Up-to-date information and resources for specialists, pharmacists, nurses and hospitals to optimise the safety and health outcomes of biological disease-modifying antirheumatic drugs and other specialised medicines for inflammatory arthritis.
For health professionals
Key points
- Optimise first-line disease modifying therapy before starting a biological/targeted synthetic disease modifying antirheumatic drug (b/tsDMARD).
- Subcutaneous methotrexate is more efficacious and generally better tolerated than oral methotrexate.
- Consider stepwise reduction in the dose of b/tsDMARDs for people with rheumatoid arthritis (RA) or axial spondyloarthritis (axial SpA) who have been in remission or sustained low disease activity for at least 6 months, but do not stop b/tsDMARDs suddenly.
- Biosimilars are safe and equally effective alternatives to the reference biologic.
- Glucocorticoids and opioids have a limited role in the long-term management of inflammatory arthritis and should be used with caution.
Value in prescribing bDMARDs program for rheumatologists
Professor Catherine Hill, ARA President and rheumatologist, outlines how the bDMARDs program will help specialists and their patients, the gaps the program will cover and some of the useful resources that will be available.
Resources to use with your patients
- Action plan: Low-dose methotrexate for rheumatoid arthritis and psoriatic arthritis
- Action plan: Managing your arthritis flare
- Down-titration decision aid: My rheumatoid arthritis is under control – what should I do about my medicine?
- Fact sheet: My rheumatoid arthritis is well controlled with a biological or targeted medicine: can I take less medicine?
- Online content: Understanding biosimilars
- Video: Living with rheumatoid arthritis: Suzanne’s story
- Roadmaps:
Educational visiting for specialists
Educational visits will cover a range of clinical updates based on the best available current evidence, developed with and informed by feedback from specialists. The updates are delivered through individualised 30-minute discussions at the preferred timing of the specialist, either online or face-to-face where COVID precautions allow. (Cost: Free)
Information and resources for health professionals
- Supporting safe practices for low-dose methotrexate: Position statement on the use of low-dose methotrexate
- Guiding principles for the governance of biologics and their biosimilars in Australian hospitals
- SHPA bDMARDs Quick Reference Guide
- PBS Practice Review – Rheumatoid arthritis
- Tocilizumab (Actemra) shortage: Patient management
- Down-titration algorithm for b/tsDMARDs
- bDMARDs down-titration strategies used in clinical trials
- Biologics, biosimilars and PBS sustainability
- Avoiding the nocebo effect: talking to your patients about biosimilars
Webinars and podcasts
In focus
The Australian Living Guideline for inflammatory arthritis
This living guideline presents the best available, current scientific evidence for pharmacological management RA, PsA and axial SpA, including choice of DMARD, combination therapy and down-titration of treatment. The guideline will be continuously updated as relevant new evidence emerges, and includes:
- Dose Reduction and Discontinuation Strategies
- Opioids for Pain Management
- Glucocorticoid therapy as an adjunct to DMARD therapy in the treatment of rheumatoid arthritis
Video: A new living guideline to provide direction for the pharmacological management of inflammatory arthritis
Dr Sam Whittle, Cochrane Musculoskeletal Alliance member and rheumatologist, introduces the living guideline, explaining how it is developed and the gaps in the evidence it will address.
For pharmacists
- Practice Audit Tool – MTX and bDMARDs: Optimising use in rheumatoid arthritis
- Online learning module: Optimising the use of biological and targeted synthetic disease modifying antirheumatic drugs - the key role of pharmacists
- Disease-modifying antirheumatic drugs and inflammatory arthritis: article from the Pharmaceutical Society of Australia (PSA)
- Webinars
Research and education
MedicineWise App
The MedicineWise app is a free health and medicines management app. Features have been developed to support people with inflammatory arthritis, including a dose tracker to manage complex dosing or stepping up or stepping down of medicines.
 |
 |
Helping consumers and health professionals make safe and wise therapeutic decisions about biological disease-modifying antirheumatic drugs (bDMARDs) and other specialised medicines. Funded by the Australian Government Department of Health through the Value in Prescribing bDMARDs Program Grant.
