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Potential new treatment for Sjogren's
Is there finally something new on the horizon in Sjogren’s syndrome?
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Mitochondria as Master Regulators of Inflammation
Mitochondrial constituents and metabolic products may give rise to immune activation; this is especially true for mitochondrial DNA, which can function as damage-associated molecular patterns (DAMPs) leading to inflammasome activation.
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Pike M Abstract 1113. Remibrutinib (LOU064) in Sjögren’s Syndrome: Safety and Efficacy Results from a 24‑Week Placebo-controlled Proof-of-Concept Study #ACRBest #ACR22 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
Fulvio et al. Labial gland US to identify lymphoma in Sjogrens. OMERACT score of 3 in 100% of lymphoma and 35% non-lymphoma @RheumNow #ACR22 Abstr#1254 https://t.co/aspctOfGp8 https://t.co/CLhN2PTvaS
Richard Conway RichardPAConway ( View Tweet)
Plenary:
Remibrutinib (LOU064) a BTK inhibitor in Sjogren’s
◦ Favourable safety profile
◦ Well-tolerated over 24 Wks
◦ Improved ESSDAI, salivary flow, Igs
◦ May be first effective oral disease-modifying therapy for SS
Dorner T Abs1113 https://t.co/FkgJpwKAJL #ACR22 @RheumNow https://t.co/znxMc27EBI
Dr. Antoni Chan synovialjoints ( View Tweet)
Sjogren’s is tough to study, isn’t it?
LOUiSSe (remibrutinib proof-of-concept SjS) - benefit with:
- ESSDAI (primary, obj dx activity) ✅
- auto-Ab ✅
- all patient outcomes ❎
Has already exceeded many attempts
Even then, still some limitations
ABST1113 #ACR22 @RheumNow https://t.co/NlBaFVuuPa
David Liew drdavidliew ( View Tweet)
Ab1113 #ACR22 Remibrutinib (LOU064, BTK inhib) in Sjogren's
Will there be new Rx for Sjo?
T Dorner: 73 pts Ph2 BTK 100mg BID/100 QD/PBO
Better ESSDAI at wk 24 (p=0.003)
Unstim saliv flow: improved vs PBO, not stat signif
Decreased CXCL13 chemokine
PROs not improved
@RheumNow https://t.co/hJp33JPpHt
Eric Dein ericdeinmd ( View Tweet)
Sjogren's in a Plenary! Remibrutinib (BTKi) in SjS
Improved ESSDAI at wk 24, but NONE on ESSPRI (more patient-centric ie fatigue, dryness, joint pain)
Definitely helps w/lab abnormalities, but worried benefit for outcomes that matter may be limited
#ACR22 @RheumNow abstr#1113 https://t.co/GutY8KndbR
Mike Putman EBRheum ( View Tweet)
Initial Remibrutinib (oral, covalent, and highly specific inhibitor of Bruton’s tyrosine kinase (BTK)) data in SS shows good efficacy and safety. Plenary Abs 1113 #ACR22 @RheumNow https://t.co/5Zr0Y1ueAv https://t.co/Iy194YUWNC
Dr. Rachel Tate uptoTate ( View Tweet)
2nd Plenary Session!
Remibrutinib (BTK inhibitor) for treatment of Sjögren's syndrome (phase 2 study)
Improvement of ESSDAI, salivary flow and pathologically elevated Ig's
Abs#1113 @RheumNow #ACR22 https://t.co/vdgxBPe6qd
Robert B Chao, MD doctorRBC ( View Tweet)
Mimics of Sjogren’s Syndrome @RheumNow #ACR22 https://t.co/nEAXKb6qF0
Dr. Antoni Chan synovialjoints ( View Tweet)
Low dose IL-2 works in Primary Sjogrens Syndr (pSS)? RCT 60 pSS pts rx w/ PBO vs LD-IL-2; latter lower ESSDAI @wk 24 (67% vs 27%; P=.004) & less Sxs (dryness,fatigue) @wk12 and expansion of TREGs & CD24highCD27+ B cells. https://t.co/39U6WX7ceM https://t.co/i56XDSvGXs
Links:
Dr. John Cush RheumNow ( View Tweet)
Here's a nice slide comparing Sjogren's disease and Sarcoidosis:
#ACR22 @RheumNow #acrreview #MedTwitter https://t.co/MQQx3GBl5f
sheila RHEUMarampa ( View Tweet)
Sialadenosis is a mimic of #sjogren - it related to fatty infiltration/metabolic syndrome. Correct underlying issue and pts will improve - Dr S McCoy @rheumnow #acrreview #acr22 https://t.co/bZPj1LmERs
TheDaoIndex KDAO2011 ( View Tweet)
Wonderful slide by Dr. Sarah McCoy on #Sjogrens #ACR22 @RheumNow
Broad differential for these patients when they present in clinic:
📍Ask about:
🚬 habits
💊 meds
🍬 🩻history: #diabetes, past radiation exposure
🦠 infection (#HIV, #HCV)
🩸 #vitamin deficiency https://t.co/6Qo23lWBs4
Catherine Sims, MD DrCassySims ( View Tweet)
Sjogrens - Dx tips, myths & mistakes:
• SS not rare; affects 1 in 400
• 95% female, but SS is more severe in men
• African Americans have a severe systemic phenotype
• Asians report dryness Sxs
• Smoking & alcohol intake often avoided by SS pts
https://t.co/B2hR7z8H5Z https://t.co/g0FKhcmoXa
Links:
Dr. John Cush RheumNow ( View Tweet)
Multicentre matched control study looked at primary Sjogrens that developed lymphoma or NOT. Parotid swelling (PSW) is an early major predictor of non-Hodgkin lymphoma in pSS; esp if present before or dx, & w/ a longer duration of PSW https://t.co/QokXF6klEv https://t.co/YqFgAqt4ku
Links:
Dr. John Cush RheumNow ( View Tweet)
🌏 Today is World Sjögren's Day!🌍
🩺 Sjögren's is not Just Dry eyes👁️ and Dry Mouth👅👄 - there's much more to it
There's still a lot about this 'invisible' #Autoimmune Disorder, we don't know
Clinical Features and Pathogenesis
#LetstalkaboutSjögrens
#MedTwitter
#RheumTwitter https://t.co/t9toed8MG7
EnvisionRheumat ERheumat ( View Tweet)
#EULAR2022 Prof Schulze-Koops highlighted a mechanistic study that baricitinib therapy ex vivo suppressed autophagy, increased apoptosis, and reduced expression of adhesion molecules in #sjogren salivary glands. Next step should be randomised controlled trial cc: @Yuz6Yusof https://t.co/1tDBNzTuwQ
Dr. John Cush RheumNow ( View Tweet)
Environmental articulate matter (PM2.5) levels can increase the odds of a systemic autoimmune rheumatic disease onset (OR 1.12; 1.08–1.15), , w/ no effect of ozone. Results not changed by controlling for smoking. https://t.co/7BGBh9h0lf https://t.co/LcUo4Lxzgx
Links:
Dr. John Cush RheumNow ( View Tweet)
