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ACR 2024 - Day 1 Report

Jack Cush, MD

ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings.  The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.

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figure sitting in top of hourglass

axSpA: Moving the needle in time to diagnosis

Antoni Chan, MD, PhD

The journey to axial spondyloarthritis (axSpA) diagnosis is often prolonged and challenging. Understanding the factors contributing to the delays is important to improve the clinical, psychological, social and economic outcomes. Data from the SPACE cohort (abstract 0566), the ASAS-PerSpA study (abstract 0550) and the US Claims data (abstract 0558), allows us to highlight the barriers to early diagnosis of axSpA and identify opportunities for improving early diagnosis and treatment.

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back, LBP, spine, AS

Difficult to Manage Axial Spondyloarthritis

Adela Castro, MD

Studies show that patients with difficult-to-manage axSpA have a higher disease activity; however, the lack of a consensus definition led researchers and clinicians to utilize their own proposed definition, resulting in variability of the characteristics of non-responders.

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Are biosimilar multi-switches an issue? real world data: DANBIO 🇩🇰 biosimilar to biosimilar switch having already had a switch prior ('previous ADAo') did not increase cessation The risk of biosimilar switching on immunogenicity is greatly overstated #ACR24 ABST1000 @RheumNow https://t.co/1yAfZrrNd0

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David Liew drdavidliew ( View Tweet)
New agent on the block: Bimekizumab IL-17A/F inhibitor Promising clinical data in SpA - what about imaging findings? Dramatic reductions in MRI activity at SI joints seen in BKZ pt, esp when compared to trajectory of PBO pt before cross-over @RheumNow #ACR24 Abst #1757 https://t.co/ACLJx5XkyN

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Brian Jaros, MD Dr_Brian_MD ( View Tweet)
A systematic review reveals significant sex-related differences in efficacy and safety outcomes in axial spondyloarthritis (axSpA) trials. Males show higher response rates to advanced therapies compared to females. Out of 79 RCTs, only a fraction reported sex-disaggregated data.… https://t.co/dkMRK4ZYHF

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)

Does psoriasis (Pso) affect radiographic progression in ankylosing spondylitis (AS)? A study comparing radiographic spine assessment in AS patients with and without Pso reveals no significant differences in structural lesions. Male gender is a key factor in structural… https://t.co/z34FjHtjEJ

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)

A meta-analysis of 11 randomized trials shows no significant difference in efficacy of bDMARDs for early vs. established axial spondyloarthritis (axSpA). Treating at different stages yields comparable short-term outcomes. Abstr#1468 #Spondyloarthritis #RheumatologyResearch… https://t.co/QYuTcVj2m1 https://t.co/ADzEEbCvUM

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Dietary changes are intermittent fasting are common in axial spondylarthritis (axSpA) patients, possibly reducing inflammation. A study found 55% currently on a diet and 31% fasting. Many believe these practices improve disease activity. Abstr#1459 #diet #axSpA @RheumNow #ACR24

Antoni Chan MD (Prof) synovialjoints ( View Tweet)

The post hoc analysis of the SURPASS study evaluated predictors of radiographic spinal progression in axial spondyloarthritis patients treated with IL-17A (secukinumab) or TNF inhibitors over 2 years. Key findings: - New syndesmophytes: 18.2% (SEC 150 mg), 15.8% (SEC 300 mg),… https://t.co/jke6OHdPjZ

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)

The 3-4-5 rule for positive MRI in axSpA remains. The MRI lesion cut-offs demonstrated high performance across different features of axSpA (PsO, AAU,IBD). Deep fat and deep sclerosis high specificity for axSpA. #Abst0821 #ACR24 @RheumNow https://t.co/4JM5MHrB8z

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Adela Castro AdelaCastro222 ( View Tweet)
The DESIR cohort of Dr. Franc et al. showed that female pts with early axSpA had significantly lower AMH levels vs. general population reflecting low ovarian reserve & fertility. Mechanism? Bigger studies need to be done @RheumNow #ACR24 abs577 https://t.co/842rX79bq6

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sheila RHEUMarampa ( View Tweet)
RheumNow Day 1 Recap: ACR Convergence 2024 Highlights https://t.co/xjCMpzXhTE

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Dr. John Cush RheumNow ( View Tweet)

Systematic review & meta-analysis by DrHChaudhary et al @DaoudAnsaam @mmagrey1 showed that males w/ axSpA who were treated with biologics had ⬆️ BASDAI150 response & likely w/ ASDAS low dse activity vs. females w/axSpA Again, effect of gender differences @RheumNow #ACR24 abs599 https://t.co/2DPYC8exES

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sheila RHEUMarampa ( View Tweet)
How early is early? Data from SPACE cohort included 548 pts with CBP (<2y duration) and different SpA features followed over 2years. -At the end of 2 years, 39% pts were dx with axSpA. -Median time to dx: 35 months. -HLAB27+, sacroilitis on MR and peripheral arthritis were the… https://t.co/AYtJCp8yno https://t.co/VL7KSrpvp9

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Adela Castro AdelaCastro222 ( View Tweet)
Prof @WalterMaks et al reports the validation of data-driven quantitative MRI cutoffs for a +SIJ MRI perform highly in pts with established axSpA. - Deep fat lesions & sclerosis: high specificity for #axSpA @RheumNow #ACR24 abs821 https://t.co/sSAtTt1GGV

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sheila RHEUMarampa ( View Tweet)
Does alcohol consumption affect radiographic progression in axSpA? Canadian cohort study over 6 years found greater radiographic progression among alcohol consumers. Still a lot of confounding factors to fully establish an association. Abst#0822 #ACR24 @RheumNow https://t.co/GG0rXq3kjC

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Adela Castro AdelaCastro222 ( View Tweet)
ASAS definition of Difficult-to-Manage Axial Spondyloarthritis (D2M axSpA) with criteria including treatment failure, suboptimal control, and persistent problematic symptoms. 89% of ASAS members endorsed the definition, including treatment-refractory cases with specific… https://t.co/3qWPQAGZ7c https://t.co/mVQzfLtaiI

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
The 2009 ASAS classification criteria did not meet the set targets of 75% sensitivity and 90% specificity in the CLASSIC cohort, indicating the need for revision of these criteria to increase its performance and validity in classification of axSpA. Abst#0820 #ACR24 #ACRBest… https://t.co/lF3QbRUpx3 https://t.co/SHPMpCjizS

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Adela Castro AdelaCastro222 ( View Tweet)
Gender based response in Axial SpA. A hot topic at ACR @ACRheum @RheumNow @hac28 @SPARTAN_Updates https://t.co/zbnE6kjQhL

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Marina Magrey mmagrey1 ( View Tweet)

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