- |||||||||| Clinical, Review, Journal, Monotherapy: Efficacy of Monotherapy with Biologics and JAK Inhibitors for the Treatment of Rheumatoid Arthritis: A Systematic Review. (Pubmed Central) - Oct 2, 2019
Despite recommendations suggesting that biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) should be used in combination with methotrexate in the treatment of rheumatoid arthritis (RA), up to one-third of patients with RA are treated with monotherapy...Forty-four monotherapy studies of abatacept, adalimumab, baricitinib, certolizumab pegol, etanercept, sarilumab, sirukumab, tocilizumab, and tofacitinib reported in 71 publications were identified...There is, however, a need for longer-term head-to-head trials to establish positioning of these interventions in the treatment algorithm for RA. Pfizer.Plain Language Summary: Plain language summary available on the journal website.
- |||||||||| Xeljanz (tofacitinib) / Pfizer, Humira (adalimumab) / Eisai, AbbVie
Journal: JAK Inhibitors in Rheumatology (Pubmed Central) - Sep 30, 2019
In the placebo-controlled trials, venous thromboembolic events (VTE) were more common in the baricitinib treated patients. The VTE rate does not appear to be elevated in baricitinib treated patients compared to RA cohorts however.In conclusion, JAK inhibitors are a powerful new treatment of RA and likely many other rheumatic diseases and fulfill an unmet need since they may be taken orally.
- |||||||||| Remicade (infliximab) / Mitsubishi Tanabe, J&J, Stelara (ustekinumab) / J&J, Humira (adalimumab) / Eisai, AbbVie
Clinical, Journal: A series of seton techniques involving "top-down therapy" for patients with Crohn's disease who initially presented with perianal fistulas. (Pubmed Central) - Sep 29, 2019
The VTE rate does not appear to be elevated in baricitinib treated patients compared to RA cohorts however.In conclusion, JAK inhibitors are a powerful new treatment of RA and likely many other rheumatic diseases and fulfill an unmet need since they may be taken orally. Our seton drainage techniques via the "top-down" approach represent a promising avenue for treating perianal fistulas in patients with CD.
- |||||||||| Remicade (infliximab) / Mitsubishi Tanabe, J&J, Humira (adalimumab) / Eisai, AbbVie
Biomarker, Preclinical, Journal: Preclinical Development of a Novel, Orally-Administered Anti-Tumour Necrosis Factor Domain Antibody for the Treatment of Inflammatory Bowel Disease. (Pubmed Central) - Sep 28, 2019
In an ex vivo human IBD tissue culture model, V565 inhibition of tissue phosphoprotein levels and production of inflammatory cytokine biomarkers was similar to infliximab, demonstrating efficacy when present at the disease site. Taken together, results of these studies provide confidence that oral V565 dosing will be therapeutic in IBD patients where the mucosal epithelial barrier is compromised.
- |||||||||| RECYCLING INFLIXIMAB: AN "ECOLOGICAL" THINKING AFTER SURGERY IN CROHN´S DISEASE (Poster Exhibition - Hall 7) - Sep 28, 2019 - Abstract #UEGW2019UEGW_4198;
2009 azathioprine was started and suspended 4 months later (myelosuppression), clinical remission was maintained with5ASA...2013 due to moderate endoscopic activity(EA) and biopsies compatible with CD, patient starts parenteral methotrexate(MTX) achieving clinical remission...In Jan2015 IFX is suspended after 7months of therapy, switching to Adalimumab(ADA)...Authorization request to Ustekinumab(UST)was done due to reluctance of patient to any surgical intervention...Request for Vedolizumab(VEDO)was done and patient started this treatment on Jan2016...IFX dose reduction to 5mg/kg every 4 weeks was performed in Apr2018. In Aug2018 (last visit) patient is asymptomatic with HBI2, CRP5,35mg/L and FC12mcg/g.
- |||||||||| Humira (adalimumab) / Eisai, AbbVie
HEPATOSPLENIC T-CELL LYMPHOMA IN BIOLOGIC THERAPY - WHEN THE CURE CAN BE WORSE THAN THE DISEASE (Poster Exhibition - Hall 7) - Sep 28, 2019 - Abstract #UEGW2019UEGW_4158;
In the latter group risk increases when duration of combination therapy exceeds 2 years. We propose that combined usage of thiopurine and biologic therapy in this cohort of patients for more than two years should be minimised, and in more difficult to treat cases, it may be better to consider an alternative biologic agent.
- |||||||||| Humira (adalimumab) / Eisai, AbbVie
Journal: A 67-Year-Old Man With Psoriatic Arthritis and New-Onset Dyspnea. (Pubmed Central) - Sep 28, 2019
Joint involvement had previously been controlled with methotrexate, which was discontinued 15 years ago after resolution of his symptoms. He developed a polyarthritis flare a year ago, and adalimumab was initiated with good response.
- |||||||||| Remicade (infliximab) / Mitsubishi Tanabe, J&J, Humira (adalimumab) / Eisai, AbbVie, Rituxan (rituximab) / Roche, Biogen
Use of Rituximab on the treatment of Vogt–Koyanagi–Harada: a case report. () - Sep 26, 2019 - Abstract #EURETINA2019EURETINA_1169;
Our patient presented with bilateral uveitis, choroidal folds and neurological and auditory manifestations, without dermatological symptoms.Early diagnosis and subsequent aggressive treatment may result in visual recovery. Initial treatment includes systemic corticosteroids, for a minimum of 6 months and immunosuppressive pharmacological therapy to reduce the frequency and severity of recurrences.Some investigators have suggested immunosuppression with agents such antimetabolites (Azathioprine, Methotrexate, MMF), calcineurin inhibitors (CsA) and biological agents (Infliximab and Adalimumab) as first-line.There are just a few case reports of the use of Rituximab in patients with VKH.
- |||||||||| Humira (adalimumab) / Eisai, AbbVie
Sympathetic ophthalmia after ruthenium plaque brachytherapy for iris melanoma () - Sep 26, 2019 - Abstract #EURETINA2019EURETINA_1130;
It represents an autoimmune T-cell-mediated response against uveal antigenic protein, which usually is exposed after a traumatic or surgical injury involving the uvea. The risk of developing sympathetic ophthalmia after charged-particle therapy in the absence of a penetrating uveal tract injury is minimal, but possible.
- |||||||||| Stelara (ustekinumab) / J&J, Enbrel (etanercept) / Takeda, Pfizer, Amgen, Humira (adalimumab) / Eisai, AbbVie
Clinical, Journal, HEOR, Real-World Evidence: Biologic treatment sequences for plaque psoriasis: a cost-utility analysis based on 10 years of Dutch real-world evidence from BioCAPTURE. (Pubmed Central) - Sep 26, 2019
The order in which biologics are used influences treatment cost-effectiveness, both in terms of costs and health effects. Initiation of a biologic treatment sequence for psoriasis may best be done with adalimumab or ustekinumab; etanercept seems less optimal from a health-economic perspective.
- |||||||||| Review, Journal, HEOR: A Systematic Review of the Cost-Effectiveness of Biologics for Ulcerative Colitis. (Pubmed Central) - Sep 26, 2019
Clinical outcomes are transferable to other countries and could be generalized; however, cost inputs are country-specific and therefore limit the transferability and generalizability of conclusions. The key drivers and variables that showed the greatest effect on the analysis results were utility weights and clinical parameters.
- |||||||||| Review, Journal: Ixekizumab for Treating Moderate-to-Severe Plaque Psoriasis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. (Pubmed Central) - Sep 26, 2019
Consistent with its conclusion regarding clinical effectiveness, the Appraisal Committee concluded that the cost effectiveness of ixekizumab for treating moderate-to-severe plaque psoriasis was similar to that of other biological treatments, already recommended in previous National Institute for Health and Care Excellence guidance. The committee concluded that the incremental cost-effectiveness ratio was within the range that could be considered a cost-effective use of National Health Service resources.
- |||||||||| Review, Journal: Baricitinib for Previously Treated Moderate or Severe Rheumatoid Arthritis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. (Pubmed Central) - Sep 26, 2019
The clinical-effectiveness evidence in the CS for BARI was based predominantly on three randomised controlled trials comparing the efficacy of BARI against adalimumab or placebo, as well as one long-term extension study...The company submitted a de novo discrete event simulation model that analysed the incremental cost-effectiveness of BARI versus its comparators for the treatment of RA from the perspective of the National Health Service (NHS) in four different populations: (1) cDMARD-IR patients with moderate RA, defined as a 28-Joint Disease Activity Score (DAS28) > 3.2 and no more than 5.1; (2) cDMARD-IR patients with severe RA (defined as a DAS28 > 5.1); (3) TNFi-IR patients with severe RA for whom rituximab (RTX) was eligible; and (4) TNFi-IR patients with severe RA for whom RTX in combination with methotrexate (MTX) is contraindicated or not tolerated...In the cDMARD-IR population with severe RA, BARI in combination with MTX dominated all comparators except for certolizumab pegol (CTZ) in combination with MTX, with the ICER of CTZ in combination with MTX compared with BARI in combination with MTX estimated to be £18,400 per QALY gained...In the TNFi-IR population with severe RA for whom RTX in combination with MTX is contraindicated or not tolerated, BARI in combination with MTX dominated golimumab in combination with MTX and was less effective and less expensive than the remaining comparators...The programming error that affected the PSA of the severe cDMARD-IR population had only a minimal impact on the results, while the error affecting the severe TNFi-IR RTX-ineligible population resulted in markedly higher costs and QALYs gained for the affected comparators but did not substantially modify the conclusions of the analysis. The NICE Appraisal Committee concluded that BARI in combination with MTX or as monotherapy is a cost-effective use of NHS resources in patients with severe RA, except in TNFi-IR patients who are RTX-eligible.
- |||||||||| Xeljanz (tofacitinib) / Pfizer, Humira (adalimumab) / Eisai, AbbVie, Rituxan (rituximab) / Roche, Biogen
Review, Journal: Tofacitinib for Treating Rheumatoid Arthritis After the Failure of Disease-Modifying Anti-rheumatic Drugs: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. (Pubmed Central) - Sep 26, 2019
All four RCTs compared TOF with placebo plus cDMARDs, one RCT also included adalimumab as a comparator...The company submitted a de novo model that assessed the cost-effectiveness of TOF versus its comparators in six different populations: (1) cDMARD-IR with severe RA; (2) cDMARD-IR with severe RA for whom MTX is contraindicated or not tolerated; (3) bDMARD-IR; (4) bDMARD-IR for whom rituximab (RTX) is contraindicated or not tolerated; (5) bDMARD-IR for whom MTX is contraindicated or not tolerated; and, (6) cDMARD-IR with moderate RA...TOF plus MTX is also recommended as an option for adults whose disease has responded inadequately to, or who cannot have, other DMARDs, including at least one bDMARD, only if (1) disease is severe, (2) they cannot have RTX, and (3) the company provides TOF with the discount agreed in the PAS. For patients who are intolerant of MTX, or where MTX is contraindicated, TOF monotherapy is recommended where TOF plus MTX would be recommended.
- |||||||||| Remicade (infliximab) / Mitsubishi Tanabe, J&J, Humira (adalimumab) / Eisai, AbbVie
STUBBORN SARCOIDOSIS: A CLASSIC CASE OF LUPUS PERNIO (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3618;
Hydroxychloroquine 200mg daily was then initiated, and due to progression of her cutaneous disease, this was increased to 400mg daily with topical Clobetasol...After one year of therapy on Infliximab/Hydroxychloroquine there was dramatic improvement in her cutaneous lesions, and she was transitioned to her current Adalimumab regimen.Sarcoidosis is a multi-organ disease of unknown etiology characterized by noncaseating granulomas found in tissue...As seen in a few small case series of refractory cutaneous sarcoid, we present a case of lupus pernio showing dramatic results after one year of treatment with Infliximab. This should be considered in select refractory cases.
- |||||||||| Remicade (infliximab) / Mitsubishi Tanabe, J&J, Humira (adalimumab) / Eisai, AbbVie
SARCOID ACRO-OSTEOLYSIS (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3609;
Acro-osteolysis is the resorption of the distal phalanx and can be a rare manifestation of sarcoid involving the bones. Immunosuppression with agents such as corticosteroids and methotrexate are the mainstay treatment.Biologic agents such as infliximab and adalimumab may be used in aggressive or refractory cases.
- |||||||||| Humira (adalimumab) / Eisai, AbbVie
THE CRIPPLING EFFECT OF MOLLY: RAPIDLY PROGRESSIVE MULTI-ORGAN FAILURE (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 4) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3507;
Medical staff should be cognizant of synthetic drug intoxications and consider it as one of their differentials when an individual presents with multiple organ derangements. Protocols should also be implemented at hospitals to address drug overdose especially with the increasing amounts of deaths associated with drug overdose.
- |||||||||| Humira (adalimumab) / Eisai, AbbVie
PULMONARY MANIFESTATIONS OF CROHN'S DISEASE (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_2796;
It is imperative to obtain biopsy results, due to the detrimental effects of withdrawing disease modifying medications and worsening CD activity. Spontaneous resolution can occur with pulmonary CD, such as in our patient.
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