Latest Conference Articles

Sunday’s poster session at the 2019 American Heart Association (AHA) Scientific Sessions in Philadelphia, Pennsylvania, included research that addressed disparities in clinical outcomes, healthcare delivery, and access to payer coverage.

Two additional analyses have come from DAPA-HF, a trial released in September that found the sodium glucose cotransporter 2 inhibitor works equally well in patients with and without diabetes in reducing cardiovascular death and heart failure (HF) events in patients with HF with reduced ejection fraction.

Results from ISCHEMIA, funded by the National Heart, Lung, and Blood Institute, are likely to change practice guidelines, according to commenters who took part in Saturday’s packed presentation at the 2019 American Heart Association Scientific Sessions in Philadelphia, Pennsylvania.

Patients without diabetes who have heart failure saw signficant benefits from the sodium glucose cotransporter 2 inhibitor dapagliflozin, prompting a commenter to ask not if more patients should be taking these drugs but when to start patients on them.

Hypertrophic cardiomyopathy can be a debilitating condition that currently has no approved therapies to treat it, highlighting the impact of potential treatments like mavacamten, said Jay Edelberg, MD, PhD, senior vice president of Clinical Development at MyoKardia.

A compelling paradigm is forming in which dapagliflozin can be prescribed not only to prevent heart failure in people with type 2 diabetes, but also in the patients without diabetes, said Kiersten Combs, US vice president of Cardiovascular Metabolism at AstraZeneca.

Depending on the type of alternative payment models, it could be more difficult or easier for practices to find overlaps and participate in multiple models, said Mike Fazio, senior vice president of client services, Archway Health.

Collaboration between stakeholders and the federal government is critical to addressing underlying gaps in patient care, said Debbie Witchey, MHA, executive vice president of the Healthcare Leadership Council.

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.

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.

While it is too early to provide insight into whether or not the OCF model will be successful, I think its preliminary ideas are a step in the right direction, said Rani Khetarpal, MBA, vice president of Oncology Value-Based Partnerships at New Century Health.

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.

More and more data are being collected on people and in healthcare, patients have to believe that the data being collected is for their good and with the goal of improving their care, said John Frownfelter, MD, FACP, chief medical officer of Jvion.

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.

A poster presented at the American Society of Nephrology's (ASN) Kidney Week 2019 sought to understand more about patient knowledge of anemia and its impact on patient quality of life, their understanding of the disease, as well as how their anemia is managed.

Former FDA Commissioner Scott Gottlieb, MD, who has returned to the American Enterprise Institute, left FDA in April after 2 whirlwind years that saw a record pace of approvals and policy actions that covered everything from high drug prices to teen vaping. He spoke Friday in Philadelphia at Patient-Centered Oncology Care®, the annual meeting of oncology reimbursement stakeholders held by The American Journal of Managed Care®.

As Kidney Week closed, nephrologists gathered to hear policy updates and information about forthcoming payment models from CMS and seemed pleased with what they heard.

The federal government wants to lower the rate of end-stage renal disease (ESRD) and improve kidney care outcomes, but such efforts will require earlier identification of chronic kidney disease (CKD), especially in veterans. At the American Society of Nephrology's (ASN) Kidney Week 2019, one poster described the gaps in identifying CKD in this population.

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.

The Advancing American Kidney Health initiative launched by HHS has a broad range of focus that includes kidney disease awareness, early diagnosis, and improvements in transplantation, according to Holly Kramer, MD, MPH, professor of medicine and public health sciences at Loyola University Chicago and president of the National Kidney Foundation.

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.