JB Boone, MD, explains the progress being made towards more personalized medicine in patients with rheumatoid arthritis, as well as the current challenges.
In the second part of an interview with HCPLive Rheumatology, Boone, a rheumatologist at Rheumatology Associates, PLLC, discussed the patient perspective of using PrismRA, a tool designed to predict the most effective treatment strategy for patients with rheumatoid arthritis (RA), as well as the evolution of RA treatment regarding step therapy.
“Patients have shown universal enthusiasm for the introduction of personalized medicine into the management of their RA,” Boone explained. “They quickly grasp the principles behind personalized medicine and are excited about the idea that we now have tools that can select the most suitable treatment options for their unique conditions based on their genetics and other clinical features. Overall, it's something they're very excited about and eager to embrace.”
He believes as rheumatologists continue to have more personalized medicine tools at our disposal, the field of RA treatment will evolve towards recognizing personalized medicine as the standard of care.
“In the long run, it will become clear that substantial cost savings can be achieved when we match patients with therapies that are better suited to their specific needs, leading to more rapid and effective disease control,” he continued. “Active, uncontrolled RA leads to increased healthcare resource utilization, so leveraging personalized medicine tools will ultimately save money for payers and benefit everyone involved.”
The intersection of step therapy protocols and personalized medicine in RA is of particular interest to Boone. Therefore, he and his team decided to investigate how it impacted their patients in real-life situations. In collaboration with his colleagues, they examined the outcomes of 150 patients who had undergone PrismRA testing in 2021 and 2022.
Surprisingly, they found 71% of patients who had a non-TNF targeted DMARD prescribed after their PrismRA results were able to access it without the need for an appeal or peer-to-peer review.
“This was quite encouraging, although it still leaves 30% of patients who must navigate step therapy restrictions,” he concluded. “There's certainly room for improvement. Legislative efforts at the state and federal levels are providing exceptions and reprieves for patients when personalized medicine tools indicate that a step therapy preferred agent is unlikely to work for them. While there's progress, it's still a work in progress.”
This transcript was edited for clarity.
Disclosures: Dr Boone’s latest step therapy research was funded with help from Schiper Medicine.