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New insights in RA-ILD therapeutics

Aurelie Najm, MD, PhD Jun 04, 2021

RA associated ILD (RA-ILD) is the most common extra-articular manifestation in RA. Its prevalence varies considerably, ranging from 5% to 30%, and is often underestimated since patients only become symptomatic or display abnormalities on chest X-Ray at a late stage of disease, leading to subsequent delay in diagnosis. In this context, several groups advocate for an earlier and more precise detection, using high resolution chest computed tomography (HRCT), which is the most sensitive for pre-clinical RA-ILD diagnosis.
But why would we want to diagnose early a manifestation that we cannot treat?

Q-DAPSA for Measuring Disease Activity in PsA by Dr. Rachel Tate ( @uptoTate) #EULAR2021 https://t.co/fbi3Kbd2GS https://t.co/afRnle1EJK

https://bit.ly/3fKa12y

DISCOVER 1&2: whole blood transcriptome in PsA: dysregulation of immune cell profiles vs. Ctrl Guselkumab modulates genes expr towards normalization of immune cell composition. Would be interesting to look at STissue signatures too 🧐 @StefanSiebert1 #POS0195 @Rheumnow #EULAR2021 https://t.co/7WChCP3U6W

#EULAR2021 POS0226 Bimekizumab (anti-IL17A and IL-17F) 160 mg Q4w for AS, 3yr phase 2b, open-label extension wk 48-156). Efficacy sustained ASAS40 63%. AEs: pharyngitis, URI, bronchitis, ⬆️ ALT, oral candida (mild/mod). @RheumNow.

Novel target (IL23-i; Guselkumab) in treating TNF-IR #psoriaticarthritis. Dr Coates presented results from Phase III COSMOS. 44.4% of GUS-treated vs 19.8% Placebo-tx achieved ACR20 response at Wk24 (p<0.001). Well tolerated and No major safety #EULAR2021 #OP0230 @RheumNow https://t.co/EuGaacSuxF

Zara Izadi presents @rheum_covid data on machine learning algorithms to predict ARDS in RMD patients with COVID. Gradient boosting machine had 81% sensitivity to predict ARDS from baseline data @RheumNow #EULAR2021 Abstr#OP0288 https://t.co/tHlPzeX9He

RheumNow’s expanded coverage of the #EULAR2021 Annual meeting is sponsored in part by Novartis, Bristol Myers Squibb, Janssen. All content chosen by RheumNow & its faculty.

Check out our Lupus content from #EULAR2021 at RheumNow. https://t.co/Gmh4sFv4Jl https://t.co/yBkbeMn0Yd

https://bit.ly/3z1NV2T

#OP0227 #TYK2 inhibitor deucravacitinib showed good efficacy in #PsA patients vs. placebo in phase 2 16weeks Primary endpoint ACR20 12mg: 62.7% 6mg: 52.9% PLC: 31.8% + well tolarated: no serious adverse events #EULAR2021 @RheumNow https://t.co/6SFqWd79db

Prospective analysis #OP0220 showed that PsA pt age, dz duration and activity level at tx initiation have ⬇️ with TNFi over the past 20 years. TNFi retention rates have ⬇️ while remission rates have ⬆️ (notably those in 1st yr tx) #EULAR2021 @RheumNow https://t.co/gnKRfvbHPQ https://t.co/PRunGIxMwx

https://ard.bmj.com/content/80/Suppl_1/131.2

IL-17i expressed in overuse tendinopathy. Secukinumab for tx of rotator cuff tendinopathy? ⭐️Phase II study - no difference in rotator cuff score (WORC) vs placebo ⭐️no difference in pain score Abs#POS0022 #EULAR2021 @RheumNow

Pregnancy is a minefield for RA pts: dx activity➡️preg risk PNL➡️preg risk, but dx activity proxy? bring on Swedish/Danish linked data: 1739 RA preg matched 1:10 ⬆️pre-term/SGA risk with bDMARDs/PNL adj for dx activity: less bad, but still concern? OP0210 #EULAR2021 @RheumNow https://t.co/AlwFtmGcZH

Ever wonder why one drug works in a pt & not another? Study of bio markers in PsA from RCT of #upadacitinib vs #adalimumab shows diff pathways affected by each drug & some overlap too @RheumNow #EULAR2021 @eular_org OP0030 https://t.co/WifrVOIMkW

UPSTREAM results #OP0223 suggest that the newly developed and preliminary validated MSKUS PsA dz activity and damage scores could be used in observational and controlled trials. #EULAR2021 @RheumNow https://t.co/Tw7OWyMcgX https://t.co/WiT0yGwVqK

http://ow.ly/dBaI50F2i4y

In the ESPOIR cohort of 813 RA followed for 10 years, polypharmacy associated w/ less DAS28 ESR Remission at 5 (45.0% in vs. 56.3% (p=0.03)) and 10 yrs (32.5% vs. 67.5% (p=0.06)) BUT no longer significant when adjusted for comorbidities! #EULAR2021 @Rheumnow #OP0098 https://t.co/pSrr1dzKFP

Double hit”: #OP0015 Phase IIA ABBV-3373 (Adalimumab linked to GC receptor modulator GRM) vs. PBO and historic ADA show promising results with a satisfactory safety profile compared to ADA. A potential new IV drug in RA! #EULAR2021 @Rheumnow https://t.co/mqLtXx9zBI

Acute Coronary Syndrom incidence in > 24,000 RA from Nordic registers followed up to 5 yrs = 5.5/1000 pyrs. After 5yrs RTX show > risk of ACS compared to ETA. In patient with >= 2 previous DMARDs ABA, INF and RTX > risk of ACS compared to ETA. #EULAR2021 @Rheumnow #OP0114 https://t.co/MjW9LI2cjt

Patients with RA > 70yo and risk of severe infection: which therapeutic strategy is the safest? #EULAR2021 @Rheumnow #OP0116

Dr Yoshida analyze data from US registry 40,721 RA patients. High 2.11 [1.13, 3.96] and moderate 1.97 [1.13, 3.43] CDAI associated w/ > HR of major adverse CV events. HRs decrease during follow up. Tight and early disease control reduces CV burden! #EULAR2021 @Rheumnow #OP0101 https://t.co/A0ZYE4v8uf

In 16,448 RA from ACR’s RISE registry: no difference in disease activity TNFi and non-TNFi at 12 months. Stratified analysis: ⬆️disease activity for TNFi vs. non TNFi in patients of Black and Asian ethnicity. To be confirmed in independent cohorts. #EULAR2021 @Rheumnow #OP0117 https://t.co/7bFnOKR9uz

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