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GCA,woman

JAK inhibitors in GCA?

David Liew, FRACP

The SELECT-GCA study, looking at upadacitinib in GCA, anchored the ACR 2024 opening plenary for a reason - it is highly notable and badly needed.

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question mark

Are Emulation Trials a Fantasy?

Janet Pope, MD, MPH, FRCPC

Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?

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Meeting audience conference

ACR 2024 - Day 1 Report

Jack Cush, MD

ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings.  The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.

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GCA,woman

SELECT-GCA suggests JAKis may be the new kid on the block

Mrinalini Dey, MD

Clinicians treating giant cell arteritis (GCA) have long had to contend with a disappointingly limited selection of drugs from which to select. A new group of drugs is finally showing promise in the treatment of GCA.

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Serrano-Combarro et al. Case series of upadacitinib in RA-ILD. 18 patients. Report stable/improved dyspnoea and HRCT over 12 months. PFTs shown, relatively stable @RheumNow #ACR24 Abstr#1372 https://t.co/yncy0lPq60 https://t.co/mrDMtEDwUt

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Richard Conway RichardPAConway ( View Tweet)
#1477 🔬Zasocitinib (TYK-2i) shows promise in phase IIb RCT ➡️n=290, randomised to PBO, 5/15/30mg gps 💥30mg group 📉 Rapid skin improvement @ Wk 2 ➡️Wk 12 PASI:~2X placebo (-2.5;p=0.004) 🛟Well tolerated ⬆️MDA (28 v. 12.5% p<0.05) promise for other PsA domains #ACR @RheumNow https://t.co/5GusMlVkQ4

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Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Exciting early data for new highly selective TYK2i zasocitinib Improved PASI skin scores (though not as much as IL23i...) Funky skin-related adverse events at higher doses, not sure what to make of that? #ACR24 @rheumnow Abstr#1477 https://t.co/CtOFsoHdBh

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Mike Putman EBRheum ( View Tweet)
Race of b/tsDMARDs in RA, the “JAK-pot” study. JAKi and TNFi with more rapid early improvement in CDIA, HAQ, and pain compared to ABA or IL-6 inhibitors…..although effects blunted after adjusting for patient and RA characteristics #ACR24 @RheumNow ABST#0501 https://t.co/8M4wX3LAbW

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Jiha Lee JihaRheum ( View Tweet)
🤵‍♂️Results from BACHELOR ➡️34 PMR pts ➡️18 BARI, 16 PBO ➡️Primary endpoint: CRP PMR-AS≤10 w/o oral GC rescue from W0 to 12 78% BARI pts reached primary endpoint vs 13% PBO No new safety signals BARI 4mg 12W, then 2mg 12W➡️36W low disease activity in PMR Ab0858 #ACR24 @RheumNow

Mrinalini Dey DrMiniDey ( View Tweet)

JAKs in PMR? "BACHELOR" study randomized 34pts to BARI vs PLBO Despite small sample, significant benefit at 12 wks (CRP PMR-AS < 10) for bari (78%) vs. PLBO (13%) Useful, but not for getting regulatory approval. Should have gone straight to phase 3! #ACR24 @RheumNow Abstr#0858 https://t.co/mmMs6c3AYC

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Mike Putman EBRheum ( View Tweet)

LTE of deucravacitinib trials in psoriasis. Remarkable & frankly surprising (to me) persistence of benefit Very encouraging for patients who start TYKs, looks like those who respond may have prolonged benefit #ACR24 @RheumNow Abstr#0290 #ACRBest https://t.co/kao4vqpPTQ

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Mike Putman EBRheum ( View Tweet)
A cohort of 9 patients with Anti-MDA5 DM with RPILD who was treated with combination of RTX, JAKi, and GCS had significantly bettery survival compared to historical cohort in this abstract! #ACR24 @RheumNow https://t.co/2t8xcYJ3UV

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Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
This is likely an oversimplification, but I've been looking for exactly this diagram Inhibiting various TYKs/JAKs corresponds to various downstream cytokine inhibition @EricFMorand does it make sense to see this as anifrolumab+ustekinumab? No? @rheumnow #ACR24 Abstr#0662 https://t.co/thti6s5TR3

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Mike Putman EBRheum ( View Tweet)
Courvoisier et al. JAK-pot study analysis. Which therapies work quicker in RA? JAKi (as expected) and TNFi (what!?) faster than IL6 and abatacept. @RheumNow #ACR24 Abstr#0501 https://t.co/7DPPwHlqpP https://t.co/3mOJ62hZhp

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Richard Conway RichardPAConway ( View Tweet)
Serrano-Combarro et al. Baricitinib in RA-ILD . 72 patient case series. PFTs in picture. HRCT stable/improved in 72% over 24 months. Dyspnoea stable/improved in 90%. @RheumNow #ACR24 Abstr#0476 https://t.co/aVI2kRZkMN https://t.co/4l5GKsFKtm

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Richard Conway RichardPAConway ( View Tweet)
PRO-SPIRIT trial data on 1192 PsA pts showed IL-17Ai seemed better than IL-12/23i and IL-23i improving cDAPSA at 3m and as effective as TNFi and JAKi. No much differences seen at 12m. Abst#0076 #ACR24 @RheumNow https://t.co/dScwsmkDOe

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Adela Castro AdelaCastro222 ( View Tweet)
#0584🔬Real-World PsA Study:Tofacitinib ➡️141 pts:47% mono,53% combo;~70% on Rx @ 6mo ➡️Similar ⬆️in disease outcomes (cDAPSA LDA: 31% mono vs 21% combo; MDA ~16%). ➡️No significant differences mono v combo outcomes 🩺Tofa effective in diverse PsA population #ACR24 @RheumNow

Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)

Is biologic response different in men vs women with axSpA? A Meta-analysis of 11 studies including 11,199 axSpA pts evaluated sex-related response to bDMARDs -Male pts more likely to achieve BASDAI 50 and ASDAS low disease activity responses compared to females. #Abst0599… https://t.co/FopBLS4bF6 https://t.co/PpoZB9HwZN

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Adela Castro AdelaCastro222 ( View Tweet)
Cool data from the JAK-POT study Have heard JAKs faster than TNF; perhaps not the case! If anything, TNFs outperformed the others in this study Trying not to over-read this, but supports my re-emerging preference for TNF #ACR24 @rheumnow Abstr#0501 https://t.co/NDyPwju3ds

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Mike Putman EBRheum ( View Tweet)
#0501 💥 JAKi & TNFi show faster short-term RA improvement (3months) compared to IL-6i & ABA ➡️n=9590(3049 JAKi, 4606 TNFi, 1284 IL-6, 651 ABA), 14 registers 🕒 JAKi, TNFi improved CDAI, pain, function in 1st two months then stabilised 💡Long-term data needed #ACR24 @RheumNow https://t.co/4yzeAAkGjq

Links:

Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
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