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Who gives a ‘JAK’ why and how they work, as long as they do!
Several abstracts have studied the mechanism of action of JAK inhibitors (JAKi) in various diseases. JAKi alter many other mediators affected by the JAK STAT pathway. For instance, T cell signature in blood that is proliferative was associated with a response in RA.
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This is particularly interesting considering this 👇🏼👇🏼
First RCT of NI auricular vagal nerve stimulation did not meaningfully improve RA disease activity or outcomes.
No SAEs
Is this supporting the need for other VNS modalities?
@RheumNow #ACR23 ABST0837 https://t.co/yFcMPoSc31 https://t.co/G069XwUyAz
Aurelie Najm ( View Tweet)
What is D2T PsA?
A proposal of definition in ABST0777
Thoughts:
A lot of features are extrapolated from the EULAR RA definition
RA & PsA population are hardly comparable
Lack of emphasis more problematic domains ie. dactylitis
Further work is required
@RheumNow #ACR23 https://t.co/A28e6XBME3
Aurelie Najm ( View Tweet)
Fascinating how upadacitinib may well have an effect on pain in RA, beyond inflammation.
Now seen similar for bari in RA & guselkumab in PsA. And, if real, for some people could be a massive get. Love to see dedicated studies
SELECT-COMPARE post-hoc #ACR23 ABST0429 @RheumNow https://t.co/Tk278mGJYY
David Liew drdavidliew ( View Tweet)
Klein et al. 205 RA-ILD. MUC5B not significantly associated survival, although wide CIs, aHR 0.75 (0.45, 1.24). Abstr#0772 #ACR23 @RheumNow https://t.co/ZfIIr2BbbR https://t.co/47DPYWNpL9
Richard Conway ( View Tweet)
FAPα possible therapeutic biomarker target of pathogenic fibroblasts. #ACR23 Abs 0802 demonstrates potential therapeutic efficacy of fibroblast-targeted immunotherapy as a novel treatment in inflammatory disease. https://t.co/ZGUfC6PZxa @rheumnow https://t.co/jj9BeuvTuc
Dr. Rachel Tate ( View Tweet)
Plasma MMPs and RA-ILD. Strong association MMPs 7 & 9 with prevalent RA-ILD. Abstr#0770 #ACR23 @RheumNow https://t.co/5qWeK3lAly https://t.co/SyZY2OhcbH
Richard Conway ( View Tweet)
Always great to see UCSD represent at #ACR23!
Pregnant women with rheumatic diseases and antiphospholipid syndrome higher a HIGHER risk for acute cardiovascular events
30% of events occurred postpartum
@RheumNow Abs#0722 https://t.co/CqZedfOlBC
Robert B Chao, MD ( View Tweet)
Are anti CCP3 the new anti CCP2 antibodies?
Not yet!
Anti-CCP3 associated w/ diagnosis of RA in a population of patients w/ MSK symptoms
But… very strong overlap between CCP2 and 3 with only 3.4% positive for CCP3 negative for CCP2
@RheumNow #ACR23 ABST 0389 https://t.co/BHRqCbqEYw
Aurelie Najm ( View Tweet)
Detectable hs-cTnT at baseline was associated with future MACE HR 5.6, in the hsCRP high→low cohort with high inflammation at baseline, not vice versa. hs-cTnT may provide additional info for assessing CV risk, Weber et al, Abst#0387 https://t.co/M4zyz2tzIO #ACR23 @RheumNow https://t.co/omMgpRzBA5
Dr. Antoni Chan ( View Tweet)
Non invasive screening for pulmonary involvement in early RA
Combination of PFT and Lung 🫁 US:
-50% with interstitial or focal changes or pleural effusion on US
-58% with abnormal DLCO
Correlation w/ higher disease activity.
Pathological meaning?
@RheumNow ABST 0393 #ACR23 https://t.co/BBcOEgcJK2
Aurelie Najm ( View Tweet)
WEAR study: adherence to wearable activity trackers in RA
Something that is consistent across all wearable studies is low adherence
Here under 50% for PRO + tracking
In an already selected population!
To implement, we need to make this better?
ABSTRACT 0344 @RheumNow #ACR23 https://t.co/csVZlzABGt
Aurelie Najm ( View Tweet)
Year in Review: Dr. P Seo
⭐️Does Pizza consumption favor improved dz activity in RA?
If in Italy
➡️ 365 pts w/RA in Milan: 18-65 yo w/ >3 mo dz
➡️Ate 1/2 a pizza > 1x/wk w/ decr in dz activity (SDAI⬇️: -3.6)
➡️Mozzarella & olive oil showed beneficial effects
#ACR23 @RheumNow https://t.co/qZTzThI39e
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Towards more personalised care in rheumatoid arthritis #ACR23 @RheumNow https://t.co/roxtcX8QHI
Dr. Antoni Chan ( View Tweet)
RA as a young woman used to mean kids were only a distant thought.
Japanese RA pts n=280 asked whether RA onset meant wanting fewer children & why.
Confidence improving across the board over time.
We want to give our RA pts choices to live their life!
#ACR23 ABST0473 @RheumNow https://t.co/OHZM2J5qxS
David Liew drdavidliew ( View Tweet)
Year in Review: Dr. P Seo
Novel RA therapy on the horizon:
⭐️ABBV-3373
➡️ Adalimumab (ADA) + GC receptor modulator vs ADA
➡️ Phase II, 48 pts, previously failed MTX
➡️ Wk 12: better DAS28-CRP, ACR20/70
🚩71% of responders stayed in remission after switch to PBO
#ACR23 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Difficult to treat RA is not an homogeneous group!
Trajectory analysis 60months shows 4 different clusters
Cluster 2 = 1/3 of patients, do better but never reach LDA.
The ones Fibromyalgia, OA and other conditions blurring assessment?
#Abstract0382 #ACR23 @RheumNow https://t.co/dxxS7vCcMt
Aurelie Najm ( View Tweet)
Year in Review: Dr. P Seo
Novel RA therapy on the horizon:
⭐️Peresolimab
➡️ stimulates PD1
➡️ Phase II, 98 pts
➡️ tx-resistant to other therapies including biologics
➡️ Wk 12: better DAS28, ACR20, not ACR 50/70
#ACR23 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
YR in Review: Dr. Seo
🚩GLORIA Trial
RA pts > 65yo: prednisolone 5 mg/d x 2 yrs vs PBO + std care
➡️decr dz activity (DAS ⬇️0.37) but 24% incr ADE
🚩Extension:
➡️Tapered off pred over 3m and..
⭐️NO ADRENAL INSUFF
But, small incr in dz activity (DAS ⬆️0.23)
#ACR23 @RheumNow https://t.co/YQbS6C8ZT5
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
It seems so simple. We should be able to use proteomics to better pick winners when it comes to b/tsDMARDs in RA.
Why is it hard? I guess:
- theory ≠ practice
- too many other factors
- it's too easy not to
Yet I hope/believe, one day we'll do better.
#ACR23 ABST0427 @RheumNow https://t.co/5VBVp3KOJN
David Liew drdavidliew ( View Tweet)
