Value-Based Care in Rheumatology
December 2012 VOL 1 • NO 6
F r o m t h e p u b l i s h e r s of A m e r i c a n H e a l t h & d r u g b e n e f i t s
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www.ValueBasedRheumatology.com
Year in Review: Clinical Perspectives, Part 1 By Wayne Kuznar
Latest Treatment Options for Lupus By Phoebe Starr
Copyright © Scott Camazine/Science Source
Washington, DC—The goal of treating lupus is to induce improvement and maintain it, said Bevra Hahn, MD, Chief, Department of Rheumatology and Arthritis, University of California at Los Angeles. Improvement can be induced in 75% of patients with currently available therapies, some of them off-label, she told listeners at the 2012 meeting of the American College of Rheumatology. “New agents for lupus hold the promise of effective treatment for patients who are not doing well on
Washington, DC—Over the past year, several publications in the peer-reviewed literature were worthy of influencing clinical practice. At the 2012 meeting of the Ameri-
can College of Rheumatology (ACR), David A. Isenberg, MD, FRCP, FAMS, Arthritis Research Campaign’s Diamond Jubilee Professor of Rheumatology, University College London, Continued on page 5
Patients Who Fail Other Biologics Respond to Tofacitinib By Phoebe Starr Washington, DC—Tofacitinib (Xeljanz), an oral Janus kinase (JAK) inhibitor, is effective in the treatment of patients with rheumatoid arthritis (RA) whose disease has an inadequate response to previous treatment with biologic therapies, and the response
with tofacitinib is maintained for 24 months. These were the findings of an analysis of data from randomized trials in the development program for tofacitinib and were presented at the 2012 meeting of the American College of Rheumatology (ACR). Continued on page 14
their current therapy or have a lot of side effects,” she stated. Antimalarials plus nonsteroidal anti-inflammatory drugs are the main stays of treatment, Dr Hahn said, but most patients will have a suboptimal response and require additional treatments. Off-Label Options Anecdotal evidence supports the use of low-dose corticosteroids for patients who do not respond to initial therapy. Two small trials suggested that the addition of methotrexate may Continued on page 6
Treat-to-Target Strategy for Rheumatoid Arthritis Does Not Increase Total Medical Costs By Wayne Kuznar Washington, DC—Compliance with treat-to-target guidelines for rheumatoid arthritis (RA) results in fewer inpatient visits, shorter lengths of stay, and lower utilization of emergency department services without additional medical service costs despite more frequent follow-up with a rheumatologist, found Martin J. Bergman, MD, FACR, FACP, Chief, Division of Rheumatology, Taylor Hospital, Ridley Park, PA,
and colleagues. They presented their data at the 2012 meeting of the American College of Rheumatology. Treat-to-target principles include the frequent monitoring of RA disease activity and corresponding drug therapy adjustment at least every 3 months to prevent structural damage and to maximize health-related quality of life through abrogation of inflammation. Although frequent Continued on page 13
inside FDA UPDATE. . . . . . . . . . . . . . . . . . . . . . Tofacitinib approved for RA
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Personalized Medicine in
HEALTH ECONOMICS. . . . . . . . . . 13 Cell phone monitoring can help reduce office visits for patients with RA
Rheumatology™ . . . . . . . . 9 ARTHRITIS UPDATE. . . . . . . . . . .
Biomarker panel measures RA disease activity, treatment response OSTEOARTHRITIS. . . . . . . . . . . . . . Strontium ranelate shows positive effects on knee OA
Rheumatology PRACTICE
Management™ . . . . . . . . . . . . . . . . .
© 2012 Engage Healthcare Communications, LLC
Streamline your clinical practice to increase efficiency
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Patients who fail other therapies respond to tofacitinib
FIBROMYALGIA. . . . . . . . . . . . . . . . . Impact on physical, cognitive, and emotional functioning
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JUVENILE IDIOPATHIC ARTHRITIS . . . . . . . . . . . . . . . . . . . . . . 18 Treatment is shifting toward biologics