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Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab

d Meral K. El Ramahi, MD, FACP, FACR

Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated. 

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Effective Treatments for Rheumatoid Arthritis ILD

d Michael Putman, MD, MSCI

The American College of Rheumatology guidelines for the diagnosis and management of interstitial lung disease, which includes rheumatoid arthritis interstitial lung disease (RA-ILD), has been one of the most controversial topics in the runup to ACR Convergence.

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Day 2 Report - ACR Plenaries: Changing the Practice of Rheumatology

d Kathryn H. Dao, M.D.

Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.

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Anterior uveitis incidence across different axSpA treatments Large review and meta-analysis on TNFi, IL-17i, JAKi Immunomodulatory therapy protective against uveitis flare Greatest in TNFi and JAKi @RheumNow #ACR23 Abs# 2550 https://t.co/l3BTL3GuRt
Robert B Chao, MD  ( View Tweet)
#ACR23 Abs #L07 data do not support tapering of TNFi treatment among RA patients in sustained remission in 3 year study. https://t.co/d0ZBWDKZlB https://t.co/EdllyGUT1y
Dr. Rachel Tate  ( View Tweet)
Persistence of IL-17i vs. TNFi in PsA treatment Large database study Persistence of IL-17i slightly greater than TNFi over 12 months Are IL-17i a better longterm strategy for PsA pts? @RheumNow #ACR23 Abs# 2240 https://t.co/9km5XgXcLE
Robert B Chao, MD  ( View Tweet)
Baker et al. TNFi vs triple therapy by BMI. 907 patients from TEAR/RACAT. Those under/normal weight have a better response to TNFi, overweight/obese respond equally to both. Abstr#2541 #ACR23 @RheumNow https://t.co/SROD3esMCD https://t.co/ni3I8tD7wI
Richard Conway  ( View Tweet)
Great summary of the big takeaways yesterday at #ACR23. Always love talking to @KDAO2011 @EBRheum @RheumNow We get into the use of MTX, the safety on TNFs and what is in the purview of rheumatology practice https://t.co/jm0a8ndrsi

Eric Dein  ( View Tweet)

#ACR23 highlights from PlenaryII 🙉#RA #ILD seems that #TNFi is equal to other bDMARDs - was thought to worsen /cause it. 🙉Septra should be given with #rituximab and #steroids in #GCA to prevent #infections not just #PJP #ACR23 @RheumNow @ACRheum #ACRbest

Janet Pope  ( View Tweet)

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Cancer and TNF inhibitors

d Richard Conway, MBBChBAO, PhD

Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions. An oral presentation by Suarez-Almazor et al provided more supportive data on using TNFi in this population.

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ACR Best

#ACRbest Abstracts – Day 2

d Jack Cush, MD

Our reporters have been prolific in finding the hot abstracts, those that were most attended or those that are getting the most buzz on social media.  Here are RheumNow's #ACRbest abstract reports from Monday, November 13, 2023 at #ACR23, covering The Great Debate, SGLPT2 inhibitors in SLE, the SMART Study of MTX, TMP/SMX Prophylaxis, RA-ILD & TNF Inhibitors, cancer research and more. 

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Crude drug retention at 1 year was 65% for JAKi, significantly lower than for other modes of action (74%) and TNFi (77%). These results are driven by the severity of the disease of patients on JAKi compared to other MOA. Aymon R Abst#1692 #ACR23 @RheumNow https://t.co/LPDpWdjoLg https://t.co/Ztaz94omd9
Dr. Antoni Chan  ( View Tweet)
Obs study, bDMARDs & malignancy TNFi w/lower risk than ABA/RTX/IL6i & numerically lower than JAKs I'm a little skeptical... KM curves diverged w/~45 days, seems implausible? Agree w/first author, possible channeling bias @RheumNow #ACR23 Abstr 1678 https://t.co/1uL3j6kTSj
Mike Putman EBRheum ( View Tweet)
Sendaydiego et al. Comparative cancer safety b/tsDMARDs. 37,026 patient database cohort study. Compared to TNFi, RTX HR 2.2 (1.5, 3.3) ABA HR 1.7 (1.3-2.4), JAKi HR 1.3 (0.9-1.9). Abstr#1678 #ACR23 @RheumNow https://t.co/bTNtaNJrln https://t.co/qQBM2F2q8N
Richard Conway  ( View Tweet)
Ritux (OR 2.2), ABA (OR 1.3), JAKi (OR 1.3) significantly increase risk of cancer vs. TNFi Cohort of 37000+ RA pts starting bio/tsDMARDs (379 incident cancers) True biologic effect or confounding by indication in a generally more comorbid population? @RheumNow #ACR23 ABST1678 https://t.co/suj6mVBEC0
Aurelie Najm  ( View Tweet)
Large observational study of TNF use among patients with RA & cancer Overall encouraging, no negative impact on survival I'm kind of a TNF-truther on this; I don't think they cause ANY increased risk of malignancy @RheumNow #ACR23 Abstr 1675 https://t.co/KRVlIFxhl8
Mike Putman EBRheum ( View Tweet)
2 RA cohorts w/Breast Cancer 17% TNFi within 1yr after surgery No diff in overall survival at 5 yr w/ TNFi or csDMARD Trend towards better BC specific survival w/ TNFi vs. csDMARD only Worst survival for GC>7.5mg/day Only 2 yrs follow up @RheumNow #ACR23 ABST1675 https://t.co/ekKlJ2dP5i
Aurelie Najm  ( View Tweet)
Does TNFi use in pts with RA and early breast cancer affect survival? TNFi did not affect overall survival or breast cancer specific survival compared to cDMARDs Steroids did increase mortality @RheumNow #ACR23 Abs#1675

Robert B Chao, MD  ( View Tweet)

No significant difference in overall survival in early stage breast cancer (BC) patients treated with TNFi (alone -/+ cDMARDs, in 1st year of BC) and cDMARDs in RA. Those on glucocorticoids had worse survival. Suarez-Almazor M, Abst#1675 #ACR23 @RheumNow https://t.co/lnZx3OpuN5

Dr. Antoni Chan  ( View Tweet)

There was a lower hazard ratio for incident cancer with exposure to TNFi compared to non-TNFi (RTX and ABA) and JAKi. Limits: potential for residual confounding by indication and small number of outcomes per drug class, Xavier S, Abst#1678 #ACR23 @RheumNow https://t.co/vJpFwl6Ivj

Dr. Antoni Chan  ( View Tweet)

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