Jeffrey Sparks, MD, MMSc: Treatment Strategies for Rheumatoid Arthritis

In an interview with HCPLive Rheumatology, Jeffrey Sparks, MD, MMSc, elaborates on his Congress of Clinical Rheumatology West presentation, “Biologic & tsDMARDs Choices for Rheumatoid Arthritis: Does it Matter?” He explains how to tailor rheumatoid arthritis (RA) treatment for an individual patient’s needs and how to discern when to consider switching or intensifying treatment for this patient population.

“As all rheumatologists are aware, we've seen significant advancements in the treatment options available over the past few decades,” Sparks explained. “These developments have revolutionized the management of conditions like RA and other rheumatic diseases.”

However, the number of choices has also made it more challenging to select the most suitable therapy. Additionally, most of the trials leading to drug approvals have compared the new drugs with placebos, with a limited number of head-to-head trials. In his presentation, he discusses these head-to-head trials to provide evidence of efficacy. Further, he explores real-world evidence, examining comparative effectiveness studies that assess different drug classes against each other.

Ultimately, there are numerous effective options for treating RA. The choice often depends on factors like patient preference, the prescriber's familiarity with a particular drug, and clinical characteristics, such as infection risk, contraindications, and preferences regarding the mode of administration.

Regarding tailoring treatment to the individual, Sparks emphasized the concept of shared decision-making is critical.

“It involves presenting patients with the available treatment options, taking into account their unique needs and circumstances,” he stated. “We look at absolute and relative contraindications, especially those related to infections and comorbidities. Additionally, we consider the patient's preferences regarding the route of drug administration and the economic aspects, including insurance coverage and affordability.”

He reiterated rheumatologists deal with these complex decisions daily, and they aim to provide evidence-based guidance to assist patients in making informed choices.

This transcript was edited for clarity.

Dr. Sparks has consulted for Bristol Myers Squibb, Gilead, Inova Diagnostics, Optum, and Pfizer.