IBD-Associated Arthritis News

Patients with early inflammatory polyarthritis diagnosed within the new millennium experienced improved disease activity, compared with those diagnosed during the early 1990s, according to findings published in the Annals of the Rheumatic Diseases.

Despite the expedited pathway for biosimilars enacted by the Biologics Price Competition and Innovation Act of 2009, the development of competition in the U.S. biologics market has been slower than expected due to several regulatory issues, according to a new perspective piece published in the New England Journal of Medicine.

Few patients with inflammatory arthritis reported participating in a structured self-management care program, although many physicians reported providing self-management support within routine care, according to findings published in Arthritis Care and Research.

A: The inflammatory bowel diseases are chronic, relapsing inflammatory disorders of the gastrointestinal tract with a propensity to develop tissue damage — including fibrosis and strictures — penetrating lesions and fistulas, and small bowel and colorectal cancer. Therefore, the aim of treatment is no longer a simple clinical response or even remission, but a state of biological and tissue remission ideally associated with the absence of disease progression. Any therapeutic decision in inflammatory bowel disease, either escalating or de-escalating the treatment, must be made by taking this into account.

Despite being heralded as lower-cost alternatives to branded biologics, the approval of biosimilar therapies for chronic diseases is not likely to yield expected cost savings due to a number of state and payer policies, according to an opinion piece published in JAMA.

NEW YORK — At the Interdisciplinary Autoimmune Summit, Steven B. Hanauer, MD, medical director of the Digestive Health Center at Northwestern University, Feinberg School of Medicine, talked about his presentation on strategies in the management of inflammatory bowel disease.

A: Current biologic therapies for inflammatory bowel disease include infliximab and adalimumab, which were approved in North America, Australia and Western Europe. Certolizumab pegol was approved in the United States and Switzerland, and natalizumab was approved in the United States.

Treatment aims in the inflammatory bowel diseases are evolving beyond the induction and maintenance of corticosteroid-free remission. More recently, it has become recognized that by treating with immunomodulatory and biologic therapies earlier in the disease course and by achieving mucosal healing, the natural history of these diseases may be modified in a positive way. Despite the clear benefits of early and appropriate introduction of these therapies, the potential for risks, some of them serious, must be understood by the clinician and discussed with patients. This excerpt reviews the relevant adverse events associated with the use of the immunomodulatory agents azathioprine, 6-mercaptopurine and methotrexate.

The FDA has released a draft guidance for industry outlining criteria for demonstrating that a biosimilar is interchangeable with a reference product under section 351 (k) of the Public Health Service Act.

Several developments in inflammatory bowel disease were presented at the two major gastroenterology conferences last month: the American College of Gastroenterology Annual Scientific Meeting in Las Vegas and the United European Gastroenterology Week in Vienna.