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Five Takeaways in PsA/SpA at RNL 2024
Continuing with the theme of clinical pearls, the PsA and SpA speakers also provided a wealth of information. Here are my five key takeaways and clinical pearls.
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ARIAA Trial: Abatacept Delays the Onset of RA
The ARIAA trial tested the utility of IV abatacept in individuals ACPA+ arthralgia patients with subclinical inflammation and showed abatacept to decrease MRI inflammation, clinical symptoms, and risk of future rheumatoid arthritis (RA) development.
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Cochrane Review: How Good is Ultrasound Diagnosing GCA?
Is temporal artery ultrasound equivalent or superior to the reference standard of temporal artery biopsy when diagnosing giant cell arteritis (GCA)?
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Vasculitis Pearls
Once again RheumNow Live 2024 really delivered with high impact learning packed into short sessions. As someone with an interest in vasculitis it was fantastic to see four of my favorite speakers in the Vasculitis Mavens and STEP talks.
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IV zoledronic acid (ZA) of PBO was given to 222 pts with symptomatic knee osteoarthritis (without severe joint space narrowing) and after 7 yrs of F/U, ZA had no effect on Knee OA progression w/ similar TKR Rates (39% vs 30%) https://t.co/P09EvRmApO https://t.co/s5fL1unM45
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Retrospective analysis of the Australian Scleroderma Cohort Study, finds 43% of SSc pts have evidence of myopathy. From 1786 participants, 155 had prox. weakness, 24% CK elevation & 4% prox weak+CK^ (latter in more severe SSc) https://t.co/cB4Ul6VMB2 https://t.co/uAIMaotPdv
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Long-Term, open-label study enrolled EGPA (MIRRA study) required prednisolone ≥5 mg/d, pts cont mepolizumab 300 mg Sc q 4 wks +SOC. 100 pts - 71% completed, 3% d/C due to AEs. Exposure~38 mos; 38% serious AEs (30/100PYs) (worsening of asthma, EGPA https://t.co/8qrbFigc9T https://t.co/7QP8qGfsSm
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Top 5 Clinical Pearls in RA Management
#RNL2024 provided a wealth of clinical insights, particularly in the realm of rheumatoid arthritis (RA) management. Here are the top five clinical pearls from the event's opening session, "Success in RA."
https://t.co/QrtnbeLxRZ https://t.co/5K2YRzvzcp
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Serious infx (SIE) is prevalent in SLE given RTX. TOtal of 174 SLE pts on RTX -- SIE rate was high at 51/100 PYs (Pneumonia 30/100 PYs; PJP in 6.1/100 PYs).12 deaths. SIE risk factors were CKD (HR 2.9), Pred ≥15 /day (HR 3.5). HCQ decreased SIE (HR 0.35) https://t.co/8GcSQx8nxh https://t.co/oZvMgTxKVI
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APIPPRA Trial: Abatacept in at-risk rheumatoid arthritis patients
Abatacept has been studied in seropositive clinically suspect arthralgia patients (at risk for rheumatoid arthritis) and shows the potential to delay or prevent the disease.
https://t.co/w944yaXNOd https://t.co/UvTVRTK1er
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TLL-018 (oral dual JAK & TYK2 inhibitor) studied in chronic urticaria unresponsive to H2 blockers and was well tolerated and showed high efficacy in moderate-to-severe patients https://t.co/FDa60c5H24 https://t.co/BhHfPaLbfE
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5 yr prospective observational study of 246 pts w/ nonradiographic Axial Spa shows that 16% of nr-axSpA progressed to r-axSpA w/in 5 yrs. SI progression more likely w/ Male sex (HR 3.16), imaging sacroiliitis (HR 6.6), & good NSAID response (HR 4.6) https://t.co/vAoE1CVkUf https://t.co/32r0TXxCDq
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Oral IL-23 Inhibitor Effective in Psoriasis
The NEJM has published the results of the FRONTIER 1 trial demonstrating the efficacy of JNJ-77242113, an oral interleukin-23 (IL-23) receptor antagonist peptide, in patients with psoriasis (PSO).
https://t.co/NRK8LnM5zp https://t.co/FnWEze976O
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Retrospective cohort analysis of 330 psoriasis pts - 83 (25%) developed #PsA after mean of 36 (3.5–114) mos. PsA Predictive factors include being female (OR=3.33), nails involved (OR=5.4), severe PSO (OR=27.4), po systemic Rx prior to PsA (4.1) https://t.co/w2OO0t3PtR https://t.co/0oh5fDqVhJ
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Sarcoid arthritis (SA) seen in 19% of sarcoid pts. Metanalsysis of 49 articles (8574 pts) found Ankles most frequent (80%) followed by knees & wrists. Monoarthritis was uncommon (1%). Acute , 0-2, I2 55%). Acute SA (oligo & poly) was linked to E nodosum. https://t.co/j5toHlmyoA https://t.co/oC1yxvFHRJ
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In 551 juvenile myositis pts, 36% had myositis assoc Abs (MAA); 13% had >1 MAA. MAA+ pts had more overlap dz (18 vs 6%, p<.001) & assoc w/ Raynauds (OR 2.44), ILD (OR 3.43), chronic Dz (OR 1.72), mortality (OR 3.76). # MAAs was assoc w/ mortality (OR 1.83) https://t.co/BXhasmel3Z
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Study of 43 SSc patients w/ gangrene shows Smoking Hx ; positive-ACA, ANCA, APL Abs & high ESR were independent risk factors for digital gangrenes in SSc. Vasculitis and macrovascular disease may contribute to the progression of digital gangrene https://t.co/3DY2Hx19s0 https://t.co/BfXANmckwF
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Tonix is developing a drug, TNX-102 SL, that targets poor sleep quality for fibromyalgia. Phase 3 trial in FM (457 pts) showed TNX-102 SL was better (vs PBO) & improved sleep quality (p=0.0000001 & improved daily pain (p=0.00005) https://t.co/QUNdWyNj2l https://t.co/CzD5TEcgTk
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Taiwan National Health claims data looked at drugs & gout flares. Signif increase flares were seen w/ ASA, thiazides, loop diuretics, ethambutol, pyrazinamide (1.15-3.35) & metformin (SR=1.14). Lower risk w/ fenofibrate (SR=0.60) & losartan (0.92) https://t.co/eBiiM83ei0 https://t.co/296XAbxwkc
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Retro study of 1,169 pts (age 66 yrs) receiving intra-articular steroids & changes on A1C. A1C increases were assoc w/ higher baseline A1C (OR 1.84) for A1C 7–8 (vs <7%) or A1C >8% (OR 4.8 ). YET most patients do not experience increase A1C after IACS https://t.co/eWyO0nHgdy https://t.co/4UQRbrUyz7
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