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#ACR BEST Abstracts from San Diego – Day 1

Jack Cush, MD Nov 13, 2023

The RheumNow faculty reporters have been scouring the meeting for what they believe to be the best presentations from the first day at ACR 2023 in San Diego. From hundreds of online presentations, the poster floor and the plenary podium, here are some of the best abstracts from Sunday Nov. 12th. You can spot these on Twitter by looking for the (#ACRbest) hashtag.

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

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

SMART study in RA, splitting MTX Split dosing better at wk 16 but ~similar at wk 24 Caveat: wonky design from wk16-wk24 makes it hard to interpret? Surprsingly, adverse events ~similar but smallish sample Mostly supports my practice of splitting? @RheumNow #ACR23 #ACRBest https://t.co/g7s4EUHeCW

Large VA study of >1k RA-ILD pts No difference in risk of respiratory hospitalization or death in RA-ILD pts using TNFi vs. nonTNFi/JAKi Data does not support avoiding TNFi in RA-ILD @RheumNow #ACR23 Abs#1582 https://t.co/LTNLXEIAPo

Important plenary session, RA-ILD outcomes in VA cohort study No difference in death/hospitalization for TNF vs non-TNF treated patients. Jives w/my priors; I do NOT avoid TNF in RA-ILD Encouraging if you (like me) prefer RA-active tx for RA-ILD 😉😆 @RheumNow #ACR23 #ACRBest https://t.co/TIDzMLOfs4

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. #ACR23 https://t.co/sfRhNj6OpZ https://t.co/k6VoG5lKO7

Glucocorticoids-free zone in SLE? | RheumNow

To remind us. Glory be! GLORIA a #RCT in elderly active #RA: MTX+10 mg daily #prednisolone which was better than MTX alone. But more infections and no comparison of inexpensive Rx such as adding #HCQ. Still debated as to benefit vs risk of this strategy @RheumNow #ACR23 @ACRheum https://t.co/slOmESbIOW

Super interesting study re: impact of ORAL SURVEILLANCE on prescribing Post safety report, JAK pts shifted younger w/lower comorbidities (esp CVD) I know many have mixed feelings, but I believe in the risk & support this type of shift @RheumNow Abstr0435 #ACR23 https://t.co/EBg9VOIbj1

No more underpowered long-term safety studies We need a "SELECT-SURVEILLANCE" study to replicate ORAL-SURVEILLANCE & tell us if UPA has the same MACE/cancer risk as TOFA Minus that, I plan to go 100% TOFA when it becomes generic in 2026 @RheumNow #ACR23 Abstr1326 https://t.co/LyQ1Q8qReO

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

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

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

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

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

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

#Benefits of #hudroxychloroquine - reduced lipids, clots, CV events, infection AND now improved #fatty #liver #NAFLD….@RheumNow #ACR23 @ACRheum https://t.co/Y43JETY6F3

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

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

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

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#ACR BEST Abstracts from San Diego – Day 1

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