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A new score to quantify GCA inflammation?
The treatment paradigm for Giant Cell Arteritis (GCA) has been a binary approach to the presence or absence of vasculitis. When GCA is present, we institute high doses of glucocorticoids for treatment of the inflammatory process. This approach is not well individualized to the patient as we do not account for the degree of inflammation that may or may not be present in the disease. Improved markers to stratify the extent of inflammation can help to tailor a more personalized approach to treatment.
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Up-front Secukinumab in PsA?
We now have an absolute plethora of agents available for use in psoriatic arthritis (PsA). In contrast we have an almost complete lack of understanding of how best to optimise use of these agents – what is the right agent at the right time for the right patient. A study presented this week has given us some further information on the topic.
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Gender Differences in SpA
One of the hot topics during the meeting was gender differences in SpA. Three abstracts presented addressed issues related to these differences particularly in the aspects of treatment response and disease activity.
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Is Pregnancy Truly the Solution for RA?
Pregnancy is perhaps the oldest treatment in rheumatoid arthritis (RA) and has been associated with a natural improvement in disease control in 50-75% of patients. Others, however, are not as successful with unchanged disease activity or… https://t.co/MesVIUl0fC https://t.co/760i5znmeu
Dr. John Cush RheumNow ( View Tweet)
💊Dapirolizumab (DZP) is a novel CD40L inhibitor
💊Results from phase 3 trial in #SLE
💊Demonstrated improvement in disease activity & GC tapering
💊More pts on DZP achieved BICLA response vs PBO
💊DZP well tolerated
AbL16 #ACR24 @RheumNow https://t.co/dtb8QFKvlN
Links:
Mrinalini Dey DrMiniDey ( View Tweet)
Dapirolizumab pegol (DZP) a novel drug wc inhibits CD40L signalling.
In the PHOENYCS GO trial, pts on DZP+SOC achieved BICLA response at wk 48 vs. DZP+PBO
-observed efficacy in SRI4, SLEDAI2K, LLDAS, BILAG
-reduxn in steroid dose
-well tolerated
@RheumNow #ACR24 abL16 #ACRBest https://t.co/5tj2uwqeUz
Links:
sheila RHEUMarampa ( View Tweet)
Allogenic CD19 CAR-NK cells in SLE, experience w/22 pts
68% LLDAS remission, no relapse
As with others, B cell reconstitution w/naive B cells & surprising safety (only 2 cases low-grade CRS)
Lots of potential; still figuring out the particulars
#ACR24 @RheumNow Abstr#L17 https://t.co/zLtMNrXIlX
Links:
Mike Putman EBRheum ( View Tweet)
LEVI-04 a novel neurotropin3-i showed:
-significant analgesia across all measures
-improvement in functional measures and PGA for all doses in a Ph2 RCT
- well tolerated
Hopefully will prove to be a therapeutic option for knee #osteoarthritis in future
@RheumNow #ACR24 absL15 https://t.co/kWsyyyGxyU
sheila RHEUMarampa ( View Tweet)
Late breaking abstract L19
Study on the efficacy & safety of Emapalumab in treating Macrophage Activation Syndrome (MAS) in Still's Disease.
Key findings:
- 53.8% achieved complete response (CR) at Week 8; 85% at any time.
- Rapid reduction in hyperinflammation biomarkers… https://t.co/VcmUdRP6PV https://t.co/r7AMt0IjYk
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Grom et al. Emapalumab (anti-IFNg) in MAS in Stills. 39 patient pooled analysis. 54% complete response at week 8, 85% at any time. Clinically meaningful glucocorticoid reduction in 72%. @RheumNow #ACR24 Abstr#L19 https://t.co/U72KCfsUh7 https://t.co/jNxsvhseVf
Links:
Richard Conway RichardPAConway ( View Tweet)
Sustained Complete Renal Remission
➡️v strict endpoint in #lupus #nephritis trial from 1 yr to 3yr f/u
▶️all added to #LN SoC
#Voclosporin 20.1% vs #placebo 11.8%
Better if 1 visit only didn’t meet endpoint
➡️ then 10% more per group
ACRBest ACR24 @ACRheum @RheumNow abst1545
Janet Pope Janetbirdope ( View Tweet)
Conaghan et al. LEVI-04, neurotrophin-3 inhibitor in knee OA. 518 patients. Significant improvements in WOMAC pain and function, and PGA. So sign of any increase in rapidly progressive OA (as with NGF inhibitors) @RheumNow #ACR24 Abstr#L15 https://t.co/qud4wTAikY https://t.co/0wjjG4U4bf
Links:
Richard Conway RichardPAConway ( View Tweet)
Late breaking abstract L16
Dapirolizumab Pegol showed significant improvement in SLE disease activity in our Phase 3 trial.
Key findings:
- 49.5% of patients achieved BICLA response at Week 48 vs 34.6% on placebo (p=0.0110).
- 60.1% achieved SRI-4 response vs 41.1% on placebo… https://t.co/ZawdsLOxmK https://t.co/gpV3KayIW1
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
PHOENYCS GO, RCT of dapirplizumab, novel CD40Li in SLE
Met primary endpoint (NNT~6 for BICLA) & numerical improvements in many other endpts
1 MI & 1 death from infection over 213 pts
Encouraging for sure! Second phase 3 being launched
#ACR24 @RheumNow Abstr#L16 #ACRbest https://t.co/QwDMKjhFvb
Links:
Mike Putman EBRheum ( View Tweet)
RheumNow’s expanded coverage of the #ACR24 Annual meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty
Dr. John Cush RheumNow ( View Tweet)
In order to have a
#DMOAD in knee #osteoarthritis
➡️ early detection may be v important
Study of early pt Symptoms was done
2/3 had pain
1/2 #joint Swelling
Need biomarkers & sensitive imaging in early #OA as symptoms are
NOT uniform
#ACR24 @RheumNow @ACRheum abst2111 https://t.co/K94m9rOjtP
Janet Pope Janetbirdope ( View Tweet)
Pts w #osteoarthritis and T2 DM
👇
Who Have
⬆️pain
Have
worse control of #diabetes
Even after adjusting for #BMI
Chicken or egg - which comes 1st
🤷♀️
#ACR24 @RheumNow @ACRheum
Abst#2110 https://t.co/eN2xAw0EMG
Janet Pope Janetbirdope ( View Tweet)
Does #hand #osteoarthritis
Benefit from
#traction #splinting?
Nope 👎
Small 2 site #RCT - not helpful
I may Recommend #splinting - sometimes pts get
Pain relief - in my opinion
but this one didn’t help
#ACR24 @RheumNow @ACRheum
Abst#2108 https://t.co/K0Ud7uCb1P
Janet Pope Janetbirdope ( View Tweet)
How long is a long acting #intra-articular #steroid #injection in #knee #osteoarthritis?
#IA steroids can be q3monthly
#RCT of IA #fluticasone #propionate
Was superior to #placebo
Seemed to last approx 24 weeks
➡️ sub analysis in moderate pain, BMI<30
#ACR24 @RheumNow #2106 https://t.co/QBFCqXd1Q8
Janet Pope Janetbirdope ( View Tweet)
#Scleroderma #molecular #signatures in #skin predict long term outcomes
👇worst with inflammatory signature
This may have clinical and trial applicability
Nice work!
Abst0711 #ACR24 @RheumNow @ACRheum https://t.co/3CFxu6bACu
Janet Pope Janetbirdope ( View Tweet)
