American College of Rheumatology Annual Meeting

Abstracts show that institutions can make internal changes to drive the use of biosimilars and that successful biosimilar-to-biosimilar switching is based on patient-related factors.

Despite concerns about treatment with immunosuppressive agents, coronavirus disease 2019 (COVID-19) infection remains low in patients with rheumatic diseases, according to 2 abstracts presented at the annual meeting of the American College of Rheumatology.

Although patient-reported outcomes (PROs) are increasingly being used to understand treatment effectiveness, there is still a lot unknown about what measures patients find most important. Two abstracts presented at the American College of Rheumatology’s annual meeting evaluated PROs in rheumatology and how PRO measures can be used in clinical care.

Pain is common in patients with rheumatologic diseases, and 2 abstracts presented at the American College of Rheumatology’s annual meeting analyzed opioid use in these patients, examining patient features associated with chronic use and changing opioid use patterns in the wake of the opioid epidemic.

Exercise can be a potent therapy for patients with rheumatologic diseases and can result in improvements in inflammation, disease activity score, pain, stiffness, and fatigue. However, exercise needs to be modified for these patients to address the unique barriers they may have compared with the general population, said panelists during a session at the American College of Rheumatology’s annual meeting.

Patients with rheumatoid arthritis (RA) not only deal with functional impairment, but also pain, fatigue, and other symptoms driven by interleukin (IL)-6 levels. In a session at the American College of Rheumatology’s annual meeting, 2 speakers examined the role of IL-6 in RA and treatment using sarilumab (Kevzara) to target and block IL-6 signals.

New technologies that can monitor sleep, track itching patterns, or assist with pain are improving outcomes and quality of life for patients with rheumatologic conditions, according to panelists at the American College of Rheumatology’s annual meeting.

Monotherapy was a big topic of conversation at the American College of Rheumatology’s annual meeting, held November 8-13 in Atlanta, Georgia, and 2 abstracts highlight the efficacy of sarilumab as a monotherapy in patients with rheumatoid arthritis.

Since there are no cures for knee osteoarthritis (OA), exercise and weight loss remain the best first-line therapies to decrease pain and improve function, said Stephen P. Messier, PhD, professor and director of the J.B. Snow Biomechanics Laboratory at Wake Forest University.

Patients with rheumatoid arthritis receiving sarilumab have lower odds of unacceptable pain and are able to reduce their dose of oral glucocorticoid; they also have lower costs per responder than most other treatments, according to a trio of abstracts presented at the American College of Rheumatology/Association of Rheumatology Professionals 2019 Annual Meeting.

Utilization management tools, such as step therapy and prior authorization, are not only time consuming for patients, but they are a burden on providers and their practices due to the time and effort spent on the process, explained Jessica Farrell, PharmD, and Madelaine Feldman, MD, FACR, during their session at 2019 ACR/ARP Annual Meeting, held November 8-13 in Atlanta, Georgia.

While biosimilars have brought down the cost of therapies, the savings are not quite as huge as providers may have been led to believe when biosimilars were initially under development, said Elaine Husni, MD, MPH, vice chair and director of the Arthritis and Musculoskeletal Center in the Orthopedic and Rheumatologic Institute at the Cleveland Clinic.

Patients with immunosuppressive conditions, particularly those being treated with tumor necrosis factor inhibitors, are vulnerable to infections, but rheumatologists have mostly been hesitant to use any live virus vaccines in these patients, said Jeffrey R. Curtis, MD, MS, MPH, professor of medicine in the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham.

Grouping patients into clusters based on shared characteristics, such as disease control and general health, may be helpful in understanding and predicting clinical outcomes in patients with rheumatoid arthritis (RA), according to an abstract presented at the 2019 ACR/ARP Annual Meeting, held November 8-13 in Atlanta, Georgia.

Nondrug therapies that might have been dismissed 30 years ago are now the sorts of treatments physicians are turning to instead of overused treatments like surgical procedures, opioids, and injections, said Daniel Clauw, MD, professor of anesthesiology, medicine (rheumatology), and psychiatry; director of translational research; and director of the Center for Chronic Pain and Fatigue Research.

Disease activity assessments can help physicians treat to targets, but in some areas those targets have not been set yet, said Yusuf Yazici, MD, clinical associate professor in the Department of Medicine at NYU Langone Health.

This year has been an exciting time for rheumatologists with impressive clinical trial results and promising outcomes for patients, said Susan Manzi, MD, MPH, codirector of the Lupus Center of Excellence and chair of the Department of Medicine of West Penn Allegheny Health System, during a session at the American College of Rheumatology annual meeting in Atlanta, Georgia.

In a Tuesday panel discussion at The American College of Rheumatology’s 2017 Annual Meeting in San Diego, California, representatives from HHS, the National Institutes of Health (NIH), and the CDC outlined ongoing federal initiatives to address the parallel problems of pain and opioid addiction.

On Tuesday afternoon, the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF) presented a draft of their new, jointly developed clinical guideline for treating psoriatic arthritis (PsA), at the ACR 2017 Annual Meeting.

In a Tuesday session at the American College of Rheumatology’s 2017 Annual Meeting in San Diego, California, Greg Mertz, MBA, FACMPE, managing director for Physician Strategies Group, LLC, presented a talk title “Value Contracting: Opportunities of Fantasy?” in which he outlined the current landscape for performance-based contracting.

A recap of abstracts presented at The American College of Rheumatology’s 2017 Annual Meeting, including an analysis of data available in an electronic health records database and outcomes and cost effectiveness of sarilumab.

Kamala Nola, PharmD, MS, professor at the Lipscomb University College of Pharmacy, provided an overview of the drugs that have been approved in the past year for the treatment of inflammatory conditions during a session at the 2017 American College of Rheumatology Annual Meeting,

During a session at the 2017 American College of Rheumatology Annual Meeting in San Diego, California, a cardiologist joined rheumatologists to give a detailed look at the relationship between rheumatic conditions and cardiovascular disease.

A panel discussion, titled, "Holy MACRA! How to Survive and Thrive in the New Era of MACRA, MIPS and APMs," was presented on Sunday at the 2017 American College of Rheumatology (ACR) Annual Meeting in San Diego, California.

The title "Reshaping the Relationship Between Physicians and PBMs" suggested that the Sunday session at the 2017 American College of Rheumatology’s Annual Meeting in San Diego, California, would focus on reconciling the goals of providers and pharmacy benefit managers (PBMs), but physicians’ challenges in dealing with PBMs quickly became the primary focus of the panel discussion.

Among the most anticipated sessions at the 2017 meeting of the American College of Rheumatology in San Diego, California was “The Great Debate: Biosimilars…to Switch, or Not to Switch? That Is the Question.”

Treating patients with rheumatoid arthritis can be difficult because the available drugs do not treat all symptoms. However, the Vectra DA test can help physicians more quickly understand if a patient is responding or needs to switch therapies, explained Grace C. Wright, MD, PhD, clinical associate professor of medicine and attending rheumatologist at New York University Langone Medical Center.

There is a need in rheumatoid arthritis to be able to individualize treatments, but without credible and reliable biomarkers, it just isn't possible yet, said Allan Gibofsky, MD, professor of medicine and public health at Weill Cornell Medical College and an attending rheumatologist at Hospital for Special Surgery.

Treat-to-target has largely become the preferred method for physicians treating patients with rheumatoid arthritis.