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Koc et al. STAMP trial in PsA. Secukinumab+MTX+GC vs MTX+GC(+SSZ if needed). Both could go to TNF if needed. Secukinumab significantly better at week 12 but no longer at week 24. @RheumNow #ACR24 Abstr#1457 https://t.co/4TGSiUPebV https://t.co/eAANkYIpzy
Richard Conway RichardPAConway ( View Tweet)
Abst #1473 evaluated association of SJC in PROs from 2 Bimekizumab trials (bDMARD naïve vs TNFi-IR)
-bDMARD naïve had less SJC at baseline
-In both groups, pts w lower SJC had sustained improvement in pain and fatigue over time.
#ACR24 @RheumNow https://t.co/zwxsSbga7c
Adela Castro AdelaCastro222 ( View Tweet)
New agent on the block: Bimekizumab IL-17A/F inhibitor
Promising clinical data in SpA - what about imaging findings?
Dramatic reductions in MRI activity at SI joints seen in BKZ pt, esp when compared to trajectory of PBO pt before cross-over
@RheumNow #ACR24 Abst #1757 https://t.co/ACLJx5XkyN
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
#1462 🔬Rx persistence in PsA; Guselkumab (GUS) v. IL17Ai
💡 GUS (n=910) persistence @ 12 months (67%) almost 2X IL-17Ai (n=2743) (50%)
⏳ Median time to discontinuation: GUS not reached v 12.3 months for IL-17Ai.
🔴Durable therapy ❓better outcomes
#ACR @RheumNow https://t.co/LfA3WygNVq
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Harkins @DrTrishHarkins et al. Novel diagnostic cytokines in treatment naive PMR. Elevations CXCL-9 (100%), MCP-1 (93%), IL-17A (83%), vs TNF (7%) and IL-6 (67%) @RheumNow #ACR24 Abstr#0881 https://t.co/DbYOn81QJH https://t.co/3eyre00D5d
Richard Conway RichardPAConway ( View Tweet)
Harkins @DrTrishHarkins et al. Novel diagnostic cytokines in treatment naive PMR. Elevations CXCL-9 (100%), MCP-1 (93%), IL-17A (83%), vs TNF (7%) and IL-6 (67%) @RheumNow #ACR24 Abstr#0881 https://t.co/DbYOn81QJH https://t.co/3eyre00D5d
Richard Conway RichardPAConway ( View Tweet)
Half of the respondents chose #IL17i for #psoriatic #arthritis #PsA Rx for #Achilles #tendonitis
Interesting as lots
Of data
On #enthesitis wIL23i
Likely all
Effective #PsA Rx helps #tenosynovitis
some have
➡️ data on #efficacy
⬆️ bio rationale
#ACR24 @RheumNow @ACRheum https://t.co/wzefjsfdaj
Janet Pope Janetbirdope ( View Tweet)
The post hoc analysis of the SURPASS study evaluated predictors of radiographic spinal progression in axial spondyloarthritis patients treated with IL-17A (secukinumab) or TNF inhibitors over 2 years.
Key findings:
- New syndesmophytes: 18.2% (SEC 150 mg), 15.8% (SEC 300 mg),… https://t.co/jke6OHdPjZ
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Evaluation of Bimekizumab in PsA
Bimekizumab (BKZ) is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)‑17A and F. There have been more updates on the 2 year data on BKZ at #ACR24, and this is a summary of four studies being presented this year at ACR24.
Read Article
Factors associated w/ secukinumab response in PsA?
Analysis of 2.7k pt in EuroSpA
Associated w/ favorable response
❗️elevated CRP >10 mg/L
❗️fewer prev tx
Associated w/ lower response:
❗️smoking
❗️higher patient global score / HAQ
@RheumNow #ACR24 Abstr 2325
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
This is likely an oversimplification, but I've been looking for exactly this diagram
Inhibiting various TYKs/JAKs corresponds to various downstream cytokine inhibition
@EricFMorand does it make sense to see this as anifrolumab+ustekinumab? No?
@rheumnow #ACR24 Abstr#0662 https://t.co/thti6s5TR3
Mike Putman EBRheum ( View Tweet)
#0600
🔬BKZ achieves sustained impact in PsA
➡️ BE OPTIMAL & BE COMPLETE trials:BKZ 160 mg Q4W bDMARD-naïve & TNFi-IR PsA pts
➡️Pain,function,fatigue & skin showed greatest & sustained reductions @ 2 yrs👇
🎯BKZ offers sustained response in 🔑PsA domains
#ACR24 @RheumNow https://t.co/uhzZoOrr3H
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
#0589
🔬Time to Response in PsA Domains: Secukinumab
➡️Post-hoc analyses, n=1366
🔑Median time (wks) to MCID 👇
🔴Systemic inflammation <2
🔴MSK: ~4 wks (enthesitis~12)
🔴Fatigue~7–8
🔴PASI75~8–12; nails ~24
🩺 Rapid MSK & QoL benefits precede skin/nail
#ACR24 @RheumNow https://t.co/WfqkryA1CC
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Switching vs cycling - which is better? In PsA & axSpA, a real-world analysis shows that switching to IL-17Ai after TNFi discontinuation may lead to similar or better outcomes compared to cycling to another TNFi. Data from the CorEvitas PsA/SpA Registry. Abstr#0585.… https://t.co/AJP4NBjmzr
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#0585 🔬PsA/axSpA: TNFi Cycling v IL-17Ai Switch
➡️470 pts: Switchers to IL-17Ai had similar/better outcomes v TNFi cyclers @ 6 mo
➡️PsA: Switchers had improved arthritis/psoriasis(-5.0, p=0.02)
➡️axSpA: Switchers had improved fatigue(-9.4, p=0.01)
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
PRO-SPIRIT trial data on 1192 PsA pts showed IL-17Ai seemed better than IL-12/23i and IL-23i improving cDAPSA at 3m and as effective as TNFi and JAKi. No much differences seen at 12m. Abst#0076 #ACR24 @RheumNow https://t.co/dScwsmkDOe
Adela Castro AdelaCastro222 ( View Tweet)
With many treatments for #PsA and #PsO, what are the prescribing trends?
Abstract 0604: TNF inhibitors remain the most common (~60%), but over the past 10 years, IL-17i use rose from 0.2% to 19%, and IL-23i from 0.1% to 39.7%! #ACR24 @RheumNow https://t.co/4TnCAkHfuY
Akhil Sood MD AkhilSoodMD ( View Tweet)
🤨To cycle or not to cycle TNFi. Abst#0585 studied pts with PsA and axSpA with primary TNFi failure:
-Switching to IL17Ai may benefit phGA for arthritis and psoriasis in PsA pts and fatigue in axSpA pts. @AlexisOgdie
#ACR24 @RheumNow https://t.co/Jc0cdmrVhI
Adela Castro AdelaCastro222 ( View Tweet)
Abstract 0587: Among PsA patients (bDMARD-naive & TNF non-responders) treated with Bimekizumab, better disease control was linked to improved work productivity, including ↓ work impairment, ↓ presenteeism, and ↓ activity impairment. #ACR24 @RheumNow https://t.co/sZBjJ9lk39
Akhil Sood MD AkhilSoodMD ( View Tweet)
TNFi cycling vs. switching to IL-17Ai?
Dr @AlexisOgdie et al from CorEvitas registry:
PsA & axSpA cohort - switchers (TNFi to IL17i) had greater improvements in cDAPSA & BASDAI vs. cyclers (2nd TNF)
Not stat significant but offers alternative Tx options
@RheumNow #ACR24 abs585 https://t.co/8m347BRM75
sheila RHEUMarampa ( View Tweet)