These year’s annual ACR Convergence has been a success with the return of an insanely active Poster Hall! F2F learning amidst miles of research and many young talented aside wizened establish presenters is such a welcome return to ACR, the way it should be.
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For as long as I can remember, methotrexate has been the anchor drug treatment of rheumatoid arthritis. We also know it has limited oral bioavailability at doses greater than 15mg. There are subcutaneous forms that offer better bioavailability, but its subcutaneous nature can sometimes sway patients away from trying it in addition to its higher cost. Split dosing of methotrexate can be a solution to attain higher bioavailability; however, its effect on clinical efficacy is unknown.
Richard Conway
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Telitacicept (BlyS/APRIL inhibitor) in MTX-IR RA. Phase 3 RCT. 479 patients. ACR20 60.0% vs 26.9%. ACR50 21.4% vs. 5.9%. Radiographic benefit also. Safety looks ok. Abstr#L20 #ACR23 #ACRbest @RheumNow https://t.co/qcinGeRX2d https://t.co/SIKKW7xhwV
Janet Pope
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#ACRbest Peter Merkel as Distinguished Investigator said Data are good.
Need data to develop questions, understand #vasculitis Hx of #vasculitis - great minds & drugs -
now challenged by funding and comparators
Session 15W127 #ACR23 @RheumNow @ACRheum https://t.co/5leIeLWZ6O
Richard Conway
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Tommasi et al. MTX (vs SSZ) lowers BP in RA in RCT. At 6 months, significant reduction in SBP (mean difference -4.0±10.8 mmHg, p=0.038), MAP (mean difference -4.3±17.9 mmHg, p=0.023). Abstr#2151 #ACR23 @RheumNow https://t.co/wAX3dCztxH https://t.co/mPG5TdeHTu
Janet Pope
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#vasculitis clinical trials are accelerating. Need the right time - early studies have lessons learned re feasibility and design/endpoints #ACR23 @RheumNow @ACRheum Great lecture - P Merkel 15W127 great graphs of vasculitis developments https://t.co/YRdPiaflxY
Aurelie Najm
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Knee OA, to inject or not to inject: the great debate 📣
A thread👇🏼👇🏼👇🏼
Maglette Klotenburg argues in favor, with moderation
IA GC improves pain
Repetitive injections can be harmful
@RheumNow #ACR23 https://t.co/3p4UVLngpx
Md Yuzaiful Md Yusof
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#ACR23 Abstr#2576 Promising therapy in Dermatomyositis. Phase 2 RCT showed rapid improvement in skin, muscle & patient reported outcomes as fast as Week 4 in PF-06823859 (anti-IFN-B) vs PBO. Could be useful to treat in either skin or muscle predominant patients @RheumNow #ACRBest https://t.co/Rj1k1z0Tsz
Meral K. El Ramahi, MD
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L20 @ #ACR23
New therapy on the horizon for RA pts that failed MTX?
⭐️Telitacicept = recombinant fusion protein targeting & neutralizing BLyS & APRIL
➡️ placebo-controlled, phase III trial, 24w
👉at wk 24, PBO pts switched to drug arm for 24 more wks
➡️ 479 pts w/… https://t.co/94MyC8sdaG https://t.co/x3MUmFJPK6
Janet Pope
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What happens when you stop #steroids and/ immunosuppressive Rx in Pts in remission for at least 1 yr in #IgG4 disease?
You are likely guessing correctly
Pts flare! Don’t stop Rx
?taper 🤷♀️
Like RA Rx - if stop Rx = flares
Large RCT from China L16 #ACR23 @RheumNow @RheumNow
Janet Pope
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#IA Injection in #knee #OA.
TLC599 vs #dexamethasone vs saline #RCT-blinded.
Both active #Rx better than #PBO. Some differences in average daily pain between active drugs.
Not sure where it may fit in? After IA steroid failure?
L18 #ACR23 @ACRheum @RheumNow https://t.co/rLh6ISBpUw
Md Yuzaiful Md Yusof
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#ACR23 Abstr#2578 AI to phenotype sporadic IBM vs AI Myositis
-Anti-NT5c1A assoc with dysphagia
-Anti-Ro52/TRIM21: female
-Anti-VCP: male
-Anti-NT5c1A + clinical markers: high accuracy in separating SIBM vs AIM
Need longitudinal data for clusters to be meaningful @RheumNow https://t.co/fu0a074XAZ
#ACR23 BEST Abstracts from San Diego – Day 1
From hundreds of online presentations, the poster floor and the plenary podium, here are some of the best abstracts from 11/12/23. You can spot these on Twitter by looking for the (#ACRbest) hashtag.
https://t.co/h4RvFy66z9 https://t.co/LEhAUaw6Cj
Eric Dein
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Palliative Care & Rheum - #ACR23 @RheumNow
Consider Pall Care for Serious Illness: "high mortality risk & negatively impacts function or QoL OR strains caregivers" - thats a lot of rheum pt
@HopkinsBayview-led session, always pt-centric
@kekuchinad @MymaAlbaydaMD @jhrheumatology https://t.co/1j4lrkb5Ra
Mithu Maheswaranathan, MD
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Clinical Year in Review at #ACR23
By @philseo (@jhrheumatology)
Review some of the most impactful scientific studies in #Rheumatology in the past year! 🍕 https://t.co/ystEjzrU8u
Daily Recap - TUESDAY https://t.co/Vq5BSHmPsv
Aurelie Najm
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ARTIC REWIND RCT 3 yrs csDMARD withdrawal
38% 3yrs csDMARDs free remission vs. 80% stable dose gpe
75% recovery after restart
Rx progression 19% in half dose gpe
More use bioDMARDs (18%) & GCs (50%) withdraw gpe
Trends towards lower infections
@RheumNow #ACR23 #ACRBest https://t.co/jhOINV7LLS
Aurelie Najm
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Tapering ABA vs. stable dose ABA in RA
No diff in DAS28 remission at 2 years
But…
Only in patients receiving concomitant MTX
Those tapering ABA mono also experience higher functional important
Of note: not an RCT
@RheumNow #ACR23 ABST2542 https://t.co/yycCDTnRiF
David Liew
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Rheumatologist - pharmacist co-management of MTX initiators @GeisingerHealth Philadelphia
Having the dual skill set actually helped with adherence to guidelines vs standard care. Would be great to see how this works with implementation in RA clinics
#ACR23 ABST2484 @RheumNow https://t.co/88R1BYzYn5
sheila
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Complements & HCQ? (Prof Petri et al)
Significant ⬆️ in C3 (p=0.022) & C4 (p=0.003) levels with HCQ whole blood levels >50 ng/mL
Increasing blood levels of HCQ significantly assocd w/⬆️prob of achieving normal C4
Improving C3,C4; addtl benefit of HCQ?
#ACR23 ABST2327 @RheumNow https://t.co/5ucpXq9ngb


