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The spicy topic of turmeric in rheumatoid arthritis
Curcumin, the active constituent of turmeric extract, has increasingly been promoted as a potential rheumatoid arthritis therapy, but data presented at ACR22 suggests that even in ideal situations, it is unable to do any better than placebo in replacing conventional RA therapies.
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Curtis et al. Primary non-adherence to csDMARDs and b/tsDMARDs in RA/PsA/SpA. Medicare and commerically-insured patients. 20-44%! of new prescriptions not filled by 6 months. Higher for csDMARDs than b/tsDMARDs @RheumNow #ACR22 Abstr#2199 https://t.co/Pwg6GKu7Gg https://t.co/wPF0pu1UDa
Richard Conway RichardPAConway ( View Tweet)
Which is better for CV risk in RA:
triple therapy DMARDs or TNFi?
TARGET study
n=159 using PET/CT surrogate (endpoint responsivenessđź‘€)
- either led to benefit
- both equally good
- benefit *not* linked to change in DAS28
A direct CV effect of RA Rx?
ABST2215 #ACR22 @RheumNow https://t.co/4FPvSbfGsD
David Liew drdavidliew ( View Tweet)
Singh @NamrataRheum et al. Frailty in patients treated bDMARD/tsDMARD assoc serious infections aHR 1.34, any infection aHR 1.18, hospitalisation aHR 1.34 (all relative non-frail). @RheumNow #ACR22 Abstr#2218 https://t.co/ONsTBq8ehB https://t.co/iTVANh5flk
Richard Conway RichardPAConway ( View Tweet)
đź’¤cognitive behavioural therapy 2 hours/wk for 6 wks for insomnia improves RA PROs at 26 wks
Insomnia Severity Index -9.8
RAID -1.4
PGA -13
Small sample size
wk6 trend improvement sleep efficiency 89% vs84% p=0.07 but not wk26
https://t.co/rpKdtbREYs Abs#2188 #ACR22 @RheumNow https://t.co/kEBcPAdIKW
Aurelie Najm AurelieRheumo ( View Tweet)
Peresolimab humanized IgG1 mab
➢ stimulates PD-1 & physiological immune inhibitory pathways
➢ In RA phase 2 study, superior to placebo at Week 12 DAS28/CDAI
➢ safety events were similar between treatment groups
Emery P #L03 https://t.co/4Jd79CW5RA #ACR22 #ACRBest @RheumNow https://t.co/PSuLQgjYuz
Dr. Antoni Chan synovialjoints ( View Tweet)
Tonight at 7pm ET! Join our RA Topic Panel with panelists: Drs. Richard Conway, Aurelie Najm, David Liew, Janet Pope, Julian Segan
@RichardPAConway @AurelieRheumo @drdavidliew @Janetbirdope @JulianSegan #ACR22
https://t.co/hIH4WghLwN https://t.co/oKQbBnMiqQ
Links:
Dr. John Cush RheumNow ( View Tweet)
Sometimes your RA pts are eligible for ICI cancer immunotherapy, but there’s hesitancy because of autoimmune risk/bad irAEs
@DanaFarber @MassGenBrigham:
more RA flares
but similar mortality, severe irAEs rates
Give them what they need!
ABST1667 @jeffsparks #ACR22 @RheumNow https://t.co/WdDP8IeIYG
David Liew drdavidliew ( View Tweet)
Fletcher et al. Epidemiology RA-ILD 2004-18 in VA. Incidence increased from 340 to 970/100,000PY. Prevalence increased 1.7% to 4.5%. More common males (4.81% vs 2.53%) and over 60 @RheumNow #ACR22 Abstr#1638 https://t.co/AbPgLUPoDz https://t.co/V25xDUwLbu
Richard Conway RichardPAConway ( View Tweet)
Peresolimab PD-1 agonist in RA Phase 2 RCT
Primary endpoint met w/ > improvement DAS28CRP Wk12
Also greater improvement of CDAI in both treated grps
TEAEs PBO 37% PER 300mg 40% PER 700mg 35%, 1 serious AE in PER 700mg
https://t.co/QtclWIWAw9
Abs#L03 #ACR22 @Rheumnow https://t.co/bLHP4JuNjt
Aurelie Najm AurelieRheumo ( View Tweet)
Wipfler et al. Characteristics refractory RA. Associations at baseline (A) and follow-up (B) @RheumNow #ACR22 Abstr#1952 https://t.co/4PJtrDp3Ba https://t.co/x1NCq07Y1h
Richard Conway RichardPAConway ( View Tweet)
Systemic Inflammation Index (neutrophils*platelet count/lymphocyte count)
predicts survival in RA in 1000+ pts
All cause mortality OR 2.64
CV-mortality OR 3.03
Another proof (if needed) of asso inflammation & mortality in RA
https://t.co/A77iPTTfTM
Abs#1650 #ACR22 @RheumNow https://t.co/8aHYAZEg6v
Aurelie Najm AurelieRheumo ( View Tweet)
Tuttle et al. Phase 2 RCT of Peresolimab (PD-1 stimulator) in DMARD-IR RA. Evidence of efficacy. No new safety signals @RheumNow #ACR22 Abstr#L03 https://t.co/vhrmtGTjw1 https://t.co/k1LLk95bv1
Richard Conway RichardPAConway ( View Tweet)
Ozen et al. Safety Opioids vs NSAIDs in RA. Similar risks except 2-fold increase in VTE with opioids. @RheumNow #ACR22 Abstr#1646 https://t.co/kWBf8t4TFh https://t.co/dxKoilOhFX
Richard Conway RichardPAConway ( View Tweet)
FORWARD databank RA
4500+ opioid & 11000+ NSAID
MACE 133 vs. 392 (18.2/1000 PY vs. 14.6/1000 PY)
Deaths 95 vs. 228 (12.6/1000 PY vs. 8.2/1000 PY)
IR MACE & mortality NSAID < Opioids
Driven by VTE > Opioids vs NSAIDs HR=2.45
https://t.co/fl7cJNGrvu
Abs#1646 #ACR22 @Rheumnow https://t.co/wV5hYMfYLl
Aurelie Najm AurelieRheumo ( View Tweet)
Brooks et al. Risk lung cancer higher in RA (aHR 1.53) and RA-ILD (aHR 3.06) than controls. Persisted in non-smokers, non-RA-ILD, incident RA @RheumNow #ACR22 Abstr#1647 #ACRbest https://t.co/c18k9OLDIm https://t.co/UTgYZAmfmk
Richard Conway RichardPAConway ( View Tweet)
Juge @Juge_P_A @PhilippeDieude et al. Increased mortality in RA-ILD. HR 3.4 vs RA. <75 HR 4.8 . ILD first HR 8.4 @RheumNow #ACR22 Abstr#1959 #ACRbest https://t.co/mnbeBPuyC7 https://t.co/sLU2ZuTMw7
Richard Conway RichardPAConway ( View Tweet)
Paul Emery presenting phase 2 data Peresolimab in RA. Novel mechanism aiming to restore immune homeostasis. Exciting for rheumatic disease beyond RA.
@RheumNow #ACR22 #LateBreaking https://t.co/oOjvo5YmDB
Julian Segan JulianSegan ( View Tweet)
Tam et al . Increased CV risk in early RA abrogated with treat to target approach. @RheumNow #ACR22 Abstr#1649 https://t.co/i2iHyPoKf0 https://t.co/u0R00oolyP
Richard Conway RichardPAConway ( View Tweet)
Kimbrough et al. Comorbidities assoc serious infection in RA. Many! 26/55 comorbidities assoc serious infection. Number of comorbidities also assoc HR 1.16 (1.13-1.19) @RheumNow #ACR22 Abstr#1950 https://t.co/gnIlaJ037B https://t.co/6SR2Ej584w
Richard Conway RichardPAConway ( View Tweet)
