2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6e7,We examine coverage of self-administered disease-modifying antirheumatic drugs (DMARDs) in Medicare Part D. Using 2022-2026 Part D formulary data, we assessed coverage of the following DMARD classes that treat relapsed rheumatoid arthritis (RA): tumor necrosis factor (TNF) inhibitors, T cell costimulatory modulator, interleukin-6 (IL-6) inhibitors, and JAK inhibitors. We measured (1) coverage of individual DMARDs and (2) the generosity of coverage between classes (the share of plans covering at least one drug in each class) and within classes (the share of covered drugs within each class). We included 26,915 plan-year observations, representing 217.6 million enrolled beneficiaries from 2022 to 2026. In the five-year period, coverage was relatively complete (>94%) for etanercept and adalimumab (TNF inhibitors) and upadacitinib (JAK inhibitor). However, coverage was lower for golimumab and certolizumab (TNF inhibitors), abatacept (the sole T cell costimulatory modulator), sarilumab (IL-6 inhibitor), and baricitinib (JAK inhibitor). Moreover, only 10.4% and 37.6% of stand-alone and Medicare Advantage (MA) Part D plans, respectively, covered all mechanisms of action, mostly due to low coverage of abatacept. In 2026, only 0.3% and 21.2% of stand-alone and MA Part D plans, respectively, covered abatacept. On the other hand, coverage increased for IL-6 inhibitors, likely due to the availability of biosimilar drugs for tocilizumab in 2024. The growing exclusions of self-administered DMARDs across several mechanisms of action and heterogeneity in coverage by plan type suggest potential barriers to accessing optimal RA treatments. Further monitoring of formulary adequacy and research into the clinical impacts of formulary exclusions are warranted.31:T949, Objective We examine coverage of self‐administered disease‐modifying antirheumatic drugs (DMARDs) in Medicare Part D. Methods Using 2022–2026 Part D formulary data, we assessed coverage of the following DMARD classes that treat relapsed rheumatoid arthritis (RA): tumor necrosis factor (TNF) inhibitors, T cell costimulatory modulator, interleukin‐6 (IL‐6) inhibitors, and JAK inhibitors. We measured (1) coverage of individual DMARDs and (2) the generosity of coverage between classes (the share of plans covering at least one drug in each class) and within classes (the share of covered drugs within each class). Results We included 26,915 plan‐year observations, representing 217.6 million enrolled beneficiaries from 2022 to 2026. In the five‐year period, coverage was relatively complete (>94%) for etanercept and adalimumab (TNF inhibitors) and upadacitinib (JAK inhibitor). However, coverage was lower for golimumab and certolizumab (TNF inhibitors), abatacept (the sole T cell costimulatory modulator), sarilumab (IL‐6 inhibitor), and baricitinib (JAK inhibitor). Moreover, only 10.4% and 37.6% of stand‐alone and Medicare Advantage (MA) Part D plans, respectively, covered all mechanisms of action, mostly due to low coverage of abatacept. In 2026, only 0.3% and 21.2% of stand‐alone and MA Part D plans, respectively, covered abatacept. On the other hand, coverage increased for IL‐6 inhibitors, likely due to the availability of biosimilar drugs for tocilizumab in 2024. Conclusion The growing exclusions of self‐administered DMARDs across several mechanisms of action and heterogeneity in coverage by plan type suggest potential barriers to accessing optimal RA treatments. Further monitoring of formulary adequacy and research into the clinical impacts of formulary exclusions are warranted. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"IL-6 Inhibitor: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on IL-6 Inhibitor (modality). Clinician-written summaries and actionable practice insights. 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Patients with a prior GCA/PMR diagnosis (26% of cohort) had significantly lower odds of discontinuing GC (sHR 0.54, 95% CI 0.30–0.96). Four symptom-based and three lab-based phenotype clusters were identified, but neither predicted GC discontinuation or time to first relapse.","limitations":"Single-centre retrospective design with missing data for some variables; cluster analyses may be underpowered given cohort size; patient numbers at risk dropped sharply after 3 years, making 4–5 year estimates unreliable.","practice_takeaway":"Patients with a prior GCA or PMR diagnosis are at higher risk of prolonged GC dependency and should be counselled accordingly. Symptom patterns and baseline inflammatory markers alone are not useful for predicting who will successfully stop GC therapy."}},{"doi":"10.1016/j.ophtha.2026.07.029","pmid":"42546975","title":"Systemic Interleukin-6 Inhibition and Risk of Diabetic Retinopathy Development and Progression","journal_title":"Ophthalmology","journal_issn":"0161-6420","published_at":"2026-08-03T00:00:00.000Z","url":"https://doi.org/10.1016/j.ophtha.2026.07.029","source_score":4,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-13T13:22:54.301Z","updated_at":"2026-08-13T13:22:54.301Z","tags":[{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"condition","value":"Diabetes Mellitus","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"condition","value":"Diabetic Macular Edema","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"condition","value":"Diabetic Retinopathy","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"condition","value":"Proliferative Diabetic Retinopathy","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"modality","value":"IL-6 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"sample_size","value":"n=5210","value_numeric":5210},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"warning","value":"No specific IL-6 inhibitor agents (e.g., tocilizumab, sarilumab, siltuximab) are named or broken out in the abstract; drug-level effects are indeterminate from available text.","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — the authors themselves call for prospective trials before clinical translation; clinicians should interpret findings as hypothesis-generating.","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"warning","value":"The primary sample size (n=5,210) reflects the primary propensity-matched cohort; the secondary NPDR analysis used a smaller matched cohort of 2,114 (1,057 per group).","value_numeric":null},{"paper_doi":"10.1016/j.ophtha.2026.07.029","tag_type":"warning","value":"The study publication date (2026-08-03) is recent; peer review status and any post-publication commentary are unknown at this time.","value_numeric":null}],"summaries":{"what_studied":"This retrospective propensity score-matched cohort study evaluated whether systemic IL-6 inhibitor use reduces the risk of incident diabetic retinopathy (DR), DR progression, vision-threatening complications, and retinal interventions in adults with type 1 or type 2 diabetes, using the US TriNetX EHR network (2004–2026) with up to 5-year follow-up.","key_result":"IL-6 inhibitor use was associated with significantly lower 5-year risks of NPDR (RR 0.50), PDR (RR 0.47), DME (RR 0.37), and vitreous hemorrhage (RR 0.41) vs. matched controls; anti-VEGF, PRP, and PPV rates were also lower; no significant difference was seen for neovascular glaucoma.","limitations":"Retrospective EHR-based design limits causal inference; residual confounding from unmeasured variables (e.g., glycemic control trends, disease severity) is possible; DR outcomes rely on diagnostic coding accuracy rather than standardized ophthalmic grading.","practice_takeaway":"Systemic IL-6 inhibitors in diabetic patients may offer a protective effect against DR onset and progression, but prospective trials are needed before incorporating IL-6 pathway modulation into routine diabetic eye disease management."}},{"doi":"10.1002/art.70262","pmid":"42370484","title":"Expert Perspective: Treatment of Patients With Calcium Pyrophosphate Deposition Disease: Where Do We Begin and Where Are We Going?","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-07-14T00:00:00.000Z","url":"https://doi.org/10.1002/art.70262","source_score":15,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:17:42.083Z","updated_at":"2026-08-04T18:17:42.083Z","tags":[{"paper_doi":"10.1002/art.70262","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"brand","value":"Kineret","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"condition","value":"Calcium Pyrophosphate Deposition Disease","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"condition","value":"Crystal Arthritis","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"generic","value":"anakinra","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"generic","value":"colchicine","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"generic","value":"hydroxychloroquine","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"generic","value":"tocilizumab","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"modality","value":"Antimalarial","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"modality","value":"Antimetabolite","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"modality","value":"IL-1 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"modality","value":"IL-6 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"study_design","value":"Expert Review / Narrative Review","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"warning","value":"Baricitinib is tagged as a JAK Inhibitor based on its drug class; its role in CPPD is investigational and not yet established.","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"warning","value":"No sample size is applicable as this is a review article, not a primary study.","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"warning","value":"Study design label 'Expert Review / Narrative Review' is used as the article does not fit a standard trial design category.","value_numeric":null},{"paper_doi":"10.1002/art.70262","tag_type":"warning","value":"This is an expert perspective/narrative review, not a systematic review or RCT; the level of evidence is inherently low and recommendations reflect author opinion synthesized from limited trial data.","value_numeric":null}],"summaries":{"what_studied":"This expert review proposes a practical treatment framework for calcium pyrophosphate deposition (CPPD) disease in older adults, covering acute and chronic manifestations, and summarizes evidence from randomized trials, open-label studies, and ongoing clinical trials.","key_result":"For acute CPP crystal arthritis, supported options include short-course systemic glucocorticoids, colchicine, intra-articular glucocorticoids, and anakinra. For chronic disease or recurrent flares, colchicine, hydroxychloroquine, methotrexate, IL-1 inhibition, and IL-6 inhibition are discussed. Ongoing trials are evaluating colchicine, tocilizumab, and baricitinib.","limitations":"No approved disease-modifying therapy exists for CPPD; the review is an expert perspective rather than a systematic review or meta-analysis, so recommendations reflect limited clinical trial evidence rather than high-quality RCT data.","practice_takeaway":"Before selecting therapy, confirm CPPD diagnosis and attribute current symptoms to CPPD specifically. Tailor treatment to disease manifestation—acute flare vs. chronic/recurrent disease—using available agents while awaiting results of ongoing trials and future disease-modifying strategies."}},{"doi":"10.1016/j.ard.2026.06.017","pmid":"42431784","title":"Cancer risk of Janus kinase inhibitors and other advanced therapies in immune-mediated inflammatory diseases: a systematic review and Bayesian network meta-analysis of RCTs","journal_title":"Annals of the Rheumatic Diseases","journal_issn":"0003-4967","published_at":"2026-07-10T00:00:00.000Z","url":"https://doi.org/10.1016/j.ard.2026.06.017","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-23T13:33:19.238Z","updated_at":"2026-07-23T13:33:19.238Z","tags":[{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"condition","value":"Inflammatory Bowel Disease","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"condition","value":"Psoriasis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"modality","value":"CD20 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"modality","value":"CTLA-4 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"modality","value":"IL-17 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"modality","value":"IL-23 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"modality","value":"IL-6 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"sample_size","value":"n=164824","value_numeric":164824},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"study_design","value":"Systematic Review and Network Meta-Analysis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"warning","value":"Class-level pooling of JAK inhibitors may mask agent-specific or dose-specific differences; individual drug comparisons are not reported.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"warning","value":"Long-term extension studies are included alongside RCTs, which may introduce exposure-time bias favoring detection of malignancy in longer studies.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.017","tag_type":"warning","value":"The absolute risk calculations depend on assumed baseline cancer incidence rates for 'standard-risk' vs 'higher-risk' populations, which are not fully specified in the abstract—clinicians should interpret absolute numbers cautiously without the full paper.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and Bayesian network meta-analysis evaluated relative and absolute cancer risk of JAK inhibitors (JAKis) vs other advanced therapies (TNFi, IL-6, IL-17, IL-23, IL-12/23, CTLA-4, CD20 inhibitors) across immune-mediated inflammatory diseases (RA, PsO/PsA, IBD) using 305 RCTs and long-term extension studies (164,824 participants; 264,100 person-years exposure) published up to February 2026.","key_result":"JAKis were associated with higher malignancy risk than TNFi (RR 1.60; 95% CrI 1.27–2.02) and standard care (RR 1.85; 95% CrI 1.38–2.47) across all three disease areas. Absolute excess risk vs TNFi was negligible in standard-risk patients (~1 extra cancer per 27,000 person-years) but clinically meaningful in high-risk patients (~1 extra cancer per 147 person-years). IL-6, IL-17, IL-23, IL-12/23, CTLA-4, and CD20 inhibitors showed cancer risks broadly comparable to TNFi.","limitations":"- Relies on RCT and long-term extension data, which may underrepresent older or higher-risk patients seen in routine care.\n- Class-level pooling may obscure differences between individual JAKi agents or doses.\n- Malignancy outcomes (including non-melanoma skin cancer) vary in ascertainment and reporting across trials.","practice_takeaway":"Clinicians should apply risk-stratified decision-making when prescribing JAKis across all IMIDs—not just RA—particularly in patients with prior malignancy or other cancer risk factors. For standard-risk patients the absolute excess risk vs TNFi is very small, but it becomes meaningful in higher-risk populations (~1 extra cancer per 147 person-years)."}},{"doi":"10.1016/s2665-9913(26)00046-9","pmid":"42034110","title":"Effectiveness and persistence of biological and targeted synthetic treatment in patients with rheumatoid arthritis and chronic kidney disease: a multicentre, prospective cohort study","journal_title":"The Lancet Rheumatology","journal_issn":"2665-9913","published_at":"2026-04-22T00:00:00.000Z","url":"https://doi.org/10.1016/s2665-9913(26)00046-9","source_score":13,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:11.117Z","updated_at":"2026-05-07T22:50:11.117Z","tags":[{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"modality","value":"B-Cell Depletion Therapy","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"modality","value":"CTLA4 Immunoglobulin","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"modality","value":"IL-6 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"sample_size","value":"n=12,123 treatment initiations (9,601 patients)","value_numeric":9601},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"warning","value":"eGFR was measured only at DMARD initiation; progressive kidney decline during follow-up was not captured, which may underestimate CKD impact.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"warning","value":"Sample size tag uses patient count (n=9,601); total treatment initiations were 12,123 — both figures appear in the paper.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"warning","value":"The 'practice_changing' impact flag reflects a significant finding in an under-studied population, though the study is observational and cannot establish causality.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00046-9","tag_type":"warning","value":"The study does not break down outcomes by individual CKD stage or by specific DMARD agent within each class, limiting granular prescribing guidance.","value_numeric":null}],"summaries":{"what_studied":"This multicentre prospective cohort study used the CorEvitas RA registry (2001–2023) to compare remission rates and treatment persistence across five classes of biological/targeted synthetic DMARDs (TNFi, CTLA4-Ig, IL-6i, B-cell depletion, JAK inhibitors) in RA patients with reduced eGFR (<60 mL/min/1.73 m²) vs. preserved eGFR, requiring moderate-to-high disease activity (CDAI >10) at initiation.","key_result":"Patients with reduced eGFR (10.4% of 12,123 treatment initiations) were significantly less likely to achieve CDAI-based remission than those with preserved eGFR (19.4% vs. 27.9%; adjusted HR 0.76 [95% CI 0.66–0.88]).","limitations":"- CKD was defined by a single eGFR measurement at DMARD initiation, without longitudinal kidney function data.\n- Non-Hispanic White females were heavily over-represented (80–82%), limiting generalizability.\n- Patient-reported outcomes and patient involvement in study design were absent.","practice_takeaway":"Clinicians should anticipate lower remission rates in RA patients with CKD (eGFR <60) on any b/tsDMARD class, and proactively plan more aggressive or tailored treatment strategies for this group. Standard DMARD protocols developed in patients with normal kidney function may be insufficient for this high-risk population."}},{"doi":"10.1002/art.70132","pmid":"41841636","title":"Coverage Generosity of Novel Antirheumatic Drugs in Medicare Advantage and Stand‐Alone Part D Plans","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-03-17T00:00:00.000Z","url":"https://doi.org/10.1002/art.70132","source_score":24,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-25","doi":"10.1002/art.70132","days":"30","issn":"2326-5191","rank":"7","field":"Clinical Medicine","score":"24","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1002/art.70132","title":"Coverage Generosity of Novel Antirheumatic Drugs in Medicare Advantage and Stand-Alone Part D Plans.","journal":"Arthritis & rheumatology (Hoboken, N.J.)","methods":"","results":"We included 26,915 plan-year observations, representing 217.6 million enrolled beneficiaries from 2022 to 2026. In the five-year period, coverage was relatively complete (>94%) for etanercept and adalimumab (TNF inhibitors) and upadacitinib (JAK inhibitor). However, coverage was lower for golimumab and certolizumab (TNF inhibitors), abatacept (the sole T cell costimulatory modulator), sarilumab (IL-6 inhibitor), and baricitinib (JAK inhibitor). Moreover, only 10.4% and 37.6% of stand-alone and Medicare Advantage (MA) Part D plans, respectively, covered all mechanisms of action, mostly due to low coverage of abatacept. In 2026, only 0.3% and 21.2% of stand-alone and MA Part D plans, respectively, covered abatacept. On the other hand, coverage increased for IL-6 inhibitors, likely due to the availability of biosimilar drugs for tocilizumab in 2024.","abstract":"$30","keywords":[],"pubmed_id":"41841636","conclusions":"The growing exclusions of self-administered DMARDs across several mechanisms of action and heterogeneity in coverage by plan type suggest potential barriers to accessing optimal RA treatments. Further monitoring of formulary adequacy and research into the clinical impacts of formulary exclusions are warranted.","publication_date":"2026-03-17T00:00:00"},"crossref":{"DOI":"10.1002/art.70132","URL":"https://doi.org/10.1002/art.70132","ISSN":["2326-5191","2326-5205"],"link":[{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/art.70132","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/full-xml/10.1002/art.70132","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/art.70132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Coverage Generosity of Novel Antirheumatic Drugs in Medicare Advantage and Stand‐Alone Part D Plans"],"author":[{"given":"Youngmin","family":"Kwon","sequence":"first","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center Nashville Tennessee"}]},{"given":"Robert W.","family":"Corty","sequence":"additional","affiliation":[{"name":"Division of Rheumatology and Immunology, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee"}]},{"given":"Stacie B.","family":"Dusetzina","sequence":"additional","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center Nashville Tennessee"}]}],"funder":[{"id":[{"id":"10.13039/100014848","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100014848","name":"Arnold 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Accessed November 23 2024.https://maprx.info/wp-content/uploads/2024/08/MAPRx_whitepaper_2024-08-15_Final.pdf","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"e_1_2_6_39_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"EVERSANA.Special Report: Inflation Reduction Act sets Part D stakeholders scrambling. September 28 2022. Accessed June 28 2025.https://www.eversana.com/2022/09/28/special-report-inflation-reduction-act-sets-part-d-stakeholders-scrambling/","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"e_1_2_6_40_1","year":"2019","issue":null,"author":"Lampner C.","volume":null,"first-page":null,"unstructured":null,"article-title":"Switch or swap: strategies for anti‐TNF failure in rheumatoid arthritis","journal-title":"Rheumatology Advisor.","doi-asserted-by":null}],"short-title":[],"update-policy":"https://doi.org/10.1002/crossmark_policy","alternative-id":["10.1002/art.70132"],"article-number":"art.70132","content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Arthritis & Rheumatology"],"reference-count":39,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,4,20]]},"references-count":39,"short-container-title":["Arthritis & Rheumatology"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1002/art.70132","is_oa":true,"title":"Coverage Generosity of Novel Antirheumatic Drugs in Medicare Advantage and Stand‐Alone Part D Plans","updated":"2026-04-21T12:05:45+00:00","published_date":"2026-03-17","best_oa_location":{"url":"https://doi.org/10.1002/art.70132","pmh_id":null,"url_for_pdf":null,"url_for_landing_page":"https://doi.org/10.1002/art.70132"}}},"created_at":"2026-05-07T22:49:27.383Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1002/art.70132","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"brand","value":"Actemra","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"brand","value":"Cimzia","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"brand","value":"Enbrel","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"brand","value":"Humira","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"brand","value":"Kevzara","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"brand","value":"Olumiant","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"brand","value":"Orencia","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"brand","value":"Rinvoq","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"brand","value":"Simponi","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"generic","value":"abatacept","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"generic","value":"certolizumab","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"generic","value":"etanercept","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"generic","value":"golimumab","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"generic","value":"sarilumab","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"generic","value":"tocilizumab","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"modality","value":"Biosimilar","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"modality","value":"IL-6 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"modality","value":"T Cell Costimulatory Modulator","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"sample_size","value":"n=26,915 plan-year observations","value_numeric":26915},{"paper_doi":"10.1002/art.70132","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"warning","value":"Sample size reflects plan-year observations (n=26,915), not individual patients; the 217.6 million figure represents cumulative enrolled beneficiaries across plan-years and should not be interpreted as unique patients.","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"warning","value":"Study design is best characterized as a repeated cross-sectional analysis of administrative formulary data; no causal inference about patient outcomes is possible.","value_numeric":null},{"paper_doi":"10.1002/art.70132","tag_type":"warning","value":"The 'safety_signal' impact flag is applied here in the access/policy sense — formulary exclusions represent a barrier to care signal, not a drug safety signal in the traditional adverse-event sense.","value_numeric":null}],"summaries":{"what_studied":"Coverage generosity of self-administered DMARDs (TNF inhibitors, T cell costimulatory modulator, IL-6 inhibitors, JAK inhibitors) across Medicare Part D stand-alone and Medicare Advantage plans from 2022–2026, using 26,915 plan-year observations representing 217.6 million enrolled beneficiaries.","key_result":"Coverage exceeded 94% for etanercept, adalimumab, and upadacitinib, but was markedly lower for abatacept (only 0.3% of stand-alone and 21.2% of MA Part D plans covered it in 2026). Only 10.4% of stand-alone and 37.6% of MA plans covered all mechanisms of action. IL-6 inhibitor coverage improved after tocilizumab biosimilars launched in 2024.","limitations":"Formulary data reflect plan-level coverage but do not capture actual patient-level access, utilization, or clinical outcomes resulting from exclusions. The study period ends at 2026, so long-term trends cannot be assessed. Reasons behind specific formulary exclusion decisions (e.g., rebate negotiations) are not examined.","practice_takeaway":"Clinicians prescribing abatacept or less-covered DMARDs to Medicare patients should proactively verify formulary status, as coverage varies widely by plan type and has been declining. Awareness of biosimilar-driven coverage gains (e.g., tocilizumab biosimilars) may help identify accessible alternatives when preferred agents are excluded."}},{"doi":"10.1038/s41433-025-04197-z","pmid":"41501285","title":"Horizon scanning from panel discussions at the EUGOGO Global TED Forum 2025 London","journal_title":"Eye","journal_issn":"0950-222X","published_at":"2026-01-08T00:00:00.000Z","url":"https://doi.org/10.1038/s41433-025-04197-z","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-08","doi":"10.1038/s41433-025-04197-z","days":"7","issn":"0950-222X","rank":"10","field":"Clinical Medicine","score":"2","category":"Ophthalmology","categories":["Ophthalmology"],"_categories":["Ophthalmology"]},"pubmed":{"doi":"10.1038/s41433-025-04197-z","title":"Horizon scanning from panel discussions at the EUGOGO Global TED Forum 2025 London.","journal":"Eye (London, England)","methods":"","results":"","abstract":"","keywords":[],"pubmed_id":"41501285","conclusions":"","publication_date":"2026-01-08T00:00:00"},"crossref":{"DOI":"10.1038/s41433-025-04197-z","URL":"https://doi.org/10.1038/s41433-025-04197-z","ISSN":["0950-222X","1476-5454"],"link":[{"URL":"https://www.nature.com/articles/s41433-025-04197-z.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41433-025-04197-z","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41433-025-04197-z.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Horizon scanning from panel discussions at the EUGOGO Global TED Forum 2025 London"],"author":[{"given":"Vickie","family":"Lee","sequence":"first","affiliation":[]},{"given":"Mario","family":"Salvi","sequence":"additional","affiliation":[]},{"given":"Anja","family":"Eckstein","sequence":"additional","affiliation":[]},{"given":"Colin","family":"Dayan","sequence":"additional","affiliation":[]},{"given":"Karim","family":"Meeran","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026,1,7]]},"member":"297","prefix":"10.1038","source":"Crossref","volume":null,"created":{"date-time":"2026-01-07T07:11:59Z","timestamp":1767769919000,"date-parts":[[2026,1,7]]},"indexed":{"date-time":"2026-01-07T12:40:36Z","timestamp":1767789636026,"date-parts":[[2026,1,7]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000,"date-parts":[[2026,1,7]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000,"date-parts":[[2026,1,7]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://www.nature.com/articles/s41433-025-04197-z"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"15 November 2025"},{"name":"revised","group":{"name":"ArticleHistory","label":"Article History"},"label":"Revised","order":2,"value":"1 December 2025"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":3,"value":"15 December 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":4,"value":"7 January 2026"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"},"order":1,"value":"Sponsors of the EUGOGO Global TED Forum included. Acelyrin (Alumis). Amgen Inc. Argenx. IMVT Therapeutics. Kriya Therapeutics. Ollin Biosciences. Roche. Shanghai Bayi. Sling Therapeutics. Thyroscope. Viridian Therapeutics.\n Individual Authors COI\n . CD Consultancy advice for Horizon AE received consulting fees from Therapeutics/Amgen, Lassen Therapeutics Roche and Lundbeck A/S. Horizon, Amgen, Viridian Roche and the Aspen Trust; and Honoraria from Horizon, the European Society of Ophthalmic Plastic Reconstructive Surgery, Sanofi, and Henning. MS BSA Institut Biochimie Valenza-Bio Roche -Institutional Funding. Horizon/Amgen Institutional Funding. VL Consultancy Advice for Horizon, Amgen, Viridian Roche Argenx. Institutional funding from Horizon, Amgen, Viridian Argenx Lassen & Sling Therapeutics. AE Consultancy Advice for Horizon, Amgen, Viridian, Roche, Argenx, Institutional funding Argenx, Sling Therapeutics, Sanofi."}],"deposited":{"date-time":"2026-01-07T07:11:59Z","timestamp":1767769919000,"date-parts":[[2026,1,7]]},"issn-type":[{"type":"print","value":"0950-222X"},{"type":"electronic","value":"1476-5454"}],"published":{"date-parts":[[2026,1,7]]},"publisher":"Springer Science and Business Media LLC","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1007/springer_crossmark_policy","alternative-id":["4197"],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"original-title":[],"container-title":["Eye"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,1,7]]},"references-count":0,"short-container-title":["Eye"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1038/s41433-025-04197-z","is_oa":true,"title":"Horizon scanning from panel discussions at the EUGOGO Global TED Forum 2025 London","updated":"2026-01-10T04:46:20+00:00","published_date":"2026-01-07","best_oa_location":{"url":"https://www.nature.com/articles/s41433-025-04197-z.pdf","pmh_id":null,"url_for_pdf":"https://www.nature.com/articles/s41433-025-04197-z.pdf","url_for_landing_page":"https://doi.org/10.1038/s41433-025-04197-z"}}},"created_at":"2026-01-11T11:19:33.869Z","updated_at":"2026-01-11T11:19:33.869Z","tags":[{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"condition","value":"Thyroid Eye Disease","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"generic","value":"belimumab","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"generic","value":"teprotumumab","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"generic","value":"tocilizumab","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"modality","value":"Anti-CD20 Antibody","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"modality","value":"FcRn Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"modality","value":"IGF-1R Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"modality","value":"IL-6 Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"modality","value":"Orbital Radiotherapy","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"study_design","value":"Expert Opinion/Editorial","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"warning","value":"Industry sponsorship and author conflicts were disclosed; interpret therapeutic recommendations with caution.","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"warning","value":"Many statements lack quantitative estimates and reflect consensus opinion.","value_numeric":null},{"paper_doi":"10.1038/s41433-025-04197-z","tag_type":"warning","value":"This is an editorial summary of expert discussions, not a primary study or guideline.","value_numeric":null}],"summaries":{"what_studied":"Commentary summarizing panel and round‑table discussions from the 2025 EUGOGO Global TED Forum on unmet needs, future directions, and practical strategies in Thyroid Eye Disease.","key_result":"Experts prioritized diplopia as the key patient‑centred outcome and endorsed more objective orthoptic measures over the Gorman score. They highlighted uncommon but clinically important permanent sensorineural hearing loss with IGF‑1R antagonists (often unilateral, high‑frequency) with advice for urgent audiometry and drug cessation if suspected, suggested a 6–12‑month (≈1‑year safer) interval before rehabilitative surgery after teprotumumab, and noted that orbital radiotherapy can be given after teprotumumab.","limitations":"Consensus opinions from a sponsored forum without new comparative or quantitative data; guidance may be influenced by disclosed conflicts of interest.","practice_takeaway":"Counsel patients on IGF‑1R inhibitors about hearing loss, arrange urgent audiometry for symptoms, and stop treatment if detected. Use objective diplopia metrics and, after teprotumumab, plan elective rehabilitative surgery at roughly 6–12 months when feasible; consider orbital radiotherapy where appropriate."}}],"initialOffset":7,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"IL-6 Inhibitor"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"IL-6 Inhibitor"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"IL-6 Inhibitor"}}}]]

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