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Reader beware! Interpretation of effectiveness & safety of JAKi vs bDMARDs in real world data

Janet Pope, MD, MPH, FRCPC

Multiple studies compared effectiveness, retention and/or safety of biological DMARDs (bDMARDs) and JAK inhibitors (JAKi) at EULAR 2021.

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EULAR 2021 – Day 4 Report

Jack Cush, MD

It's been nearly two weeks since EULAR 21 ended. There were several presentations on the last day; notably, the late breaking abstracts and others. Here are a few of my favorites from Day 4, the final day of the meeting.

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Problems at the FDA

Jack Cush, MD

"While the Food and Drug Administration decision on new drugs usually follows the recommendations of the advisory committee..."; this oft used proviso is used to either indicate a pending FDA decision or an FDA decision that is contrary to the recommendation of the advisory committee co

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depression oh no HA

Psoriatic arthritis mortality & morbidities

Paul Studenic, MD, PhD

Psoriatic arthritis (PsA) is a chronic condition with manifold clinical presentations. Health issues may be far beyond the classical associated conditions like uveitis, enthesitis etc. The current study of Tillett et al (OP0231) assessed comorbidities and patient characteristics comparing psoriasis patients with or without PsA.

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pregnant, pregnancy, mother, fertility

Current approach to lupus and pregnancy

Robert Chao, MD

All of us are extremely cautious with lupus patients when it comes to pregnancy. Presentation 6888 (Common issues in pregnancy management in lupus and anti-phospholipid syndrome by Dr. Rebecca Fischer-Betz) was an excellent overview of our current approach to lupus and pregnancy. 

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RheumNow Podcast - Best of EULAR 2021

Jack Cush, MD

Dr. Jack Cush reviews and highlights his favorite abstracts and presentations from last week's virtual EULAR 2021 meeting.

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DPGN, lupus, nephritis, GN, glomerulonephritis, biopsy, kidney

Combination vs. Sequential Therapy for the Treatment of Lupus Nephritis

Kathryn H. Dao, M.D.

Combination disease modifying antirheumatic drug (DMARD) therapy may not be only for rheumatoid arthritis; combining disease modifying agents may be the path to better renal response. 

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Novel TYK2 Inhibitor Efficacious for Treatment of Psoriatic Arthritis

Meral K. El Ramahi, MD, FACP, FACR

Dr. Philip Mease et al presented results of a phase II trial (OP0227) at EULAR 2021 that shows the efficacy and safety of an oral tyrosine kinase inhibitor (TYKi), deucravacitinib, for treatment of active psoriatic arthritis (PsA).

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RA after 70: Too Old for bioDMARDs?

Aurelie Najm, MD, PhD

In RA, the two most common peaks of incidence are thirties and fifties; however a significant percentage of patients above the age of 70 present with active RA -of early or later onset- and require adapted treatment.

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Video: Combination DMARD for Lupus Nephritis: Dr. Kathryn Dao ( @KDAO2011 ) #EULAR2021 https://t.co/RGVZ6jukYy https://t.co/PTjSOfM7YQ

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Dr. John Cush RheumNow ( View Tweet)
Video: The PsA SpA Paradox of Choice Dr. Rachel Tate ( @uptoTate) reviews Dr. Laura Coates' presentation Personalized Treatment Strategies in Psoriatic Arthritis, given at the virtual #EULAR2021 meeting. https://t.co/Yg12SHR1MF https://t.co/UiCYDU5XGc

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Dr. John Cush RheumNow ( View Tweet)
Video: Prevalence of Long Term HCQ in Retinal Toxicity: Dr. Kathryn Dao (@KDAO2011 ) Dr. Kathryn Dao reviews abstract OP0133, "The Prevalence and Risk Factors of Retinal Toxicity Associated with Long-Term Hydroxychloroquine Use", presented at #EULAR2021. https://t.co/tZyXQhZgLG https://t.co/x6AfItFWEU

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Dr. John Cush RheumNow ( View Tweet)
OP0140 at #EULAR2021: ➡️Obs, prospect Nordic study characterized axSpA pts w/ high BASDAI + ASDAS & multiple bDMARD use (indicating difficult to tx dz) ➡️1 in 10 received at least 3 bDMARDs *⃣Multiple switchers were more often F, had higher b/l dz activity, & psoriasis @Rheumnow https://t.co/syq0szVWKe
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
⭐️JUNIPERA: RCT of SEC in active ERA & JPsA (2-18yo, most on MTX) -Tx . (TP)1: SEC 75/100 mg till wk 12 -TP2: cont SEC or switch to PBO till wk 104 ⭐️SEC efficacious on JIA ACR30/70 ⭐️74% w/ resolution of enthes ⭐️Median T2flare in PBO in TP2 = 453d LB0004 #EULAR2021 @Rheumnow https://t.co/JsG2pXz9r6
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Excellent talk on SLE, APS abs pregancy ⭐️pregnancy counseling is important ⭐️aspirin 81mg in all pregnant SLE pts ⭐️do not discontinue HCQ ⭐️stable LN - can switch MMF to AZA Abs#6888 #EULAR2021 @RheumNow

Robert B Chao, MD doctorRBC ( View Tweet)

@DanielAletaha @RheumNow In the end the best treatment choice after #MTX insufficient responders not yet clear. Head to head JAK-i vs. non-TNFi interesting Brilliant developing discussion number needed to harm vs. number needed to treat #EULAR2021 @RheumNow

Paul Studenic Stiddyo ( View Tweet)

EULAR 2021 - Day 2 Podcasts Check out this compilation of our EULAR 2021 Day 2 broadcasts below. You can also follow the EULAR 2021 RheumNow podcasts on iTunes and Soundcloud. https://t.co/GskToSkfLk https://t.co/nF2FkHgBtu

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Dr. John Cush RheumNow ( View Tweet)
Results: MTX vs. PBO ✅Difference in least-squares mean ΔeGFR 0.93 mL/min/1.73m2 (p<0.001) ✅HR for kidney AE on safety labs: 0.73 (0.59-0.91) ✔️HR for kidney AE clinical events: 0.87 (0.56-1.36) ✔️4 vs. 8 severe kidney AEs (HR 0.50, 0.15-1.64)

Jeffrey Sparks MD MMSc jeffsparks ( View Tweet)

🤜MTX safe from kidney perspective if baseline CrCl 40+ 🤜Potential for immunomodulation to prevent/slow progression to CKD? Deserves dedicated studies @Nephro_Sparks

Jeffrey Sparks MD MMSc jeffsparks ( View Tweet)

How does MTX affect kidney function/adverse events? Pre-specified analysis of DBRCT: MTX 15-20mg/wk (n=2391) vs. PBO (n=2395) both with folic acid over median f/u 23 months ✅We demonstrated kidney safety of MTX ⚡️⚡️Also a *suggestion* of LESS decline in eGFR for MTX than PBO https://t.co/SZXloLRmnj

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Jeffrey Sparks MD MMSc jeffsparks ( View Tweet)

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