What's in Store for Rheumatology in 2018?

Rheumatology is the branch of medicine that deals with the diagnosis and treatment of rheumatic diseases. Rheumatic diseases include a group of over 200 chronic conditions that affect the joints, muscles, and ligaments. Over two decades ago, the development of drugs, known as biologics, were introduced in the field of modern rheumatology. Most recently, scientific research has zoomed in on the background of autoimmune diseases, which is the cause of a majority of rheumatic diseases. What’s more, further research on biologics and findings from clinical trials have introduced a new and promising approach to treating rheumatic diseases. Researchers are now turning their focus towards the use of medications to treat rheumatic diseases, as opposed to using surgical interventions. So, what else is in store for rheumatology in 2018?

The costs of medications

This year, it is estimated that the cost of medications, including generics and biologics, will rise. In fact, drug manufacturers have begun the year by raising the costs of numerous medications in the United states by 10%. “The biggest issue in rheumatology in 2018 will be the continued marked increases in the price of certain medications,” said James R. O’Dell, Chief of the Section of Rheumatology at the University of Nebraska Medical Center. He made his point by stating that in 2014, there was a shortage for the drug hydroxychloroquine, but by 2015, high costs of the drug drew concerns. The Lupus Foundation of America expressed their concerns by stating that the unaffordable cost would lead patients to miss their doses or stop taking the drug altogether. “Hydroxychloroquine is the mainstay of lupus therapy. It prevents half of lupus flares, reduces renal and CNS lupus, cuts blood clots in half, reduces future seizures, diabetes, and LDL cholesterol, and improves survival,” stated Michelle Petri, director of the Hopkins Lupus Center at Johns Hopkins University, on the foundation’s website. By 2017, the average price for hydroxychloroquine had reached $222.16.

David Pisetsky, director of the Duke University Arthritis Center, stated that an important topic concerning rheumatology in 2018 is the introduction of biosimilars for the treatment of inflammatory arthritis. Even with the increased quantities of newly introduced medications and biosimilars, costs have not been lowered. In fact, the costs of two of the most commonly used tumor necrosis factor inhibitors, etanercept and adalimumab, have increased by over 70%. This occurred despite the introduction and FDA approval of their biosimilars. Roy Fleischmann, Clinical Professor in the Department of Internal Medicine at the University of Texas Southwestern Medical Center, argued that a majority of approved biosimilars have yet to be introduced due to patent concerns. For instance, an approved biosimilar to adalimumab, known as Amjevita, will not become available until 2023 while waiting upon a patent litigation to be settled.

Read on to learn more about advancements in rheumatology for 2018.