Rheumatology in practice - 2008

Comment: Who will bear the cost of the rheumatic diseases?
Paul Emery
pp 3-3
One of the major problems that has arisen from the availability of effective but expensive therapies in the management of patients with rheumatic conditions is how to organise their reimbursement.

Current biologic therapies and their reimbursement
Tina Hawkins
pp 4-7
The introduction of biologic therapies in the last nine years has had a significant impact on the cost of managing rheumatoid conditions. Patients previously managed on simple analgesia and standard disease-modifying antirheumatic drugs (DMARDs) are now being commenced on biologic therapies costing several thousand pounds per patient per year. Where does the additional funding come from to support the cost of these new drug treatments?

Why you need to know about cyclic citrullinated peptide
Cyndi and Andrew Östör
pp 8-11
Rheumatoid arthritis (RA) is a chronic, progressive multisystem autoimmune disease leading to significant morbidity and premature mortality. The recent focus in the management of RA has been to treat early and intensively to reduce the burden of disease. Anti-cyclic citrullinated peptide (anti-CCP) antibodies have helped greatly in this endeavour and have also given us insights into the pathophysiology of the condition.

Measuring quality of life in ankylosing spondylitis
Stephen McKenna and Lynda Doward
pp 12-14
The efficient and cost-effective management of chronic disease requires competing treatment regimens to be evaluated in terms of their ability both to control the disease and improve quality of life (QoL). This article describes and reviews the different types of patient-reported outcomes (PROs) used in ankylosing spondylitis (AS) studies.

Spinal MRI: a strategy to influence outcome
Elaine Buchanan
pp 15-17
Back pain accounts for at least 7% of a GP’s workload and is one of the most common reasons for referral to secondary care. For spinal symptoms MRI is considered to be the imaging of choice, due to its safety and high sensitivity to pathology. Compared with other forms of imaging, MRI has a larger field, superior soft-tissue contrast, and allows better visualisation of marrow and the contents of the spinal canal.

Reflections on anti-tumour necrosis factor therapy
Louise Warburton
pp 18-19
Many years ago, I did an intercalated degree in clinical immunology and oncology. My own particular project was to identify natural killer (NK) cells in the rat. I undertook this at the Paterson laboratories at the Christie Hospital in Manchester. At that time (1982), NK cells were identifiable under the microscope, but were difficult to harvest.

2008, Volume 6 Number 1

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ISSN 1366-6541 (Print) ISSN 2052-3130 (Online)