PDUS signals >1 are rarely seen in normal synovial joints. GSUS synovitis, but not PDUS, may reflect age-related joint changes. PDUS correlated with VEGF, providing further evidence of a central role for VEGF in synovial neo-angiogenesis.

Background and aims Biosimilars used in multiple rheumatic conditions offer the potential for cost savings. We present the outcomes of a service evaluation of switching rheumatic patients established on originator etanercept (Enbrel) to biosimilar Benepali, using a managed switching programme funded through a novel fi xed price incentivisation model. Methods Evaluation outcomes included savings in drug acquisition costs, patient-reported side effects, adverse events, patient outcomes and patient experience. Results A total of 154 patients on Enbrel were identifi ed for switching. A total of 113 patients (43 had rheumatoid arthritis, 43 had axial spondyloarthritis and 27 had psoriatic arthritis) were switched from originator etanercept to Benepali from August 2016 to March 2017. The Royal Berkshire NHS Foundation Trust had the highest percentage of switches in the Thames Valley in this period. There was no increased incidence of side effects before and after switch. Drug acquisition costs were decreased by £95,000 with an overall reduction in prescribing costs of £186,000 for the local health economy. Conclusions A managed switching programme from originator etanercept to biosimilar Benepali, using a novel fi xed price model, delivers signifi cant cost savings and investment in clinical services while maintaining similar patient-reported outcomes and good patient experience.

To our knowledge, as of March 24, 2006, this is the first case in which a DTH reaction to piperacillin/tazobactam manifesting as fever, neutropenia, and thrombocytopenia has been associated with paresthesiae.

No abstract

NSAIDs and PPIs are often prescribed inappropriately.