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By Janet Pope, MD, MPH, FRCPC | 26 June 2017
The following are my favorite and least favorite presentations and abstracts from EULAR 2017. This originally appeared on RheumReports.com, a great Rheumatology website run by Dr. Andy Thomspon.
- Vobarilizumb is a nanobody that inhibits IL-6, but failed in MTX-IR RA trials (there were country differences with respect to placebo response which may or may not have affected the outcome of the study). (Dorner T, et al, OP098)
- Ongoing infection safety of JAK-inhibitors (baricitinib meta-analysis of phase III trial results adds to tofacitinib and TNFi and non-TNFi biologics) – all will similar serious infection rates. (Strand V, et al, THU0211)
- Doesn’t matter (in RA) what target you use, just use it to get more patients into remission/low disease state. Favorite targets are CDAI, SDAI, DAS28, RAPIDs3, Boolean remission, ultrasound remission, etc. (numerous abstracts)
- All ANCAs are not created equally – they have post translational changes that may be important for prognosis, flaring, etc. (Luqmani R, et al. SP0132)
- Certrolizumab pegol does not cross the placenta and should be safe in women needing treatment while pregnant. (Mariette X, et al, OP0017)
- IL-18 is in the IL-1 family. Tadekinig alpha is a recombinant IL-18 protein binding inhibitor that seemed to help patients with adult onset Still’s disease who were recalcitrant to previous treatment, in an open label phase II trial. (Gabay C, et al, FRI0582).
- In giant cell arteritis, MTX can prevent relapses compared to patients not on MTX. (D Frietes, et al, THU0309) and the dose of tocilizumab in GCA is likely more optimal as TCZ 162 mg sc weekly. (Stone J, et al OP0131)
- Lots of early and later phase trials in SLE with varied mechanisms (atacicept [BLyS and APRIL with B cell signalling changes,] drugs affecting plasma cells, CC2, ICOS, gamma interferon reduction, calcineurin inhibitor the latter in SLE nephritis had more deaths when added to MMF than MMF alone). More to come I assume.
- Stop doing IL-1 inhibition in OA, the studies all fail as did one presented at EULAR.
- Retention and response (EULAR good response) is better of non-TNFi biologics in RA is better than TNFi as the first biologic (Swedish register). (Frisell T, FRI0213)
- Oral strategy study (Fleischmann R, et al. Lancet 2017) in MTX-IR showed that MTX adding either tofacitinib or adalimumab were not inferior to each other, but stopping MTX and switching to tofacitinib has inconclusive results (not non-inferior but can’t say inferior, but numerically is a bit less).
- Rituximab with belimumab helped severe refractory SLE (open label severe SLE). (Krasji T et al SAT0258, OP0302)
- Cyclophoshamide did not prolong survival in follow up of sleroderma lung study (Volkmann ER, et al, OP0124)