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Real-world JAK persistence in RA is low: <30% at 2 years across Medicare & Marketscan data (n≈20K). Baricitinib lowest persistence; TOF & UPA slightly higher. Oral convenience hasn’t solved long-term adherence. Why? Safety, cost, access?
@RheumNow #ACR25 A#0369
Jiha Lee JihaRheum ( View Tweet)
Project from my group & rheum-bound resident Mary Peng!
As expected, ischemic vision loss for GCA compared to PMR (HR 5.4) and gen pop (HR 5.6) 😬
NO difference for PMR vs gen pop (aHR 1.10, 95% CI 0.86–1.41)
Reassuring for pts w/PMR!
#ACR25 @RheumNow Abstr#0753 #ACRBest https://t.co/HKzc7OOzmP
Mike Putman EBRheum ( View Tweet)
Avacopan in the real world: we need to be braver
If we want to get steroid-sparing benefit in AAV, we need to trust it
claims data shows modest PNL reduction with avacopan
some manifestations are harder to taper in, but others we just need to be bolder
#ACR25 ABST0726 @RheumNow https://t.co/51nGdpR2db
David Liew drdavidliew ( View Tweet)
#ACR25 Abstr#776 2-Year SELECT-GCA RCT showed that #GCA patients receiving continuous UPA15 to 2-yr maintained their remission (69%) vs those who switched to PBO after in remission for ≥24 weeks (29%). Lower serious infection but higher herpes zoster in UPA15. One VTE @RheumNow https://t.co/FCTNqCVxiZ
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Lindberg et al. Nationwide case-control study in Sweden. Big increase in risk of DVT/PE in AAV, most marked early after diagnosis @RheumNow #ACR25 Abstr#718 https://t.co/FpDcbX15hm
Richard Conway RichardPAConway ( View Tweet)
Heydari-Kamjani et al. Risk of DILI with avacopan. Real world study, propensity score matching. Risk DILI 2% with avacopan vs 1.9% PBO @RheumNow #ACR25 Abstr#724 https://t.co/UhVkcXEYjF
Richard Conway RichardPAConway ( View Tweet)
Ogdie et al. Week 24 results of SOLSTICE study. Guselkumab in TNF-IR in PsA. Good efficacy on skin and joint disease. No difference seen in Q4 vs Q8 weekly doses. @RheumNow #ACR25 Abstr#563 https://t.co/ztK0O9iKb8
Richard Conway RichardPAConway ( View Tweet)
Observational study of fibrinogen for diagnosis of GCA
At a cutoff of 4.7, roughly similar diagnostic performance as compared to ESR/CRP
Kind of neat, but does not appear to have additive benefit
#ACR25 @RheumNow Abstr#0750 https://t.co/xy2qn4jHXP
Mike Putman EBRheum ( View Tweet)
Abstract 0806
Compared to belimumab, Anifrolumab associated with:
↑ infection risk b (HR 1.40, 95% CI 1.05–1.88)
↑ herpes zoster (HR 3.94) & COVID-19 (HR 1.66)
No diff in mortality or hospital use
📈 3-yr infection: 38.3% vs 21.3%
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Real world effectiveness of voclosporin for SLE
Reduction in UPCR from 2.1 at b/l to 0.9 at 6 months, no improvement in eGFR; as expected based on trials
Wonder about market share of BEL vs voclo vs ANI - anyone seen pubs on this?
#ACR25 @RheumNow Abstr#0661 https://t.co/l7i7IWhLSe
Mike Putman EBRheum ( View Tweet)
Albach et al. CAR T-cells in D2T RA. 6 patients. Safety looks ok. ACR20 in 4/6, ACR50 in 2/6. ACPA and RF disappeared. Results maybe not as positive as we might have anticipated? @RheumNow #ACR25 Abstr#471 https://t.co/TaEVWiWsNm
Richard Conway RichardPAConway ( View Tweet)
#0776
In the 2-yr SELECT-GCA trial, continued upadacitinib 15mg maintained remission in 69% vs 29% who switched to PBO, cutting flare risk by 90% and reducing steroid exposure by ~1g.
No new safety signals in older adults (mean 71yrs). @RheumNow #ACR25 https://t.co/KC9sm3ic3q
Mrinalini Dey DrMiniDey ( View Tweet)
Singla et al. In secukinumab phase 3 trials, fungal (inc candida) infections uncommon. 5.51 for sec vs 3.39 for PBO per 100PY. @RheumNow #ACR25 Abstr#585 https://t.co/g78zUsxD5a
Richard Conway RichardPAConway ( View Tweet)
Post-hoc PEXIVAS study, estimating risk of relapse from baseline variables
Lotsa fancy stats, mostly corroborated known risk factors, but model predicted relapse reasonably well!
Probably useful for approach to monitoring... mayyybe treatment?
#ACR25 @RheumNow #Abstr0722 https://t.co/XI9y8KgDNR
Links:
Mike Putman EBRheum ( View Tweet)
Statins and SLE: To add or not to add? 💊
Abstract #0599: In an emulated target trial of patients with SLE, statin users vs non-users had significantly⬇️ risk of all-cause death in both ITT & per-protocol analyses.
- No significant differences in MACE or ESKD.
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Plenary 1: SELECT-GCA (RCT, UPA vs PLBO in GCA)
Pts in remission re-randomized at wk52
Higher maintenance of remission in pts who continued UPA15 (69%) vs switchers from UPA15->PLBO (29%)
Argues strongly for continuing tx in GCA for >1yr!
@RheumNow #ACR25 Ab#0776 #ACRBest https://t.co/exmmIcpgbP
Links:
Mike Putman EBRheum ( View Tweet)
Ribeiro et al. Case series of combination bDMARD/tsDMARD in PsA from Toronto. 24 patients, median just over a year follow-up. Appear effective, especially for objective skin and joint measures. No major safety concerns but short follow-up to date. @RheumNow #ACR25 Abstr#565 https://t.co/Zk3odT2EX2
Richard Conway RichardPAConway ( View Tweet)
#0775
Higher circulating microbial small RNA tDR-1 linked to lower risk of developing RA in CCP3+ individuals (AUC 0.86).
tDR-1 downregulates interferon-response genes in vitro, suggesting microbiome-mediated anti-inflammatory mechanism in RA pathogenesis. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
#0774
Multi-omic profiling of anti-CCP3+ “at-risk” individuals reveals Tph & cytotoxic CD8+ expansions, altered gene/chromatin profiles and predictive model (AUC 0.77) for RA conversion
PTPN22 locus accessibility & Tph ≥ 2.45% identify highest risk. @RheumNow #ACR25 https://t.co/JDSMkdmoGv
Mrinalini Dey DrMiniDey ( View Tweet)
Dr. Werth on the #SLE guidelines on tx of cutaneous LE:
🔅All patients should be on hydroxychloroquine unless with CI.
☝️Important! For SLE pts presenting with new-onset rashes, review/ask about medications; consider drug-induced SCLE.
#ACR25 @RheumNow https://t.co/ok5jAi7uO0
Links:
sheila RHEUMarampa ( View Tweet)
