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#ACR25 Abstr#0855 Five extra patients were added to complete IMPACT Open Label Phase 2 trial of add-on Certolizumab in APS women + LAC+ve. Results stood: primary endpoint was met (adverse pregnancy outcome=19.6%; lower than 20% expected). Significant enough to adopt @RheumNow https://t.co/zhFVGYXiaU
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
RheumNow’s expanded coverage of the #ACR25 annual meeting is sponsored by Bristol Myers Squibb, Novartis, and UCB. All coverage content is independently selected by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)
In a retrospective study of TAK patients, ~about 1/3 developed new lesions on imaging over time
Most lesions:
- stenotic
- L carotid
- Abdominal aorta
- SMA
50% of the 1/3 = 2 or more lesions
Serial imaging is crucial!
@RheumNow #ACR25 Abst 1631
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
ANCA status does not inform IL-5 agent response in EGPA patients
Terrier et al. analyzed the OLE of MANDARA and compared ANCA+ and ANCA- subgroups:
- similar rates of remission
- similar rates of GC withdrawal
- comparable relapse rates
@RheumNow #ACR25 Abst 1594
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Abstract 1657: Can LLMs track medication history? GPT-4 outperformed most LLMs in identifying TNFi start/stop events and reasons for switch. 💊 Common reasons for TNFi switching: lack of effectiveness, adverse events, and insurance/cost barriers. @RheumNow #ACR25 https://t.co/5FUR9tBoyu
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
#ACR25 Abstr#1608 10! 10! Across the board. 2-yr data from RCT + Open Label showed frequency of both airway and non-airway features of #EGPA improved with Benralizumab/Mepolizumab. Provides assurance to use more in real-world @RheumNow https://t.co/i78xXojGja
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
RheumNow’s expanded coverage of the #ACR25 annual meeting is sponsored by Bristol Myers Squibb, Novartis, and UCB. All coverage content is independently selected by RheumNow & its faculty.
Dr. John Cush RheumNow ( View Tweet)
How many patients do you need to treat to prevent one RA conversion in at-risk individuals?
APPIPRA and ALTO Interception studies, long term data
Number Necessary to Treat to prevent 1 RA conversion across time:
1yr = 4
2yrs = 7
3, 4, 5 yrs = 9
6 yrs = 11
#ACR25 #ABSTRACT1678 https://t.co/GBzUJG8jVk
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
TNFi induction first year in RA leads to:
- less D2T RA at 5y
- more sustained remission from 10y onward
- less DMARD utilization
- less healthcare utilization
in these real-world matched cohorts
given biosimilar prices, this might be worth considering
#ACR25 ABST1677 @RheumNow https://t.co/uL9nHtLkXZ
Links:
David Liew drdavidliew ( View Tweet)
What is the secret of a VNS RCT that works in RA?
=> Implant the device!
RESET-RA RCT Sham controlled 3mo
Then open label in active arm for 66mo
40% pts IR to >=3 bioDMARDs
ACR 20 3 mo 42% vs. 19%
CDAI LDA 27% vs. 11%
82% TNF IR pt had no change in treatment over 12mo
99% https://t.co/lfxa4YXUB4
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Did we need a 2nd Interception RCT of HCQ in Pre-RA?
Unsure but in any case, it does not work either
STOPRA CCP3+>=2 ind 71 HCQ and 74 PBO
36 months RA conversion
Dr Deane's take: "probably wrong drug rather than wrong timing"
#ACR25 @RheumNow #ABSTRACT1674 https://t.co/jysdo8iz7v
Aurelie Najm AurelieRheumo ( View Tweet)
New tx for IPF/autoimmune ILD, nerandomilast (PDE4Bi)
Subgroup analysis from FIBRONEER-ILD, marginally less FVC worsening (-65mL tx grp vs -107mL plbo grp) & no clear improvements in dyspnea/fatigue/cough
But also... 6% absolute reduction in overall, persisted (small n) in https://t.co/Faf26UZuDx
Links:
Mike Putman EBRheum ( View Tweet)
In a cohort of 269,304 IBD patients, NSAID use showed a small increase in IBD-related hospitalisation (HR 1.08), meeting non-inferiority threshold (HR <1.2). No risk in UC (HR 0.96); modest risk in Crohn’s (HR 1.16). Relooks at the current paradigm of blanket NSAID avoidance in https://t.co/O8MWg1BP50
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Interim analysis of Ph3 TULIP-SC trial:
Anifrolumab 120mg SC or PBO weekly + SOC x 52wks
Primary endpt met: BICLA response w/Anifrolumab (60.3%) vs. PBO(43.9%)[p=0.014]
Pts on Ani had sustained BICLA response upto wk 52 (HR 2.1)
Promising results.
#ACR25 @RheumNow Abs1545 https://t.co/nqse1BiGq2
Links:
sheila RHEUMarampa ( View Tweet)
Fragoulis et al. Real world study of bimekizumab demonstrates equal efficacy in IL-17i naive and exposed. @RheumNow #ACR25 Abstr#1439 https://t.co/aCcLgnKvFJ
Richard Conway RichardPAConway ( View Tweet)
In a prespecified exploratory analysis of REGENCY trial data by DrRovin et al,
Bet. wks 24 and 76:
Obinutuzumab ⬇️ LN flares vs. PBO (HR 0.44; p=0.0074)
Pts on Obi had less unfavorable kidney outcomes vs. PBO (HR 0.37; p=0.0039)
Addtl tx option for LN
#ACR25 @RheumNow Abs1521 https://t.co/N5K9Nzh71E
sheila RHEUMarampa ( View Tweet)
Post-hoc analysis of CARE(Ph2B) Study to assess sustained responses in mSLEDAI-2K vs. PBO x 12mos in pts given Cenerimod
Sustained response in Cenerimod Ex-4mg (63.5%) > PBO (50%); HR 1.43
Ongoing research, further data needed.
#ACR25 @RheumNow Abs1519 https://t.co/cQbVVIIyxW
sheila RHEUMarampa ( View Tweet)
Mayer et al. NSAIDs in IBD. Retrospective cohort study. 250000 individuals. Non-inferiority study. No increased IBD-related hospitalisation in UC, but an increase in all-cause hospitalisation. @RheumNow #ACR25 Abstr#1434 https://t.co/he2Xmcqslk
Richard Conway RichardPAConway ( View Tweet)
In ICONIC-LEAD, adolescents (12 to <18 years) with moderate-to-severe psoriasis treated with icotrokinra (ICO) achieved Investigator Global Assessment (IGA) 0/1 in 84.1% vs 27.3% (placebo) and PASI 90 in 70.5% vs 13.6% at Week 16. Week 24 responses reached 88.6%. Safety profile https://t.co/L7h8BlnWaO
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Concerns using dupilumab in EGPA due to secondary eosinophilia
What about when combined with IL-5 therapy?
16 pt on dupi + IL5 agent
- if dupi alone caused eosinophilia -> quelled by IL-5
- no eosinophilia when dupi added to IL-5
- effective but slow
@RheumNow #ACR25 Abst 1605
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
