MedPage Today interviewed specialists in rheumatology in the United States about the advances in rheumatology in 2016. Below are the five most common advances mentioned.
1. Tocilizumab (Actemra) for the treatment of giant cell arteritis
Giant cell arteritis affects over 200,000 people in the United States. Research data from an international clinical trial showed that after a year of treatment, 56% of the 250 study participants given tocilizumab weekly plus prednisone were in sustained remission, compared with just 14% of those given placebo alone (P<0.0001).
At the annual meeting of the American College of Rheumatology (ACR), Dr. John H. Stone of Harvard University at Boston noted: “There is something new in giant cell arteritis at last, and the era of unending glucocorticoid treatment with no viable alternative is over."
2. Baricitinib for the treatment of rheumatoid arthritis
A research presented at the ACR by Dr. Peter C. Taylor of Oxford University in England showed that baricitinib, an oral JAK1/2 inhibitor, had greater improvements on the ACR20 response criteria at week 24 than placebo or adalimumab (74%, 37%, and 66%, respectively).
3. Anifrolumab for the treatment of systemic lupus erythematosus
Richard Furie 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<0.0001). His research was presented at the European League Against Rheumatism.
4. Approval of biosimilars
In 2016, biosimilars such as infliximab (Inflectra), etanercept (Erelzi), and adalimumab (Amjevita), have been approved for diseases like rheumatoid arthritis, psoriatic arthritis, inflammatory bowel disease, juvenile idiopathic arthritis, and ankylosing spondylitis.
5. The crisis of dwindling access to specialty care
A research study presented at the ACR states that access to specialty care will become more difficult in the near future. Half of the current rheumatology workforce will be retiring in the next 15 years.
In an interview with MedPage Today, Dr. Eric Matteson of the Mayo Clinic in Rochester, Minn. said: "This is 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."