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@RheumNow Obinutuzumab for lupus nephritis was a very recent FDA addition two weeks ago, and we’ll play catch-up with the hematologists to get familiar with it, including its safety profile
#ACR25 FDA Update @RheumNow https://t.co/h6bf4roGzB
Links:
David Liew drdavidliew ( View Tweet)
Cooper et al. FAERS based analysis of adverse events with avacopan.3658 patients on avacopan, 30 million overall. DILI seems to be the big concern, with Reporting Odds Ratio of >17. @RheumNow #ACR25 Abstr#2519 https://t.co/1LoDvRHkqa
Richard Conway RichardPAConway ( View Tweet)
#ACR25 Abstr#LB14 Deep blood & tissue depletion are not just confined to CAR-T. Exploratory analysis of REGENCY showed Obinutuzumab induced near-complete depletion & significantly reduced plasma in kidney tissue vs PBO @RheumNow https://t.co/r1danWBM7D
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
After melanoma, should RA patients stop DMARDs?
These VA data (n=644) showed no mortality signal, and trending to survival benefit with b/tsDMARDs
Provisos over methotrexate, invasive disease etc, but don’t hold off treating the RA because of melanoma
#ACR25 ABST2237 @RheumNow https://t.co/l9n1V6YVln
David Liew drdavidliew ( View Tweet)
#IL2 #Rx in active #SLE?
Maybe 🤔
IL2 is tricky - low dose May help #SLE but too much of a good thing may have a neg impact.
RCT of IL2i in #SLE gave a good dose response and improved TRegs.
#ACRBest #ACR25 @RheumNow @ACRheum #LB01 https://t.co/F61qz5x5We
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Janet Pope Janetbirdope ( View Tweet)
Adverse events from avacopan the WHO pharmacovigilence database (VigiBase)
Not a lot new - infections happen, hepatic events happen but seem to be somewhat rare
Pharmacovigilence is hard; most events go unreported & we often have the classic "denominator problem" (ie we saw https://t.co/28tYkXv0Lz
Mike Putman EBRheum ( View Tweet)
In the CLOSE-UP study of UPA in RA
- 61% in remission with responses sustained to 24 mo
- Benefit consistent irrespective of prior DMARD use
- No new safety signals
@RheumNow #ACR25 Abstract#2281
Jiha Lee JihaRheum ( View Tweet)
#ACR25 Abstr#LB10 Promising 4-Year data of Deucravacitinib in blinded phase 2 RCT +LTE study showed efficacy inc. LLDAS and CLASI-50 response were maintained/improved over time in #SLE No concerning safety signal. Looking forward to Phase 3 results next year @RheumNow https://t.co/fZv82zJ6Q4
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Serrano-Combarro et al. Abatacept in RA-ILD. 343 patients. Progressive ILD in 23%. Similar to the numbers progressing on baricitinib by same group. Previous MTX treatment appears to REDUCE risk (OR 0.45). Disease activity increases risk (OR 1.29). @RheumNow #ACR25 Abstr#2265 https://t.co/0tl0kGgm5p
Richard Conway RichardPAConway ( View Tweet)
#ACR25 How hard will you go & at what cost? A study in China using CD20/BCMA Bispecific autologous CAR-T showed profound depletion, normalisation of abs and good response in #SLE (10/11 had LN). But 2 had G3 infections & cytopenia. Presenters said some had IVIG @RheumNow #ACRBest https://t.co/TF0wpib5rr
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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Starting biologic early could save more than joints. In 329 RA pts, first-line anti-TNF reduced testing and hospitalization costs vs csDMARDs across Europe. Earlier targeted therapy pay off in outcomes and economics.
@RheumNow #ACR25 Abstract#2271 https://t.co/zZ32CpT36d
Jiha Lee JihaRheum ( View Tweet)
#1747 Serious infections ~2× more common in RA-LD, esp RA-ILD. Pulmonary, bacterial, viral & fungal infections all increased, underscoring need for tailored prevention and vaccination. @RheumNow #ACR25 https://t.co/soyzqLk7Vj
Mrinalini Dey DrMiniDey ( View Tweet)
#1746 In large US RA cohort, elevated GDF-15 & pentraxin-3 levels linked to prevalent RA-ILD; high GDF-15 predicted future ILD risk.
Other fibrosis-related mediators from IPF or heart failure were not associated, suggesting RA-ILD has distinct pathogenic pathways @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
New insights into Pre-RA: It ranges from asymptomatic individuals with ACPA positivity to those with symptomatic pre-clinical synovitis. Predicting who will develop RA is difficult, and there is a need for reliable biologic tools. Focusing on high-risk patients could https://t.co/SPOP7f0t7y
Dr. John Cush RheumNow ( View Tweet)
When every option fails, bold moves remain.
In 5 multi-resistant RA pts, TNFi + JAKi combo brought remission in most without major AEs.
Not standard, not risk-free, but in young, low-infection-risk pts, it may offer a path forward.
@RheumNow #ACR25 Abstract#2272
Jiha Lee JihaRheum ( View Tweet)
Post hoc eval of relapses from MANDARA, MEPO vs BEN in EGPA
30% of pts had relapse, 81% of which were asthma +/- sinonasal disease
Remainder were mostly muscle involved, only a few mononeuritis
Mostly as expected; useful epi data for clinic
#ACR25 @RheumNow Abstr#1769 https://t.co/IKKolMZJlF
Links:
Mike Putman EBRheum ( View Tweet)
Late Breaker: Phase 2 RCT of low dose IL2 in SLE
Dose dependent response in SRI4 over 12 weeks
& surprisingly high rates of LLDAS
Too early to know if useful, but worth evaluating in a phase 3
#ACR25 @RheumNow Abstr#LB01 https://t.co/oPOLG82nwi
Mike Putman EBRheum ( View Tweet)
Late breaking: secukinumab out-performs ustekinumab in PsA pt who have failed TNF therapy
RCT of 119 pt
57.1% response at wk 28 in SEC
27% response at wk 28 in UST
Numerically lower adverse events leading to d/c in SEC
@RheumNow #ACR25 #ACRBest Abst LB06 https://t.co/wDxtscP2ku
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Serrano-Combarro et al. Baricitinib in RA-ILD. Observational, 42 patients. Progressive ILD in 26%. More frequent in women. @RheumNow #ACR25 Abstr#2229 https://t.co/ZXfgxKoau7
Richard Conway RichardPAConway ( View Tweet)
Cutaneous vasculitis: who is most likely to have systemic disease?
430 pt w skin vasculitis examined in case-control
Associated with risk for systemic vasculitis/CTD:
- GI sx
- ulcerating/necrotic lesions
- constitutional sx
- hematuria
@RheumNow #ACR25 Abst 2525 https://t.co/lRjLKRYxDW
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
