Latest Conference Content

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.

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.

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.

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.

What should providers do about intentional nonadherence, and what strategies should they try to get their patients to take their hypertension medicine? At a session at the American Society of Nephrology (ASN)’s Kidney Week 2019, physicians discussed direct observation therapy (DOT), drug monitoring, case studies, and other published work about patients who don’t take their medications. Then they heard from a directly from a patient who shared why she stopped taking her medication and the scary consequence that developed as a result.

Patients receiving dialysis living in communities with a high percentage of black residents are known to have worse morbidity and mortality outcomes, and a study presented Saturday at the American Society of Nephrology Kidney Week 2019 meeting found that patients receiving dialysis in those communities also had higher hospitalization rates.

The evidence shows that chimeric antigen receptor (CAR) T-cell therapies are effective, but the price tags on these treatments are high and have raised concerns about how many patients will get treated. During a discussion at The American Journal of Managed Care®’s Patient-Centered Oncology Care® meeting, held Friday in Philadelphia, panelists outlined the efficacy of the 2 FDA-approved therapies, Medicare reimbursement for CAR T-cell therapies, and the pace of innovation in healthcare.

The results of phase 3 studies of roxadustat, a drug in the new class of hypoxia-inducible factor stabilizers, are satisfying in terms of both efficacy and safety, said Jay Wish, MD, professor of clinical medicine at Indiana University and chief medical officer for dialysis at Indiana University Health.

The risk of major adverse cardiovascular events was comparable with placebo in patients not treated with dialysis who received the investigational drug roxadustat, according to pooled cardiovascular safety data about the first-in-class oral therapy for patients with chronic kidney disease (CKD).

The large number of patient participants at the American Society of Nephrology’s Kidney Week 2019 meeting reflects the understanding that patients should be elevated in the conversations around kidney care, said Paul Conway, chair of global affairs and public policy and immediate past president, American Association of Kidney Patients.

A simple risk-assessment tool that helps physicians with early identification of patients at increased risk of chronic kidney disease (CKD) could lead to improved and targeted surveillance strategies, according to research published Friday.