillo, Anna Balato, Raffaele Scarpa
OBJECTIVES: To evaluate the incidence of new cases of psoriatic arthritis (PsA) in patients with plaque psoriasis receiving biologic drugs. METHODS: A retrospective study was performed on 434 psoriatic patients under biologic treatment, attending the Psoriasis Care Centre of Dermatology at the University Federico II of Naples from January 2011 to November 2015. As part of the routine clinical practice, assessment of disease activity was made at baseline, and every 3 months...
September 8, 2016: Clinical and Experimental Rheumatology
Philip Mease, Iain B McInnes
INTRODUCTION: Psoriatic arthritis (PsA) is an immune-mediated chronic inflammatory arthropathy associated with impaired physical function and reduced quality of life. Biologic therapies that target tumor necrosis factor (anti-TNF) have significantly improved clinical outcomes. Partial, non- and transient responses remain common comprising significant unmet clinical need. New therapies with novel modes of action are urgently required. OBJECTIVES: The interleukin (IL)-17 pathway has recently been attributed a critical role in the pathogenesis of spondyloarthritides...
June 2016: Rheumatol Ther
Alan G Wade, Gordon M Crawford, David Young, Joyce Leman, Neil Pumford
BACKGROUND: Scottish Intercollegiate Guidelines Network and National Institute of Health and Care Excellence guidelines stress the importance of assessing patients with psoriasis for psoriatic arthritis, comorbidities associated with severe disease and quality of life (QoL). The purpose of the study was to evaluate the primary care management of psoriasis in relation to disease severity and QoL from a patient's perspective. METHODS: A cross-sectional survey of adults (≥18 years) with psoriasis managed in primary care was conducted in Scotland over 1-year (2012-2013)...
October 14, 2016: BMC Family Practice
Soumya M Reddy, Sheila Crean, Amber L Martin, Meghan D Burns, Jacqueline B Palmer
Anti-tumor necrosis factors (Anti-TNFs) are a class of biologic disease-modifying anti-rheumatic drugs indicated for the treatment of moderate-to-severe psoriatic arthritis (PsA). Refractory patients are commonly managed by switching from one anti-TNF to another. To assess the evidence on the effectiveness of anti-TNF cycling in PsA patients, a systematic review of the literature was conducted. MEDLINE- and Embase-indexed English-language publications were systematically searched from 1995 to 2015 for studies assessing real-world effectiveness outcomes of anti-TNF cycling in PsA patients...
October 12, 2016: Clinical Rheumatology
Jamileh Moghimi, Ali Asghar Rezaei, Raheb Ghorbani, Mohammad Reza Razavi, Daryoush Pahlevan
In the current study, the overall prevalence and the main underlying etiologies of inflammatory low back pain (ILBP) were determined, and the effectiveness of treatment with sulfasalazine was investigated in patients with inflammatory versus mechanical low back pain (LBP). In a prospective study conducted from July 2013 until August 2015, 1,779 consecutive patients within the age range of 18-50 years with a primary complaint of LBP referring to the rheumatology clinics were included. The patients were classified into two distinct groups: those suffering from ILBP (n=118) and those having mechanical LBP (n=1,661)...
2016: Drug Design, Development and Therapy
Roy Fleischmann, Michael Schiff, Désirée van der Heijde, Cesar Ramos-Remus, Alberto Spindler, Marina Stanislav, Cristiano A F Zerbini, Sirel Gurbuz, Christina Dickson, Stephanie de Bono, Douglas Schlichting, Scott Beattie, Wen-Ling Kuo, Terence Rooney, William Macias, Tsutomu Takeuchi
Objective This Phase 3 study evaluated baricitinib, an oral Janus kinase (JAK)1/JAK2 inhibitor, as monotherapy or combined with methotrexate (MTX) compared to MTX in patients with active rheumatoid arthritis (RA) with no or minimal prior conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) and naive to biologic DMARDs. Methods Patients (N=588) were randomized 4:3:4 (MTX: baricitinib 4 mg once daily: baricitinib 4 mg + MTX) for 52 weeks. The primary endpoint assessment was noninferiority of baricitinib monotherapy to MTX based on American College of Rheumatology 20% (ACR20) response at Week 24...
October 9, 2016: Arthritis & Rheumatology
Bernhard Rintelen, Jochen Zwerina, Manfred Herold, Franz Singer, Johann Hitzelhammer, Wolfgang Halder, Gabriela Eichbauer-Sturm, Rudolf Puchner, Miriam Stetter, Burkhard F Leeb
No abstract text is available yet for this article.
October 3, 2016: BMC Musculoskeletal Disorders
Ömer Karadağ, Timuçin Kaşifoğlu, Birol Özer, Sabahattin Kaymakoğlu, Yeşim Kuş, Murat İnanç, Gökhan Keser, Sedat Kiraz
Biological drugs (tumor necrosis factor inhibitors, rituximab, tocilizumab, abatacept, and tofacitinib) are important treatment alternatives in rheumatology, particularly for resistant patients. However, they may cause hepatitis B virus (HBV) and hepatitis C virus (HCV) reactivation; for instance, HBV reactivation may occur in a patient who is an inactive hepatitis B surface antigen (HBsAg) carrier or who has resolved HBV infection. Therefore, the screening of patients before biological treatment and the application of a prophylactic treatment, particularly with respect to latent HBV infections, are recommended when necessary...
March 2016: Eur J Rheumatol
Martin Feuchtenberger, Arne Schäfer, Axel Philipp Nigg, Michael Rupert Kraus
BACKGROUND: Only limited data are available on the prevalence of hepatitis B in patients with proven rheumatic diseases and thus the risk of reactivation under immunosuppressive therapy. OBJECTIVE: To analyse hepatitis B serology in patients with rheumatic diseases prior to therapy. METHOD: In total, 1,338 patient records were analysed for HBsAg, HBsAb and HBcAb in a cross-sectional, single-centre study between 2011 and 2015 at first presentation...
2016: Open Rheumatology Journal
Pascale Schwab, Harlan Sayles, Debra Bergman, Grant W Cannon, Kaleb Michaud, Ted R Mikuls, Jennifer Barton
OBJECTIVES: Many veterans enrolled in Veterans Affairs (VA) also receive care through other healthcare systems. Both VA and non-VA healthcare use must therefore be considered when conducting research in this population. This study characterized dual care utilization in veterans with rheumatoid arthritis (RA) and explored associations with RA disease activity. METHODS: Through a questionnaire mailed to RA patients at three VA sites, veterans reported medical services by non-VA primary care and subspecialty providers, comorbidities, non-VA medications, and hospitalizations...
October 1, 2016: Arthritis Care & Research
Jinoos Yazdany, Nick Bansback, Megan Clowse, Deborah Collier, Karen Law, Katherine P Liao, Kaleb Michaud, Esi M Morgan, James C Oates, Catalina Orozco, Andreas Reimold, Julia F Simard, Rachel Myslinski, Salahuddin Kazi
BACKGROUND: The Rheumatology Informatics System for Effectiveness (RISE) is a national electronic medical record (EMR)-enabled registry. RISE passively collects data from EMRs of participating practices, provides advanced quality measurement and data analytic capacities, and fulfills national quality reporting requirements. Here we report the registry's architecture and initial data, and demonstrate how RISE is being used to improve the quality of care. METHODS: RISE is a certified Centers for Medicare and Medicaid Services Qualified Clinical Data Registry, allowing collection of data without individual patient informed consent...
October 1, 2016: Arthritis Care & Research
Maxime Dougados, Désirée van der Heijde, Ying-Chou Chen, Maria Greenwald, Edit Drescher, Jiajun Liu, Scott Beattie, Sarah Witt, Inmaculada de la Torre, Carol Gaich, Terence Rooney, Douglas Schlichting, Stephanie de Bono, Paul Emery
BACKGROUND: Baricitinib is an oral, reversible, selective Janus kinase 1 and 2 inhibitor. METHODS: In this phase III, double-blind 24-week study, 684 biologic disease-modifying antirheumatic drug (DMARD)-naïve patients with rheumatoid arthritis and inadequate response or intolerance to ≥1 conventional synthetic DMARDs were randomly assigned 1:1:1 to placebo or baricitinib (2 or 4 mg) once daily, stratified by region and the presence of joint erosions. Endpoint measures included American College of Rheumatology 20% response (ACR20, primary endpoint), Disease Activity Score (DAS28) and Simplified Disease Activity Index (SDAI) score ≤3...
September 29, 2016: Annals of the Rheumatic Diseases
Lídia Teixeira, Ana Rita Fonseca, Gisela Eugénio, Marília Rodrigues, Nikita Khmelinskii, Sílvia Fernandes, Sofia Serra, Tiago Costa, Maria José Santos
INTRODUCTION: Infections are a major cause of morbidity and mortality in systemic inflammatory rheumatic diseases and the management of infectious complications in patients under biological therapies deserves particular attention. OBJECTIVE: Develop evidence-based recommendations for the management of infections in rheumatic patients receiving biological therapies. METHODS: A search in PubMed (until 10 November 2014) and EMBASE (until 20 December 2014) databases was performed...
August 6, 2016: Acta Reumatológica Portuguesa
Yoshiya Tanaka
Central nervous system damage, a major organ manifestation of systemic lupus erythematosus (SLE), causes significant morbidity and mortality. Designating this condition as neuropsychiatric SLE (NPSLE), the American College of Rheumatology defines it as involving the central and peripheral nervous systems and being characterized by various manifestations including stroke, seizures, and psychosis. NPSLE treatment mainly seeks to reduce damage accrual. In patients with NPSLE, the use of high-dose corticosteroids is recommended in combination with immunosuppressants, such as mycophenolate mofetil and intravenous cyclophosphamide pulse therapy...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
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