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TNFi induction first year in RA leads to:
- less D2T RA at 5y
- more sustained remission from 10y onward
- less DMARD utilization
- less healthcare utilization
in these real-world matched cohorts
given biosimilar prices, this might be worth considering
#ACR25 ABST1677 @RheumNow https://t.co/uL9nHtLkXZ
Links:
David Liew drdavidliew ( View Tweet)
What is the secret of a VNS RCT that works in RA?
=> Implant the device!
RESET-RA RCT Sham controlled 3mo
Then open label in active arm for 66mo
40% pts IR to >=3 bioDMARDs
ACR 20 3 mo 42% vs. 19%
CDAI LDA 27% vs. 11%
82% TNF IR pt had no change in treatment over 12mo
99% https://t.co/lfxa4YXUB4
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Did we need a 2nd Interception RCT of HCQ in Pre-RA?
Unsure but in any case, it does not work either
STOPRA CCP3+>=2 ind 71 HCQ and 74 PBO
36 months RA conversion
Dr Deane's take: "probably wrong drug rather than wrong timing"
#ACR25 @RheumNow #ABSTRACT1674 https://t.co/jysdo8iz7v
Aurelie Najm AurelieRheumo ( View Tweet)
New tx for IPF/autoimmune ILD, nerandomilast (PDE4Bi)
Subgroup analysis from FIBRONEER-ILD, marginally less FVC worsening (-65mL tx grp vs -107mL plbo grp) & no clear improvements in dyspnea/fatigue/cough
But also... 6% absolute reduction in overall, persisted (small n) in https://t.co/Faf26UZuDx
Links:
Mike Putman EBRheum ( View Tweet)
In a cohort of 269,304 IBD patients, NSAID use showed a small increase in IBD-related hospitalisation (HR 1.08), meeting non-inferiority threshold (HR <1.2). No risk in UC (HR 0.96); modest risk in Crohn’s (HR 1.16). Relooks at the current paradigm of blanket NSAID avoidance in https://t.co/O8MWg1BP50
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Interim analysis of Ph3 TULIP-SC trial:
Anifrolumab 120mg SC or PBO weekly + SOC x 52wks
Primary endpt met: BICLA response w/Anifrolumab (60.3%) vs. PBO(43.9%)[p=0.014]
Pts on Ani had sustained BICLA response upto wk 52 (HR 2.1)
Promising results.
#ACR25 @RheumNow Abs1545 https://t.co/nqse1BiGq2
Links:
sheila RHEUMarampa ( View Tweet)
Fragoulis et al. Real world study of bimekizumab demonstrates equal efficacy in IL-17i naive and exposed. @RheumNow #ACR25 Abstr#1439 https://t.co/aCcLgnKvFJ
Richard Conway RichardPAConway ( View Tweet)
In a prespecified exploratory analysis of REGENCY trial data by DrRovin et al,
Bet. wks 24 and 76:
Obinutuzumab ⬇️ LN flares vs. PBO (HR 0.44; p=0.0074)
Pts on Obi had less unfavorable kidney outcomes vs. PBO (HR 0.37; p=0.0039)
Addtl tx option for LN
#ACR25 @RheumNow Abs1521 https://t.co/N5K9Nzh71E
sheila RHEUMarampa ( View Tweet)
Post-hoc analysis of CARE(Ph2B) Study to assess sustained responses in mSLEDAI-2K vs. PBO x 12mos in pts given Cenerimod
Sustained response in Cenerimod Ex-4mg (63.5%) > PBO (50%); HR 1.43
Ongoing research, further data needed.
#ACR25 @RheumNow Abs1519 https://t.co/cQbVVIIyxW
sheila RHEUMarampa ( View Tweet)
Mayer et al. NSAIDs in IBD. Retrospective cohort study. 250000 individuals. Non-inferiority study. No increased IBD-related hospitalisation in UC, but an increase in all-cause hospitalisation. @RheumNow #ACR25 Abstr#1434 https://t.co/he2Xmcqslk
Richard Conway RichardPAConway ( View Tweet)
In ICONIC-LEAD, adolescents (12 to <18 years) with moderate-to-severe psoriasis treated with icotrokinra (ICO) achieved Investigator Global Assessment (IGA) 0/1 in 84.1% vs 27.3% (placebo) and PASI 90 in 70.5% vs 13.6% at Week 16. Week 24 responses reached 88.6%. Safety profile https://t.co/L7h8BlnWaO
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Concerns using dupilumab in EGPA due to secondary eosinophilia
What about when combined with IL-5 therapy?
16 pt on dupi + IL5 agent
- if dupi alone caused eosinophilia -> quelled by IL-5
- no eosinophilia when dupi added to IL-5
- effective but slow
@RheumNow #ACR25 Abst 1605
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Case series of 5 patients with binutuzumab (CD20) in AAV
Short story short; it worked. Of course it worked. Obviously it worked. Everyone knew it would work.
Why aren't we doing more TRIALS with new/better B cell inhibitors in AAV?
#ACR25 @RheumNow Abstr#1601 https://t.co/H6Zz3Tf3xo
Mike Putman EBRheum ( View Tweet)
Don’t forget
👇
#lcSSc Pts can get and progress #ILD
1/3 of #limited #cutaneous #systemic #sclerosis #scleroderma GET ILD
From #EUSTAR
>14% progress
Esp +Scl70
Remember to screen #CREST Pts
& allow these Pts into lung disease trials
#ACR25 @RheumNow @ACRheum abst#0879 https://t.co/X15tUgClzN
Links:
Janet Pope Janetbirdope ( View Tweet)
Liraglutide had decreased synovial inflammation and fibrosis in mouse models, however dexamethasone didnt have changes in fibrosis scores
Abst#1734 #ACR25 @RheumNow https://t.co/O4JYGtDD5N
Bella Mehta bella_mehta ( View Tweet)
Safety & benefit of #Deucravacitinib in #SLE #LTE #PAISLEY #RCT
👇
over 4 yrs
Stable response sustained over 4 yrs
No new Safety signals
Await Ph3 RCT results - fully enrolled
#SoTyktu
Abst#LB10 #ACR25 @RheumNow @ACRheum https://t.co/ZpmzOYVnq9
Janet Pope Janetbirdope ( View Tweet)
Avouac et al. Lipid changes after JAKi initiation. 85 patients. Increases at 6 months. Largely appeared driven by HDL increase, and correlated CRP decrease. Appeared transient with return to baseline with time. @RheumNow #ACR25 Abstr#1333 https://t.co/CQ6u3ck1Ch
Richard Conway RichardPAConway ( View Tweet)
RheumNow’s expanded coverage of the #ACR25 annual meeting is sponsored by Bristol Myers Squibb, Novartis, and UCB. All coverage content is independently selected by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)
Ultra-low dose (ULD) RTX in AAV maintenance
200mg q6 mo vs. 500mg q6 mo interim analysis
No major difference in infection risk or hypogammaglobulinemia thus far but both doses appeared similarly efficacious
#ACR25 @rheumnow Abst 1609 https://t.co/ZGYNVGY3dr
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Icotrokinra, the new kid on the bloc!
Targeted oral peptide IL-23R-inhibitor
Effective in Ph2 and Ph3 in PSO Adults
Data in Adolescents (12-18yo) with PSO
ICO 200mg QD 44pts vs. PBO 22pts 16wks
All pts received ICO wk16-wk24
Clear/Almost clear skin IGA 0/1 84% vs. 24%
PASI 90 https://t.co/77YvXtdLi1
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
