2016's Top 5 Advances in Rheumatology

From MedPage Today, by Nancy Walsh, December 2016

1. Tocilizumab (Actemra) for Giant Cell Arteritis

In a plenary session at the annual meeting of the American College of Rheumatology (ACR), John H. Stone, MD, PhD, of Harvard University in Boston, said "There is something new in giant cell arteritis at last, and the era of unending glucocorticoid treatment with no viable alternative is over."   This finding emerged from an international clinical trial that enrolled 250 patients. After a year of treatment, 56% of those given tocilizumab weekly plus prednisone were in sustained remission, compared with just 14% of those given placebo alone.  Stone said: "It is the biggest breakthrough in this disease since the invention of cortisone in 1949.”

2. Baricitinib for Rheumatoid Arthritis

In presentations at the ACR meeting, including a late-breaker presented

by Peter C. Taylor, BM, BCh, PhD, of Oxford University in England, the oral JAK1/2 inhibitor baricitinib showed greater improvements on the ACR20 response criteria at week 24 than placebo or adalimumab (74%, 37%, and 66%, respectively).

3. Anifrolumab for Systemic Lupus Erythematosus

At the annual meeting of the European League Against Rheumatism, Richard Furie, MD, of Hofstra Northwell School of Medicine in Great Neck, N.Y. reported that at 1 year, 62.6% of patients receiving anifrolumab had achieved a SLE Responder Index compared with 40.2% of those given placebo (P<0.001). "These are the best lupus data we've ever seen," said Furie.

4. Approval of Biosimilars

Biosimilars have now been approved for infliximab (Inflectra), etanercept (Erelzi), and adalimumab (Amjevita), for conditions including rheumatoid arthritis, psoriatic arthritis, inflammatory bowel disease, juvenile idiopathic arthritis, and ankylosing spondylitis.

5. A Crisis Unfolding

There may be a crisis in the availability of specialists!  One reason may be that approximately half of the current rheumatology workforce is expected to retire in the next 15 years.  "This is in the face of a growing and gaining population, for which reason demand for rheumatologic services will grow by over 130%, a mere 14 years from now. Efforts to train not only rheumatologists, but also advanced practice nurse practitioners and physician assistants in rheumatology are especially critical to ensure that rheumatology patients are properly diagnosed and managed," Dr. Matteson told MedPage Today. 

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