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Future Therapeutics for Rheumatoid Arthritis and Lessons Learned - RNL2021 Highlights

Kathryn H. Dao, M.D.

In case you missed it, RheumNow Live 2021 delivers what it promises: a good consistent program pack with high energy interactive learning.

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Liver.hepatitis.jpg

Liver Management in Rheumatoid Arthritis - RNL2021 Highlight

Olga Petryna, MD

While rheumatoid arthritis (RA) is not known to affect the liver directly, underlying liver disease and treatment-related effects on the liver can often become an obstacle in the management of many RA patients. In his Sunday presentation at RNL2021, Dr.

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RA ILD RTX lung

Rituximab vs. JAK inhibitors in Rheumatoid Lung Disease

Jack Cush, MD

There are no current FDA approved therapies for rheumatoid arthritis associated interstitial lung disease (RA-ILD) or bronchiectasis, but a recent retrospective cohort study showed equivalent outcomes when RA-ILD patients were treated with either rituximab or janus kinase inhibitors.

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Super RA superman

Are You a Super Rheum?

Jack Cush, MD

Several weeks ago, at the Rheumatology Winter Clinical Symposia, an interesting debate between Drs. Orrin Troum and Marty Bergman hashed over the concept of whether rheumatologists should sub-specialize with a practice, research or career devoted to one disease ("Super Rheum"), or be "selective" about what disorders and diseases they would treat or just be a generalist. 

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#RNL2021 Highlights: Future Therapeutics for Rheumatoid Arthritis and Lessons Learned https://t.co/NxLyHeI2f4 https://t.co/df7lPEia0D

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Dr. John Cush RheumNow ( View Tweet)
Claims data analysis (MarketScan, Medicare, Optum) of 87,653 RA patients starting either TNF inhibitor or tofacitinib shows venous thromboembolism (VTE) is rare (<1 per 100) RA Rx with either. VTE risk was same for Tofa and TNFi (HR of 1.13 [0.77-1.65]) https://t.co/UoMQRp12vo

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Dr. John Cush RheumNow ( View Tweet)

Dr. Fleischmann vs. Dr. Matsumoto: get rid of MTX vs. get rid of biologic in RA remission. Both argue on sustained remission, risk for anti-drug antibodies, longterm safety. Dr. Buch’s perfect answer… “it depends on patient’s preference, cost.” #RNL2021 https://t.co/FBf2uoDx0B
k dao KDAO2011 ( View Tweet)
Adding RTX to leflunomide works but may at ACR50 level. 140 RA pts on LEF given RTX or PBO w/ ongoing LEF. Wk 16, RTX+LEF ACR50=32% (vs PBO 15%; P=0.02), but not wk 24 (27 vs 15%), yet ACR20 was signif. RTX had more SAEs (20 vs 2%) https://t.co/t6Z9m7P2Ur

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Dr. John Cush RheumNow ( View Tweet)

News Feature: Liver Management in Rheumatoid Arthritis - #RNL2021 Highlight by Dr. Olga Petryna ( @DrPetryna ) https://t.co/OeuloE0yEd https://t.co/qYd1K0dADu

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Dr. John Cush RheumNow ( View Tweet)
Dr. Buch discusses the differences between difficult to treat vs refractory RA in #RNL2021. @RheumNow https://t.co/TqrHcBt0la
Dr. Rachel Tate uptoTate ( View Tweet)
News Feature: Rituximab vs. JAK inhibitors in Rheumatoid Lung Disease https://t.co/2P0tdxvZD2 https://t.co/7gfE1CPSEx

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Dr. John Cush RheumNow ( View Tweet)
Early RA pts given steroids (GC) do Not have short or long term benefits from GCs. 180 ERA pts given compared to 294 who did not. 5 yr F/U showed no differences in DAS28-CRP, HAQ or pain between groups. Steroids were used more in seronegative RA. https://t.co/CDUKDgsLRa

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Dr. John Cush RheumNow ( View Tweet)

Using both glucocorticoids & PPI leads to additive risk of osteoporotic fractures - UK database studiedd 12351 RA pts - 1411 w/ OP Fx. Concomitant GCs + PPIs assoc w/ 1.6-fold risk of OP Fx (adj HR: 1.60) vs nonuse; more than 1.2-fold risk w/ either alone https://t.co/vvA6P5LEgs

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Dr. John Cush RheumNow ( View Tweet)

Mavrilimumab (anti-GM-CSF) metanalysis shows gret benefit in #RA - 1145 pts, 3 trials shows significant 12 week responses by: 1) DAS28-CRP remission (RR = 3.31); 2) ACR20 (RR = 2.38); 3) ACR50 (RR = 2.93) & 4) ACR70 (RR = 4.9). Where is it? https://t.co/9L5PFEB1DI

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Dr. John Cush RheumNow ( View Tweet)

Leading the Rheumatoid Arthritis pod with discussions on pneumonia and RA and interstitial lung disease in RA. #RNL2021 https://t.co/psxMTHsOva
Dr. John Cush RheumNow ( View Tweet)
@RheumNow #RNL2021 Dr. Buttgereit on steroids in RA: 2.5 mg/d of prednisone increase total steroid amount in the body by 100% - great therapeutic effect but comes w/plethora of side effects. Q: how do you feel out long term low dose steroids for RA?

Olga Petryna DrPetryna ( View Tweet)

Metanalysis reveals significant heterogeneity in defining Refractory Disease in RA and polyarticular JIA. Should include: 1) Resistance to multiple drugs w/ different MOAs (≥2bDMARDs) and 2) Persistent symptoms and disease activity https://t.co/CL6Mr3cs7J

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Dr. John Cush RheumNow ( View Tweet)

News Feature: Are You a Super Rheum? https://t.co/LsGpFNXlkp https://t.co/Q9iojEQNqL

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Dr. John Cush RheumNow ( View Tweet)
Epi study of Scleritis in the UK (1997-2018) shows incidence declined from 4.23 to 2.79/100K persons/yr. Scleritis pts have 2 fold incr risk of IMIDs- esp GPA, Behçets Sjögrens, ReA, RA, SLE, Crohns, SLE & AS (OR 51 to >3). https://t.co/FzaCLRvmEX https://t.co/98M5o66fpD

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Dr. John Cush RheumNow ( View Tweet)
News Feature: Rheumatic Patients Are at Risk for COVID Death https://t.co/bhJG1vuVA4 https://t.co/VEN3nwSOPB

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Dr. John Cush RheumNow ( View Tweet)
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