Vazquezsimmons1638

ACR Open Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.OBJECTIVE Most patients with rheumatoid arthritis (RA) strive to consolidate their treatment from methotrexate combinations. The objective of this analysis was to identify patients with RA most likely to achieve remission with tocilizumab (TCZ) monotherapy by developing and validating a prediction model and associated remission score. METHODS We identified four TCZ monotherapy randomized controlled trials in RA and chose two for derivation and two for internal validation. Remission was defined as a Clinical Disease Activity Index score less than 2.8 at 24 weeks post randomization. We used logistic regression to assess the association between each predictor and remission. After selecting variables and assessing model performance in the derivation data set, we assessed model performance in the validation data set. The cohorts were combined to calculate a remission prediction score. RESULTS The variables selected included younger age, male sex, lower baseline Clinical Disease Activity Index score, shorter RA disACR Open Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.OBJECTIVE It is unclear if biosimilars of biologics for inflammatory arthritis are realizing their promise to increase competition and improve accessibility. This study evaluates biosimilar tumor necrosis factor inhibitor (TNFi) utilization across rheumatology practices in the United States and compares whether patients initiating biosimilars remain on these treatments at least as long as new initiators of bio-originators. METHODS We identified a cohort of patients initiating a TNFi biosimilar between January 2017 and September 2018 from an electronic health record registry containing data from 218 rheumatology practices and over 1 million rheumatology patients in the United States. We also identified a cohort of patients who initiated the bio-originator TNFi during the same period. We calculated the proportion of biosimilar prescriptions compared with other TNFi's and compared persistence on these therapies, adjusting for age, sex, diagnoses codes, and insurance type. RESULTS We identified 909 patients prescribed the biosimilar infliximab-dyyb, the only biosimilar prescribed, and 4413 patients with a new prescription for the bio-originator infliximab. Biosimilar patients tended to be older, have a diagnosis code for rheumatoid arthritis, and covered by Medicare insurance. Over the study period, biosimilar prescriptions reached a maximum of 3.5% of all TNFi prescriptions. Patients persisted on the biosimilar at least as long as the bio-originator infliximab (hazard ratio [HR] 0.83, P = 0.07). CONCLUSION The uptake of biosimilars in the United States remains low despite persistence on infliximab-dyyb being similar to the infliximab bio-originator. These results add to clinical studies that should provide greater confidence to patients and physicians regarding biosimilar use. © 2020 The Authors. ACR Open Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.OBJECTIVE To assess the current state of knowledge for the utility of coronary calcium scoring (CCS) in connective tissue disorders (CTDs) as it relates to the presence and quantification of coronary atherosclerosis. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search via PubMed, Embase, Scopus, Web of Science Core Collection, CINAHL, and Cochrane Database of Systematic Review retrieved 1019 studies (since database inception on May 7, 2018) from which 121 manuscripts were eligible for review. Inclusion criteria consisted of studies that investigated CCS in adults with respective CTDs. Studies were excluded if a complete manuscript was not written in English or was a case report. RESULTS Thirty-one studies were included (27 with healthy age-/gender-matched control group for comparison and 4 without). CTDs analyzed in articles with control group 11 rheumatoid arthritis (RA), 14 systemic lupus erythematosus (SLE), 4 systemic sclerosis (SSc), 1 idiopathic inflammatory myopathies (IIM), 1 Takayasu arteritis, and 1 psoriasis. Nine out of 11 RA studies, 12 out of 14 SLE studies, and 2 out of 4 SSc studies showed statistically significant increased CCS when compared with the control group. CTDs analyzed in studies without control group two Kawasaki disease, one juvenile idiopathic arthritis (JIA), and one antiphospholipid syndrome (APS) article, which demonstrated increased coronary arterial calcium burden, however, without statistically significant data. CONCLUSION CTDs, especially SLE and RA, are associated with higher CCS compared with the control group, indicating increased risk of coronary atherosclerosis. Our search did not elicit sufficient publications or statistically significant results in many other CTDs. © 2020 The Authors. ACR Open Rheumatology published by Wiley Periodicals, Inc. Iadademstat on behalf of American College of Rheumatology.OBJECTIVE Provide state-level estimates of the number of physically inactive adults in the United States with arthritis and other rheumatic and musculoskeletal diseases (RMDs) who could improve their anxiety and depression by exercising. METHODS Utilizing 1) number-needed-to treat (NNT) data from two prior meta-analyses of randomized controlled trials addressing the effects of exercise on anxiety and depression in adults with arthritis and other RMDs, 2) recent state-level prevalence estimates on arthritis and physical inactivity in adults with arthritis and other RMDs, and 3) state-level 2010 US Census population data, the number of physically inactive adults with arthritis and other RMDs who could improve their anxiety and depression by exercising was estimated. RESULTS Across all states and the District of Columbia, the number of adults with arthritis and other RMDs who could improve their anxiety and depression by starting an exercise program was estimated at 3 433 167 (95% confidence interval [CI] = 3 171 000-3 703 522) for anxiety and 2 942 706 (95% CI = 2 718 000-3 174 438) for depression. For anxiety, numbers ranged from 3677 (95% CI = 3235-4154) in the District of Columbia to 271 253 (95% CI = 243 998-298 508) in Texas. For depression, numbers ranged from 3151 (95% CI = 2773-3561) in the District of Columbia to 232 502 (95% CI = 209 140-255 863) in Texas. CONCLUSION These state-specific data suggest that a large number of physically inactive US adults with arthritis and other RMDs could improve their anxiety and depression by starting and maintaining a regular exercise program. © 2020 The Authors. ACR Open Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.