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Rheumatoid,RA,nodules,damage

Shifting Trends in Initial RA Treatment Approaches

Caoilfhionn Marie Connolly, MD

A recent study by Sparks et al reveals evolving trends in DMARD usage for rheumatoid arthritis over two decades in the United States. This retrospective analysis evaluated 407,728 DMARD initiation episodes among 229,365 unique patients from 2001 to 2021.

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ACR24 Preview Podcast (11.15.2024)

Jack Cush, MD

ACR 2024 starts tomorrow. Here are a few previews of abstracts to be presented, along with my recommendations of sessions you don’t want to miss.

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No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients

Jack Cush, MD

UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse cardiovascular events (MACE) in JAKi vs TNFi use in IBD.

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Dr. Quotes (11.8.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week from RheumNow.com.

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SELECT-GCA Trial results show UPA 15 mg + 26-week GC taper leads to 46% sustained remission vs. 29% with placebo + 52-week taper (P=.0019). UPA15 reduced GC use (median 1615mg vs. 2882mg, P<.0001) and improved fatigue scores. Key finding: UPA15 combined with a 26-week GC… https://t.co/rdHU3GuOwc https://t.co/oMS7x46sIB

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Safety data reassuring with UPA 15 mg vs PBO No UPA MACE events, low VTE Ab#0770 @RheumNow #ACR24 https://t.co/lMf2dCz2RX https://t.co/3DnPIoVOt8

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Eric Dein ericdeinmd ( View Tweet)
Upadacitinib (UPA), a new oral treatment option for GCA? Dr. Peter Merkel discusses SELECT-GCA. UPA15 + 26-week GC taper >> PBO with a 52-week GC taper for GCA remission. #ACR24 #ACRBest @RheumNow ABST#0770 https://t.co/UbQLVA8X7r

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Jiha Lee JihaRheum ( View Tweet)
Major update in tx for GCA beyond Toci SELECT-GCA showed upadacitinib 15mg daily achieving higher rates of remission with SHORTER (26wk) steroid use compared to placebo (52wk) No significant adverse safety signal w JAKi including MACE/malignancy @RheumNow #ACR24 Abstract 0770 https://t.co/45D0Txed2N

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Brian Jaros, MD Dr_Brian_MD ( View Tweet)

Results from SELECT-GCA ➡️UPA 15mg + 26W GC taper demonstrates superior efficacy & reduced GC use vs PBO + 52W GC taper ➡️No new safety signals Is UPA the new kid on the block in #GCA? Ab0770 #ACRBest #ACR24 @RheumNow https://t.co/pHzozYiid5

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Mrinalini Dey DrMiniDey ( View Tweet)

SELECT-GCA: Upa in GCA Merkel Upa 15 mg v 7.5 v PBO w slower GC taper 70% new onset, 30% relapse. Few prev on IL6 Primary endpt: sustained remission at w52- UPA 15 mg beats PBO (p=0.0019) 34% relapse in UPA vs 60% PBO Less steroids, longer time to flare @RheumNow #ACR24 #ACRBest https://t.co/1OV2889Ny0

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Eric Dein ericdeinmd ( View Tweet)
Upadacitinib in GCA. Merkel et al. SELECT-GCA study. Sustained remission week 52 Upa (+26 week steroid) 46% vs PBO (+52 week steroid) 29%. Reduced flare rates with UPA (see picture). Similar to GiACTA results. @RheumNow #ACR24 Abstr#0770 https://t.co/fr75XK21L1 https://t.co/Hhax7po7vV

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Richard Conway RichardPAConway ( View Tweet)
Real-world data from @k_lauper's Jak-pot study (>9000 RA pt) on how quickly b/tsDMARDs work: JAKi, TNFi quicker than tocilizumab, abatacept Even though they all get to a similar place eventually, some get there quicker (but worth any safety tradeoffs?) #ACR24 ABST0501 @RheumNow https://t.co/YVpTBMe3gi

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David Liew drdavidliew ( View Tweet)
Spatial Proteomics study for TEN Marked enrichment of type I and II interferon and STAT1 activation Pathways suggests benefit for JAKi in this condition Clinical response in case photos, suggests benefit of pursuing clinical trial Year in Review #ACR24 Bridges @RheumNow https://t.co/K34lbnenRH

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Eric Dein ericdeinmd ( View Tweet)
Like we've seen in many parts of the world, RA prescribing in Germany is moving away from JAKi, in response to regulatory safety warnings. Whether all of this is appropriate or not, we'll have to see... #ACR24 ABST0503 @RheumNow https://t.co/VSqdCz6zc5

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David Liew drdavidliew ( View Tweet)
Looking forward to this Plenary - upadacitinib vs plbo in GCA Similar to GiACTA, 26wk taper w/UPA better than 52wk taper w/PLBO. Too small for safety, but no new rsks Strong argument for DMARDs upfront in GCA... but doesn't help with which 😉 #ACR24 @RheumNow Abstr#0770 https://t.co/MZY4QUazhI

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Mike Putman EBRheum ( View Tweet)
#Baricitinib in refractory #myositis? A ‘weak’ trial design comparing #Bari to #Bari Rx started 12 weeks later in a small N =15 neat idea but NO answer 👇 looked like 👍 it worked BUT this is not the #RCT design that can show differences #ACR24 @RheumNow abst#1731 @ACRheum

Janet Pope Janetbirdope ( View Tweet)

No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse… https://t.co/XY0UVDTAI6 https://t.co/b09FB3niNP
Dr. John Cush RheumNow ( View Tweet)
Pain in PsA = predictor of disability and QoL TYK-2 inhibition lowered clinical pain outcomes and ALSO pain-associated biomarkers vs PBO @RheumNow #ACR24 Abstract #2366 https://t.co/DAgmdmmTE0

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Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Summary of treatments in psoriatic arthritis #PsA @RheumNow #ACR24 https://t.co/EybzRCPLtA

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Metanalysis of 26 RCTs suggests JAK inhibitors have a low, but signif. increased risk of infections (vs placebo) (RR 1.39; 1.096-1.76). No risk of tuberculosis or hepatitis, but an incr. risk of H. zoster was seen (RR 1.71; 0.84-3.51) https://t.co/kXOcldz46l https://t.co/Y5OWk4W1NZ

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Dr. John Cush RheumNow ( View Tweet)
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