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  • Intriguing Therapies to Improve Life for Those with Rheumatic Disease
    Millions of individuals contend with the inflammation and even debilitation that accompanies rheumatic disease. Spanning over 100 or more specific diseases affecting connective tissues, joints, and joint tissues, arthritis is a widespread and yet sometimes under-recognized health condition. New understanding of systemic autoimmune diseases and the potential genetic components is leading to improved treatments and expanded drug approvals that can help treat certain types of arthritis.

    The combined medical spend and the overall lost wages for patients coping with the effects of arthritis approaches $304 billion annually. Since the estimates of how many total individuals are affected by arthritic conditions tend to be conservative, the actual costs could be much more significant. An aging population in the US also means that diagnoses of arthritis will continue to increase. Within two decades, an estimated 78.4 million adults are expected to be diagnosed with some form of arthritis.

    Arthritis does not only occur in adults. Almost 300,000 US children have juvenile arthritis. Drug approvals from the Center for Drug Evaluation and Research included two new therapies in 2020 for treating polyarticular juvenile idiopathic arthritis (JIA). Each is in a different drug class, giving valuable new options for prescribers treating what can be a complex disease. The first of these is Simponi Aria (golimumab), a TNF inhibitor. Simponi Aria is administered by IV infusion and is approved for patients aged 2 years and older who have polyarticular JIA. The second is Xeljanz (tofacitinib), which is classified as a JAK inhibitor. Xeljanz received approval for two formulations, a tablet and an oral solution, and it became the first JAK inhibitor approved in the US for the treatment of polyarticular JIA. The condition itself is a subset of JIA, with patients having four or more affected joints within the first six months of their illness.

    Two rare types of inflammatory arthritis in adults also gained a new treatment approval in 2020. Ilaris (canakinumab), an interleukin-1β blocker, was approved for the treatment of active Still’s disease, including adult-onset Still’s disease (AOSD), a rare and serious autoinflammatory disease of unknown origin. Ilaris is the first FDA-approved therapy for AOSD. It is administered subcutaneously.

    An additional recent approval to help arthritis patients was for a new biosimilar. Availability of new biological products gives more options for healthcare providers and their patients. Slated for launch in the US in 2023, Hulio (adalimumab-fkjp) is a biosimilar for Humira (adalimumab). Hulio is a TNF inhibitor and has approved indications for rheumatoid arthritis, polyarticular JIA, and psoriatic arthritis, ankylosing spondylitis, adult Crohn’s disease, ulcerative colitis, and plaque psoriasis.

    Healthcare providers treating patients with arthritis need to be aware of the available and emerging therapies and the current clinical practice guidelines. An aid for this is the Guideline and Criteria App provided by the American College of Rheumatology (ACR). The mobile tool includes guidelines and recommendations developed or endorsed by the ACR. The app is available for free on the App Store and Google Play. For deeper involvement and connectivity to the therapy landscape of arthritis treatment, this year’s ACR Convergence 2021 will be taking place from November 1–10.