Underuse of Methotrexate in the Treatment of Rheumatoid Arthritis: A National Analysis of Prescribing Practices in the US.

Objective: Methotrexate (MTX) is the anchor drug in the treatment of rheumatoid arthritis (RA) due to its effectiveness, tolerability, and cost. This study examines MTX prescribing practices in the US from 2009 to 2014.

Methods: Symphony Health Solutions, which covers 274 million patients in the US, was used to identify patients diagnosed with RA who were naive to MTX in 2009 and 2012.

Etanercept treatment for autoimmune inner ear disease: results of a pilot placebo-controlled study.

Purpose: Autoimmune Inner Ear Disease (AIED) is an idiopathic progressive, often bilateral, sensironeural hearing loss that occurs over weeks to months, generally resulting in significant auditory disability. Response to treatment with immunomodulators other than corticosteroids has been poor. Data from a guinea pig model of AIED and a recent open label trial of etanercept suggested potential treatment benefit.

Analysis of 16 retrieved proximally cemented femoral stems.

Sixteen proximally cemented, collared, and distally splined, Bridge Hip femoral stems with a matte proximal surface and smooth distal surface were retrieved because of loosening. Electron microscopy, with correlated elemental analysis, identified titanium particulate embedded in the internal surface of the cement mantle. Data supported the observations that loosening of the femoral stems was related to proximal debonding at the cement-implant interface, loosening at the proximal cement-bone interface, and inherent rotational instability.

Bringing the clinical experience with anakinra to the patient.

The recombinant interleukin-1 receptor antagonist, anakinra (Kineret; Amgen Inc., Thousand Oaks, CA), has been approved by the US Food and Drug Administration and the European Commission for the treatment of patients with active rheumatoid arthritis (RA). Approval was granted following the extensive evaluation of anakinra in five pivotal clinical trials that assessed its efficacy and safety in RA patients.

Leflunomide.

Leflunomide (Arava) was approved for the treatment of rheumatoid arthritis by the regulatory authorities in the US and Europe in 1998. This approval was based on three pivotal randomised clinical trials conducted in the US and Europe. This report will focus on the use of leflunomide in rheumatoid arthritis based on the data from these trials as well information on the efficacy and safety learned from post release clinical experience.