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ACR20 - Day 2 Report
Saturday was the day 2 with many posters and live sessions at the 2020 Virtual ACR/ARP meeting. Here are a few of my highlights from day two:
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Decreasing immunogenicity, improving efficacy of pegloticase in gout
At #ACR20 three different medications are reviewed in different studies to decrease the immunogenicity of pegloticase – Methotrexate, Azathioprine and Mycophenolate Mofetil.
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Outcomes Switching to Monotherapy: SEAM-RA Trial
Combination therapy with biologic and conventional DMARDs can be highly effective at inducing remission in patients with RA. Once controlled, patients are often interested in stopping combination drug therapy due to concerns related to medication burdens, side effect profiles, or safety.
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ACR/AF JIA guidelines presented @ACR20:
👉Initiate DMARD early over NSAID monotherapy
👉Use SQ MTX> oral MTX > SSZ/LEF
👉add biologic preferred over triple DMARD
👉DON'T use chronic low dose steroids
👉combo biologic+DMARD > biologic monoRx
https://t.co/lwoFSTuV91
@rheumnow https://t.co/wzh2LCS0dN
k dao KDAO2011 ( View Tweet)
Trivia from John Stone's pearls talk: Which is the biggest risk factor for disease flare in GCA? (All are statistically signif RFs). #ACR20 @RheumNow
Eric Dein ejdein1 ( View Tweet)
John Stone: "The HISTORY is the Rheumatologist's scalpel." TA bx is not gold standard in diagnosis, as not fully sensitive. @RheumNow #ACR20.
Eric Dein ejdein1 ( View Tweet)
Abatacept in IgG4-RD. Plausible, but does it work?
Pilot n=10 @MGHrheumatology
ABA +<4w PNL
Some hit, some miss - but mechanistic correlates of response: Tfh2, unswitched memory B cells.
Exploring new options (w real benefit) very welcome in IgG4-RD!
#ACR20 ABST1480 @RheumNow https://t.co/0saS941Lga
David Liew drdavidliew ( View Tweet)
#ACR20 Dr. M. Crow on Lupus #StateofArtLecture reviews treatment of SLE:
1. HCQ is the foundation of Rx
2. keep pred <7.5mg/day
3. belimumab works better when given early in disease (<2 yrs)
4. combination Rx may be needed
@rheumnow https://t.co/6zh1xkLXgN
k dao KDAO2011 ( View Tweet)
Both fat mass and fat free mass have an impact on the response to bDMARDs after 6 months of treatment in AS pts. No tx response changes w/ skeletal muscle mass, visceral fat as well as water components. #ABS1376 #ACR20 @RheumNow https://t.co/oIdE8qvJPp https://t.co/wlXFf8esey
Dr. Rachel Tate uptoTate ( View Tweet)
5yr DESIR cohort data estimated incidence rate of uveitis at 1.3/100p-y; over five years, uveitis was associated w/ dactylitis, biologic and sacroiliac MRI inflammation. #ABS1304 #ACR20 @RheumNow https://t.co/qmXlY7PmBB
Dr. Rachel Tate uptoTate ( View Tweet)
Important thoughts- how do we actually use the biologics in practice for the rare diseases that do not have many FDA approved options? @RheumNow #ACR20 abstract 1429 https://t.co/SsYC1kF5uv
alexa meara lexmeara ( View Tweet)
Feasibility of 18F-fluorodeoxyglucose Positron Emission Tomography to Monitor the Effect of Tocilizumab on Vascular Inflammation in Giant Cell Arteritis: A Prospective Observational Cohort Study https://t.co/Z91MhXJ5HK #gca #tocilizumab #pet what about the radiation?
Peter Nash drpnash ( View Tweet)
The Use of Tocilizumab and Tofacitinib in Patients with Resolved Hepatitis B Infection: A Case Series https://t.co/2OBy0lxd6b #hepb #tocilizumab #tofacitinib no reactivation in resolved infection
Peter Nash drpnash ( View Tweet)
Reducing Immunogenicity of Pegloticase (RECIPE) w/ concomitant use of MMF in pts w/ refractory gout is a phase II double blind RCT that shows sustained serum urate lowering effect in addition to decrease in monthly rate of flares. #ACRbest #Abst0952 @RheumNow Practice changing? https://t.co/Z7GwCXZftE
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Based on RECIPE, how many of you will use MMF concomitantly with start of pegloticase in treating refractory gout patients? #ACR20 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Dr Khanna presents RECIPE RCT of MMF to reduce immunogenicity of pegloticase. Sustained urate response ≤6mg/dL at 24 weeks 68% with MMF compared to 30% in placebo. @rheumnow #ACR20 Abstr#952 #ACRbest https://t.co/64nN5AqK3W
Richard Conway RichardPAConway ( View Tweet)
Today's #ACR20 lecture @r_burmester shows the biologic revolution was a result of serendipity -- this will spark the long-awaited new & improved name of our profession: serendipitology! Hi I'm Dr. Worthing I'm a Serendipitologist. I use drugs intended for infections, cancer etc.! https://t.co/buDqwAVK9u
Angus Worthing MD AngusWorthing ( View Tweet)
After the SEAM-RA study, in patients taking MTX and ETN in sustained remission would you? #ACR20 @rheumnow
Richard Conway RichardPAConway ( View Tweet)
We have great options all around! Both are efficacious in biologic (TNFi) failures for RA patients.
Comparative Clinical Efficacy of Sarilumab versus Upadacitinib over 12 Weeks: Matching-Adjusted Indirect Comparison Analysis Abst#0827 #ACR20 @RheumNow
https://t.co/1SsL9qLJD3
k dao KDAO2011 ( View Tweet)
@RheumNow #ACR20 abs0710 early biologic therapy (BT) in JIA: Early BT=better outcome ( 81.8% on TNFi). BT start after 7,5mo from Dx correlates w/higher probability of active disease at 2 yrs (S=0,67 E=0,63). In active group at 2y 75% arthritis, 16,7% uveitis& 8,3% both. #ACRbest
Olga Petryna DrPetryna ( View Tweet)
