All News
The Influence of Obesity on Choice of Biologic in Rheumatoid Arthritis
In rheumatoid arthritis we have a wide range of options available to us when we progress to a biologic treatment option. We have little to differentiate between these agents based on the clinical trials.
Read Article
Top vasculitis takeaways from ACR 2021
There were several hot topics at ACR21. Here I concentrate on top abstracts in vasculitis.
Read Article
The Influence of Obesity on Choice of Biologic Agent in Rheumatoid Arthritis
In rheumatoid arthritis we have a wide range of options available to us when we progress to a biologic treatment option. We have little to differentiate between these agents based on the clinical trials.
Read Article
FDA Update: 3 trials showing Efficacy of Tocilizumab in COVID 19:
1. RECOVERY - lower mortality
2. EMPACTA - Less progression to mech vent or death
3. REMDACTA & COVACTA - did not meet primary endpoints (but not contradictory) FDA Metanalysis of all 4 trials #ACR21 EUA 6/21 https://t.co/9yHu87KGej
Dr. John Cush RheumNow ( View Tweet)
TCZ in GCA: one disadvantage is that you can't use CRP+/- ESR for flares
Mavrilimumab in GCA:
- CRP/ESR consistently go up with symptomatic flares
- CRP/ESR up less (cf. placebo), in the absence of Sx flares
More signal, less noise.
phase 2 post-hoc #ACR21 ABST1401 @RheumNow https://t.co/c0lMJMcQv0
David Liew drdavidliew ( View Tweet)
NORD-STAR Trial: outcomes in tx-naïve, early RA pts after 48w of csDMARDs+GC vs bDMARD (ABAtacept, CerToliZumab, or ToCiluZumab)+MTX
➡️ Superior CDAI remission rates w/ ABA+MTX & CZP+MTX but not TCZ+MTX vs csDMARD+GC
➡️Imaging progression low in all
Abst#0825 #ACR21 @RheumNow https://t.co/QaFIF4WNEG
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR21 Abs#0834: CorEvitas Registry TNFi vs IL-6 in RA
⭐️IL6 pts older, longer h/o RA, higher CDAI, more prior Rx
▶️ No difference in outcomes bw IL6 and TNFi (monotherapy or combo w MTX).
▶️1/3 of pts achieved LDA
Limits: real-world, unblinded
https://t.co/AJtzeMuj1T @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)
ADACTA & MONARCH both showed IL6i monoRx > TNFi monoRx for RA in DBRCTs.
What about in real-world data?
Looking at CorEvitas, less so
LDA: aOR 0.99
MCID in CDAI: 1.06
Even without MTX, both great drug classes for RA
Equally so?
#ACR21 ABST0834 @RheumNow https://t.co/6wvzVrXTW6 https://t.co/fYEktJhZuV
David Liew drdavidliew ( View Tweet)
It's all happening for biologic therapies in PMR!
phase 2/3 double-blind RCT:
- new PMR
- n=36
- 11w PNL taper (until relapse - clinical not lab)
- weekly sc TCZ for 16w vs placebo
big benefit persists post-TCZ cessation
real steroid sparing
PMR-SPARE #ACR21 ABST0507 @RheumNow https://t.co/w8tgOPAtyJ
David Liew drdavidliew ( View Tweet)
In GCA, why might you target GM-CSF over IL-6?
Entirely plausible TCZ might be leaving some Th1 stones unturned, esp:
vascular remodelling
downreg pathways
Transcriptomics from toci/mavri-treated TAB show it's plausible beyond just theory...
Cid group #ACR21 ABST0506 @RheumNow https://t.co/YephlzHOdj
David Liew drdavidliew ( View Tweet)
Gender differences in AS pts?
IL-23R, IL-12R, IL-6R, JAK, STAT and TYK2 ⬇️regulated in men
Small study of 20 pts, but could it guide targeted therapy based on gender?🤔
Abs#0050
https://t.co/OQHQCCzfuC
#ACR21
@RheumNow
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
#ACR21 Abst#0269
⭐️TCZ: ⬆️cholesterol, LDL, TG. ⬇️ hsCRP compared to TNFi. No ⬆️ risk of Reynold risk score (RRS)
Take-away: good data on TCZ effect on lipids, but I wouldn't use RRS to calculate CVD risk on med that ⬇️ CRP @Rheumnow https://t.co/zMltktfHkS https://t.co/bwKXiGIi8a
Links:
Eric Dein ericdeinmd ( View Tweet)
