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SELECT-GCA suggests JAKis may be the new kid on the block
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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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
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
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
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
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
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
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
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)
