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Objective: Methotrexate (MTX) is the anchor drug in the treatment of rheumatoid arthritis (RA) due to its effectiveness, tolerability, and cost. This study examines MTX prescribing practices in the US from 2009 to 2014.Methods: Symphony Health Solutions, which covers 274 million patients in the US, was used to identify patients diagnosed with RA who were naive to MTX in 2009 and 2012. Data were collected, including medication use and doses, demographics, and medical comorbidities.Results: Of the patients who had 5-year followup data available, oral MTX was started in 35,640 in 2009, and 44% continued taking this dose during the followup. Of the 20,041 patients who changed therapy during the study period, 87% had the addition of or switched to a biologic agent, while 13% were changed from oral to subcutaneous (SC) MTX. The mean oral dose prior to the start of a biologic agent was 15.3 ± 5 mg/week. A comparison of 2009 with 2012 showed a modest increase in the mean dose of oral MTX from 15.3 mg/week to 15.9 mg/week, as well as a small but statistically significant (P < 0.0001) increase in the use of SC MTX after failure of oral MTX from 13% to 16% of patients.Conclusion: MTX is underutilized in the treatment of RA with suboptimal dosing, inadequate duration of therapy, and failure to use SC administration. The comparison of MTX use between the 2009 and the 2012 cohorts demonstrates only a marginal increase in the dose of oral MTX and the use of SC MTX. [ABSTRACT FROM AUTHOR]

To evaluate the use of starting doses of rofecoxib and nabumetone in patients with osteoarthritis (OA) of the knee. A 6-week, randomized, parallel-group, double-blind, placebo-controlled study. One hundred thirteen outpatient sites in the United States. A total of 1,042 male and female patients aged 40 and older with OA of the knee (>6 months). Rofecoxib 12.5 mg once a day (n=424), nabumetone 1,000 mg once a day (n=410), or placebo (n=208) for 6 weeks. The primary efficacy endpoint was patient global assessment of response to therapy (PGART) over 6 weeks, which was also specifically evaluated over the first 6 days. The main safety measure was adverse events during the 6 weeks of treatment. The percentage of patients with a good or excellent response to therapy as assessed using PGART at Week 6 was significantly higher with rofecoxib (55.4%) than nabumetone (47.5%; P=.018) or placebo (26.7%; P<.001 vs rofecoxib or nabumetone). Median time to first report of a good or excellent PGART response was significantly shorter in patients treated with rofecoxib (2 days) than with nabumetone (4 days, P=.002) and placebo (>5 days, P<.001) (nabumetone vs placebo; P=.007). The safety profiles of rofecoxib and nabumetone were generally similar, including gastrointestinal, hypertensive, and renal adverse events. Rofecoxib 12.5 mg daily demonstrated better efficacy over 6 weeks of treatment and quicker onset of OA efficacy over the first 6 days than nabumetone 1,000 mg daily. Both therapies were generally well tolerated. [ABSTRACT FROM AUTHOR]

Focuses on ghetto consumers in the United States. Procedures proposed by the Federal Trade Commission concerning ghetto dwellers; Impact of the rising level of violence in the ghetto on opening up channels for the orderly distribution of goods.

The article profiles Joan M. Bathon who has accepted the editorship of the periodical on July 1, 2010. Bathon earned her bachelor of science degree at Marquette University in Milwaukee, Wisconsin with magna cum Laude. She is a professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland. She founded the John Hopkins Arthritis WebSite in 1998. She is also a recipient of various awards including the Mary Betty Stevens Award. Her plans for the periodical are noted.