The annual meeting of the American College of Rheumatology was held from Nov. 3 to 8 in San Diego and attracted approximately 17,000 participants from around the world, including rheumatology specialists, scientists, and other health professionals. The conference featured presentations focused on the latest advances in the diagnosis and treatment of arthritis as well as other rheumatic and musculoskeletal diseases.
During the meeting, the European League Against Rheumatism and the American College of Rheumatology presented the draft of the new classification criteria for systemic lupus erythematosus (SLE). The new criteria were developed to more accurately identify SLE patients for inclusion in clinical trials.
“It is a very exciting time for systemic lupus erythematosus clinical trials because there are new therapeutic agents being developed that will be studied over the next few years,” Sindhu Johnson, M.D., Ph.D., of the University of Toronto, said in a statement. “Classification criteria are used for the inclusion of participants in clinical trials and help us identify a more homogenous group of patients for these studies.”
Johnson added that a patient perspective was included in the development process. “So these new classification criteria are global, collaborative, and include that valuable patient involvement.”
In one study, Christina Chambers, Ph.D., M.P.H., of the University of California San Diego in La Jolla, and colleagues found no significant excess of serious or opportunistic infections in infants born to women with biologic treatment anytime in pregnancy or in the third trimester specifically.
“There have been questions about the safety of maternal use of biologics, especially in later pregnancy, in terms of risk of serious infections in the infant after birth,” said Chambers.
The investigators studied about 1,500 infants born to mothers in the U.S. and Canada with rheumatic diseases who enrolled in the MotherToBaby Autoimmune Diseases in Pregnancy study. They examined the risk of serious infections in the first year of life in infants whose mothers took a biologic medication anytime in pregnancy and those who continued their biologic medication into the third trimester of pregnancy compared with the risk in babies born to mothers who had the same rheumatic diseases but no biologic treatment and mothers who had no chronic diseases.
“These data, although preliminary, provide reassurance to clinicians and pregnant women who need to be treated with biologics in pregnancy regarding the risk for more serious infections in their infants. More work needs to be done to confirm these findings and to examine risk of less serious infections in these infants,” said Chambers.
Jinoos Yazdany, M.D., M.P.H., of the University of California, San Francisco, and colleagues evaluated performance on quality measures for practices participating in the new Rheumatology Informatics System Effectiveness (RISE) registry and developed a dashboard to help rheumatologists monitor Merit-Based Incentive Payment System (MIPS) quality scores.
RISE is a HIPAA-compliant, qualified clinical data registry created and managed by the American College of Rheumatology. There is no fee associated with RISE, and practices can use the service to directly report quality of care measures to the Centers for Medicare and Medicaid Services. Those who participate in MIPS through RISE can qualify for performance-based payments.
In this study, the investigators evaluated the performance on quality measures from 548,990 patients reported by 491 clinicians and 109 practices. They found that the average performance of practices in RISE exceeded targets for the first quarter of 2017 for two of five quality measures for which Medicare has set national benchmarks. However, they identified significant variation in quality measure performance across the practices.
“For the first time, rheumatologists can join a national registry that provides tools to measure quality of care and outcomes. This will enable practices to see where they are performing well, and where there is room for improvement. Importantly, as a community, we have an opportunity to learn from practices that are excelling and work to adapt successful workflows to improve care for our patients and to thrive financially under the MIPS program,” Yazdany said in a statement.
Also during the meeting, the draft of the American College of Rheumatology/National Psoriasis Foundation treatment guideline for psoriatic arthritis was presented. The guideline includes pharmacologic and non-pharmacologic recommendations for treating adult patients with active psoriatic arthritis.
The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation methodology. This approach uses systematic reviews of the scientific literature to evaluate and grade the quality of evidence and then use the evidence reviews to determine guideline recommendations.
Sarah Patterson, M.D., of the University of California, San Francisco, and colleagues evaluated whether body composition, specifically excess adiposity, contributes to worse health-related quality of life and greater symptom burden in women with lupus.
The researchers found that obesity is independently associated with worse patient-reported outcomes, including lupus disease activity, depression, pain, and fatigue. These associations remained strong even after they controlled for potential confounding factors such as education, income, smoking, medication use, and disease damage.
“The relationship we observed between excess fat and worse outcomes underscores the need for lifestyle interventions for lupus patients who are overweight, ” Patterson said. “It is possible that such interventions will reduce both cardiovascular risk and the severity of debilitating symptoms common in this disease. I hope this work sparks greater interest and motivation among rheumatologists to address weight management and physical activity with their lupus patients.”
ACR: Consult Via Mobile App Cost-Saving for Rheumatology Patients
TUESDAY, Nov. 7, 2017 (HealthDay News) — The Smart System of Disease Management (SSDM) series of applications is feasible and cost-saving for patients of rheumatologists, according to a study presented at the annual meeting of the American College of Rheumatology, being held Nov. 3 to 8 in San Diego.
ACR: Successful Tapering of DMARDs in RA Explored
MONDAY, Nov. 6, 2017 (HealthDay News) — For patients with rheumatoid arthritis (RA), characteristics associated with successful tapering of biologic disease-modifying antirheumatic drugs (DMARDs) include a low serum level of C-reactive protein (CRP), according to a study presented at the annual meeting of the American College of Rheumatology, being held Nov. 3 to 8 in San Diego.
ACR: Ratio of Omega-6 to Omega-3 Affects Outcomes in SLE
MONDAY, Nov. 6, 2017 (HealthDay News) — For patients with systematic lupus erythematosus (SLE), increasing omega 6 (n-6)-to-omega-3 (n-3) fatty acid ratios are associated with disease activity, and low vitamin D is associated with later total organ and renal damage, according to two studies presented at the annual meeting of the American College of Rheumatology, being held Nov. 3 to 8 in San Diego.
ACR: Opioids, SSRIs Tied to Higher Fracture Risk in RA
MONDAY, Nov. 6, 2017 (HealthDay News) — For patients with rheumatoid arthritis (RA), opioids and selective serotonin reuptake inhibitors (SSRIs) are associated with increased risk of osteoporotic (OP) fractures, according to a study presented at the annual meeting of the American College of Rheumatology, being held Nov. 3 to 8 in San Diego.
ACR: Temporary Cessation of MTX Ups Flu Shot Immunogenicity
MONDAY, Nov. 6, 2017 (HealthDay News) — For patients with rheumatoid arthritis (RA), temporary discontinuation of methotrexate (MTX) for two weeks after influenza vaccination is associated with improved immunogenicity of vaccination, according to a study presented at the annual meeting of the American College of Rheumatology, being held Nov. 3 to 8 in San Diego.
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