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#ACR25 How hard will you go & at what cost? A study in China using CD20/BCMA Bispecific autologous CAR-T showed profound depletion, normalisation of abs and good response in #SLE (10/11 had LN). But 2 had G3 infections & cytopenia. Presenters said some had IVIG @RheumNow #ACRBest https://t.co/TF0wpib5rr
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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Starting biologic early could save more than joints. In 329 RA pts, first-line anti-TNF reduced testing and hospitalization costs vs csDMARDs across Europe. Earlier targeted therapy pay off in outcomes and economics.
@RheumNow #ACR25 Abstract#2271 https://t.co/zZ32CpT36d
Jiha Lee JihaRheum ( View Tweet)
#1747 Serious infections ~2× more common in RA-LD, esp RA-ILD. Pulmonary, bacterial, viral & fungal infections all increased, underscoring need for tailored prevention and vaccination. @RheumNow #ACR25 https://t.co/soyzqLk7Vj
Mrinalini Dey DrMiniDey ( View Tweet)
#1746 In large US RA cohort, elevated GDF-15 & pentraxin-3 levels linked to prevalent RA-ILD; high GDF-15 predicted future ILD risk.
Other fibrosis-related mediators from IPF or heart failure were not associated, suggesting RA-ILD has distinct pathogenic pathways @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
New insights into Pre-RA: It ranges from asymptomatic individuals with ACPA positivity to those with symptomatic pre-clinical synovitis. Predicting who will develop RA is difficult, and there is a need for reliable biologic tools. Focusing on high-risk patients could https://t.co/SPOP7f0t7y
Dr. John Cush RheumNow ( View Tweet)
When every option fails, bold moves remain.
In 5 multi-resistant RA pts, TNFi + JAKi combo brought remission in most without major AEs.
Not standard, not risk-free, but in young, low-infection-risk pts, it may offer a path forward.
@RheumNow #ACR25 Abstract#2272
Jiha Lee JihaRheum ( View Tweet)
Post hoc eval of relapses from MANDARA, MEPO vs BEN in EGPA
30% of pts had relapse, 81% of which were asthma +/- sinonasal disease
Remainder were mostly muscle involved, only a few mononeuritis
Mostly as expected; useful epi data for clinic
#ACR25 @RheumNow Abstr#1769 https://t.co/IKKolMZJlF
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Mike Putman EBRheum ( View Tweet)
Late Breaker: Phase 2 RCT of low dose IL2 in SLE
Dose dependent response in SRI4 over 12 weeks
& surprisingly high rates of LLDAS
Too early to know if useful, but worth evaluating in a phase 3
#ACR25 @RheumNow Abstr#LB01 https://t.co/oPOLG82nwi
Mike Putman EBRheum ( View Tweet)
Late breaking: secukinumab out-performs ustekinumab in PsA pt who have failed TNF therapy
RCT of 119 pt
57.1% response at wk 28 in SEC
27% response at wk 28 in UST
Numerically lower adverse events leading to d/c in SEC
@RheumNow #ACR25 #ACRBest Abst LB06 https://t.co/wDxtscP2ku
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Serrano-Combarro et al. Baricitinib in RA-ILD. Observational, 42 patients. Progressive ILD in 26%. More frequent in women. @RheumNow #ACR25 Abstr#2229 https://t.co/ZXfgxKoau7
Richard Conway RichardPAConway ( View Tweet)
Cutaneous vasculitis: who is most likely to have systemic disease?
430 pt w skin vasculitis examined in case-control
Associated with risk for systemic vasculitis/CTD:
- GI sx
- ulcerating/necrotic lesions
- constitutional sx
- hematuria
@RheumNow #ACR25 Abst 2525 https://t.co/lRjLKRYxDW
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
To be continued (or discontinued?): Abstract 2360: Compared to TNFi, IL-17i & JAKi users had 🔹 Higher odds of med switching <180 days 🔹 Shorter time to discontinuation @RheumNow #ACR25 #axSpA https://t.co/IOHaFSJqHn
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Interesting study evaluating the "CALLY" index (serum albumin × lymphocyte count / CRP / 10,000) for predicing mortality in AAV
I typically dislike these because (1) they are often cumbersome to calculate & (2) they often perform poorly
This one piqued my interest; pretty https://t.co/ziroQOH5Cq
Mike Putman EBRheum ( View Tweet)
Meta-analysis of 3 RCTs (n=1990) shows IL-17i offers comparable joint response but superior skin clearance vs adalimumab in biologic-naive PsA. IL-17i also had fewer discontinuations due to adverse events. Supports sequencing of biologics through different mechanisms of action in https://t.co/SJgFUMxWVb
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
RESET-RA, RCT of vagus nerve stim (device that zaps pts in neck)
Marginal improvements in ACR20 at wk 12; trend in to improvement in unblinded part of study fwiw
Have never seen result that is more likely to be driven by plbo effect & unblinding 🤪
@RheumNow #ACR25 Abstr#2278 https://t.co/BlR570nv7k
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Mike Putman EBRheum ( View Tweet)
MSK side effects of CAR-T, based on FAERS pharmacovigilance data (also see @DrGomezPuerta in @seminarthrheum https://t.co/LnwjU5aebs) #ACR25 ABST1731 @RheumNow https://t.co/kREEy3HLE9
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David Liew drdavidliew ( View Tweet)
PLEX continues to be OUT for DAH in AAV
Retrospective review of ~1.4k AAV-DAH pt
375 who received PLEX compared to those who did not
PLEX tx patients:
- higher odds of death
- higher sepsis
- increased LOS
- increased hospitalization cost
@RheumNow #ACR25 Abst 2517
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Mateo Faxas et al. TriNetX study, propensity score matched. 3000 patients. Arrythmia risk is higher with IL-6i vs TNFi in diabetic RA patients. V Tachy (HR 1.4), PPM need (HR 1.4) significantly higher. AF, SVT, VF all numerically increased. @RheumNow #ACR25 Abstr#2283 https://t.co/U2Tk38Mobg
Richard Conway RichardPAConway ( View Tweet)
Molina et al. 52 weeks of MANHATTAN study. Guselkumab vs second TNFi after failure 1st TNFi in PsA. MDA 52% vs 33%. Remission/LDA 67% vs 62%. @RheumNow #ACR25 Abstr#2373 https://t.co/qdtOlKLfNU
Richard Conway RichardPAConway ( View Tweet)
CD19 counts during RTX maintenance therapy do NOT perform well in assessing the risk of relapse
Interestingly, only younger age was associated with relapse in this retrospective study
@RheumNow #ACR25 Abst 1766 https://t.co/crsFKJ0LnP
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
