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Bimekizumab is Coming… in Third Place
Of the many exciting advancements for patients with psoriatic arthritis at ACR Convergence, one upcoming therapy stood out: the dual IL-17A/F inhibitor bimekizumab. Nearly two dozen bimekizumab abstracts will be featured at this year’s meeting and it recently received authorization in Europe and the U.S. for psoriasis. That makes this the year I plan to figure out where this drug will be useful for my patients with PsA.
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Glucocorticoids-free zone in SLE?
For over 70 years, glucocorticoids, (GC) have been a part of standard therapy in SLE. They are classically used to not only induce remission or treat an acute flare, but also as maintenance therapy. They are a valuable 'friend' if used wisely, and can become a 'foe' if used excessively.
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Real-life data about the PEXIVAS reduced-dose glucocorticoid regimen in #granulomatosis with polyangiitis and microscopic #polyangiitis (Abstract 0725 https://t.co/7x34Hr0OMP)
@TerrierBen
#ACR23
#ACRambassador https://t.co/D8UfZvXQCl
Alessia Alunno ( View Tweet)
ABS0524:
⭐️Benefit of Certolizumab (CZP) over standard non-biologic tx in reducing acute anterior uveitis (AAU) flares among high risk pts w/ axSpA
➡️active dz, HLAB27+, 2 or more AAU flares
⭐️CZP reduced AAU flare rate by 87%
#ACR23 @RheumNow
#ACRBest https://t.co/rW0N18agMO
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Are we tapering steroids too rapidly? Real world experience: steroid tapering in severe #AAV based on #PEXIVAS protocol noted higher rates of dz progression, relapse, ESRD, death. Risk greatest when creatinine > 300umol/L and w/RTX induction #Plenary1 #ACR23 Abst#0725 #ACrBest https://t.co/Rtv7vkzUUD
TheDaoIndex KDAO2011 ( View Tweet)
Ph2a Nipocalumab: FcRn blocker
IV15mg/kg TNF IR RA 32 pts
Delta DASCRP -1 vs -0.5 PBO
ACR50 20% vs 0 PBO
DAS Remission 40% vs 16% Only in ACPA+ pts
SAEs 1 infusion related reaction
Not extremely convincing alone
Currently studied in combination w/ TNFi
@RheumNow #ACR23 ABST0839 https://t.co/6wTu2ellhN
Aurelie Najm ( View Tweet)
Lots of our patients taking CBD products, and they won’t always tell us…
but if you don’t ask, you’ll miss the drug-drug interaction that affects the meds we rely on.
#ACR23 @US_FDA session @RheumNow https://t.co/Q9UMJiTDkq
David Liew drdavidliew ( View Tweet)
Ab#498 Does DMARD for PsO and PsA decrease MACE?
#ACR23 @RheumNow
Retrospective database Israeli study.
PsO, PsA on MTX or bDMARD: lower MACE compared to health matched controled (HR 0.45-0.68, p<0.001)
Pts on topical Rx had marginally Increased MACE (HR 1.14, p <0.001) https://t.co/0uRgjzYbFp
Eric Dein ( View Tweet)
#Benefits of #hudroxychloroquine - reduced lipids, clots, CV events, infection AND now improved #fatty #liver #NAFLD….@RheumNow #ACR23 @ACRheum https://t.co/Y43JETY6F3
Janet Pope ( View Tweet)
Important plenary re:reduced vs standard GC for AAV... IRL
PEXIVAS & recent guidelines supported low dose taper
Real world data w/severe dx? Increased risk of death & ESKD for REDUCED pts
Need full data but yikes...
@RheumNow #ACR23 #ACRBest https://t.co/3S23O9d1ok
Mike Putman EBRheum ( View Tweet)
Interesting study on PEXIVAS reduced steroid use from today's plenary session!
Reduced steroid dose in GPA/MPA pts associated w/
INCREASED risk of death, ESKD, progression of dz
Even greater risk in pts with higher Cr lvls or RTX induction use
@RheumNow #ACR23 Abs#0725 #ACRbest https://t.co/frsOrANKhf
Robert B Chao, MD ( View Tweet)
Real world data on low dose PEXIVAS steroid by Nagle et al. Increased risk of progression/relapse/death/ESKD in those with severe GPA/MPA HR 1.72. More marked in those with creat>300 or with RTX induction Abstr#0725 #ACR23 @RheumNow https://t.co/vTXVZfjbXx https://t.co/4FuMjxOuyB
Richard Conway ( View Tweet)
Higher disease activity and systemic inflammation at baseline associated with greater risk of MACE in bDMARD nonusers but not in users. bDMARD-specific benefits directly on MACE risk beyond reducing inflammation, Karpouzas et al Abst#0391 #ACR23 @RheumNow https://t.co/lfoccZffTW https://t.co/ASpKYQof1I
Dr. Antoni Chan ( View Tweet)
YR in Review: Dr. Seo
🚩GLORIA Trial
RA pts > 65yo: prednisolone 5 mg/d x 2 yrs vs PBO + std care
➡️decr dz activity (DAS ⬇️0.37) but 24% incr ADE
🚩Extension:
➡️Tapered off pred over 3m and..
⭐️NO ADRENAL INSUFF
But, small incr in dz activity (DAS ⬆️0.23)
#ACR23 @RheumNow https://t.co/YQbS6C8ZT5
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Yet another (mostly) reassuring report about lymphoma and DMARDS
The skin cancer signal in the CIRT trial was weird; would be worth looking into that in observational studies as well @NamrataRheum
#ACR23 Abst0438 @RheumNow https://t.co/Beg8UUe2mn
Mike Putman EBRheum ( View Tweet)
Year in Review by Dr. P Seo
NORD-STAR trial:
⭐️Abatacept or Certolizumab >> Tociluzumab > triple therapy in tx of 812 early RA patients based on clinical & radiographic results
➡️tx-naive, all got MTX
➡️mod-sev dz activity
➡️randomized to 48 wks therapy
#ACR23 @RheumNow https://t.co/vy2uYuyOse
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Interesting question... but feels like some time related bias or perhaps confounding?
Seems implausible that MTX & biologic would be protective for PsO & harmful for PsA
@RheumNow #ACR23 Abstr 0498 https://t.co/pSRoLHRTAm
Mike Putman EBRheum ( View Tweet)
Nice VA study evaluating risk of lung cancer w/respect to RA treatment strategies
Take home? No association. Aside from the (small risk) w/JAKi's, I think malignancy risks have been mostly overblown
@NamrataRheum @RheumNow ABST0453 #ACR23 https://t.co/lDz0nV1KHt
Mike Putman EBRheum ( View Tweet)
PEXIVAS results: the reduced-dose GC regimen associated w/ ^ death, ESRD, and uncontrolled dz risk in severe GPA/MPA pts. Even greater risk in pts w/ creatinine levels > 300 μmol/L & in those tx w/ RTX induction. #ACR23 Plenary 0725 https://t.co/mBMrEaGj5k @rheumnow https://t.co/flAfYEKSXJ
Dr. Rachel Tate ( View Tweet)
Join us tonight at 6pm PT/ 9pm ET for our daily #ACR23 recap. https://t.co/0RDwTdzhwS
Dr. John Cush RheumNow ( View Tweet)
