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The Overpricing of Drugs (1.14.2022)

Jan 14, 2022 12:27 am

Dr. Jack Cush reviews the news and journal articles from the past week on This week we discuss amputations, a $57 billion RA market, an FDA approved drug for Cat arthritis and drug that works in Sjogren's.

  1. Study 126 rheumatic disease (RMD) patients showed that post-vaccination flares of RMD are rare. Despite being on DMARDs, biologics, immunosuppressives, the rate of RMD reactivation was 0.007 person/mo. 5 mild articular flares in 3 women

  2. Patients on biologics are NOT at higher risk for COVID-19 infx. Retrospective matched cohort study compared 7631 Biologic Rx pts to 74910 matched cohort with equal Infx & death rates. COVID infx assoc w/ age, minorities, more comorbidities

  3. JAMA study shows that, compared with usual care, colchicine did not significantly reduce mechanical ventilation or 28-day mortality in patients hospitalized with COVID-19 pneumonia (HR 0.83; 95% CI, 0.67-1.02; P = .08).

  4. JAMA cohort study of 5.9 million VA pts and with & without gout (556521)-gout pts had higher rates of lower extremity amputation (HR 1.59), than those without gout. This was assoc w/ poor uric acid control (>7), but not urate lowering therapy.

  5. Global Burden of Disease Study shows that globally, from 1990 to 2019, the age-standardized incidence rate (ASIR) of hip osteoarthritis increased from 17.02 per 100,000 persons to 18.70 per 100,000 persons

  6. Duloxetine added to usual analgesics failed to improve pain in 132 hip or knee OA pts by WOMAC pain scores: 1) Dulox + usual care vs 2) Usual care showed no diff in pain at 3 mos or 12 mos.

  7. FDA has approved an NGF inhibitor for arthritis in cats...yes CATS!  Presumably for OA, Solensia (frunevetmab) is a cat-specific MAb that binds nerve growth factor (NGF). In humans several NGF MAbs have failed (tanezumab in 2021)

  8. Biomarker study of 21 systemic juvenile idiopathic arthritis (sJIA) shows you can differentiate between active & inactive disease. From 69 biomarkers, these were predictive: IL-6, MMP1, S100A12 (p < 0.0001), HMGB1; but IL-18 elevated in both groups!

  9. Single center comparison of pts with MAS vs malignancy assoc. HLH (mHLH) - overall MAS had less hepatomegaly (0 v 25%), double platelet #s (50 v 29Kµ/L), but lower sIL-2R (6814 vs. 27,972.0) and less mortality (22 v 44%, p=0.18).

  10. RheumNow Live, March 19-20, 2022. Attend onsite or virtually.  Registration is free for fellows and NPs/PAs;

  11. Study of subcutaneous ianalumab in patients with primary Sjögren's syndrome met primary objective, showing dose-related decrease in disease activity (ESSDAI) at week 24: randomised, double-blind, placebo-controlled trial.;

  12. In Mouse Model of Lupus, when the gut microbiome of NZM2410 mice colonized w/ SFB, glomerulonephritis worsened & was assoc. w/ incr in TH17, MCP-1 and CXCL1, & more microbial abundance & biodiversity (dysbiosis)

  13. NICE (UK) has recommended upadacitinib for use in active Psoriatic Arthritis, 15 mg qd +/- MTX, in pts not responding to DMARDS. UPA can now be used in England Wales and Scotland

  14. Cosentyx (secukinumab) was FDA approved for use in pediatric psoriatic arthritis & enthesitis-related arthritis, based on results of the ph III JUNIPERA study. Dosing based on weight (SEC 75 mg sc if 15-50kg; SEC 150 mg sc if 50 kg or more)

  15. Study of biologic/ts DMARD switching in 8,398 axial spondyloarthritis pts from 5 Nordic registries showed a low rate of multiple switches (refractory?) over 3 years; ≥3 DMARDs (8%), ≥4 (3%) & ≥ 5 (1%); more w/ women, comorbiditiy & psoriasis

  16. KEEPSaKe-1 Trial in Psoriatic Arthritis - IL-23 Inhibition is Effective
  17. BEAT LUPUS - Belimumab after Rituximab in SLE
  18. COVID-19 in Pregnant Rheumatic Women
  19. The global rheumatoid arthritis drugs market size was valued at $57,929 million in 2019, and is projected to reach $62,935 million by 2027.
  20. Why Are Physicians Silent About Outrageous Drug Prices?
The author has received compensation as an advisor or consultant on this subject

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