Challenges with Step Therapy Protocols in Treating Rheumatoid Arthritis

Author(s):

Nehad Soloman, MD, FACR,Andrew Sharobeem, DO, FACR

In this MEDcast episode, Drs Soloman, Sharobeem, Boone and Feldman discuss the use of step therapy in rheumatoid arthritis, how step therapy was intended to be used, how it is actually used, and challenges and solutions to its use.

To watch the video series component of this episode, click here.

00:06 Welcome and introduction

01:43 Treatment landscape of rheumatoid arthritis

08:30 Use of TNFi in rheumatoid arthritis

12:33 Switching from TNFi in rheumatoid arthritis

14:33 Step therapy in medicine

20:16 Variations in the use of step therapy between states

22:40 Outcomes with step therapy

26:25 Step therapy legislations

27:09 Administrative burden of step therapy

28:28 Safe step act

29:19 CSRO map tool for step therapy

32:20 Processing of exceptions to step therapy protocols

33:44 Step therapy in rheumatoid arthritis

36:45 Impact of staying on ineffective RA treatments

38:59 Personalization of medicine in RA

41:20 Use of molecular signature response classifier (MSRC) in RA

42:58 Step therapy and use of molecular signature response classifier (MSRC) test in clinical practice

46:12 Advice for patients and HCPs in navigating step therapy protocols