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Are Emulation Trials a Fantasy?
Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?
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Spicy network SRMA, 123pts w/JAK-TNF-PLBO
TNF >> JAK w/respect to malignancy (expected) & better than PLBO (spicy!)
JAK > PLBO for heme cancers (makes sense); no significant (but slight trend) toward PLBO > JAK for all cancer
The debate continues
#ACR24 @RheumNow Abstr#0989 https://t.co/tBnb02gyzF
Mike Putman EBRheum ( View Tweet)
Koc et al. STAMP trial in PsA. Secukinumab+MTX+GC vs MTX+GC(+SSZ if needed). Both could go to TNF if needed. Secukinumab significantly better at week 12 but no longer at week 24. @RheumNow #ACR24 Abstr#1457 https://t.co/4TGSiUPebV https://t.co/eAANkYIpzy
Links:
Richard Conway RichardPAConway ( View Tweet)
Abst #1473 evaluated association of SJC in PROs from 2 Bimekizumab trials (bDMARD naïve vs TNFi-IR)
-bDMARD naïve had less SJC at baseline
-In both groups, pts w lower SJC had sustained improvement in pain and fatigue over time.
#ACR24 @RheumNow https://t.co/zwxsSbga7c
Adela Castro AdelaCastro222 ( View Tweet)
Are biosimilar multi-switches an issue?
real world data: DANBIO 🇩🇰
biosimilar to biosimilar switch
having already had a switch prior ('previous ADAo') did not increase cessation
The risk of biosimilar switching on immunogenicity is greatly overstated
#ACR24 ABST1000 @RheumNow https://t.co/1yAfZrrNd0
David Liew drdavidliew ( View Tweet)
Single centre experience of belimumab at @GSTTnhs
@RheumNow #ACR24 https://t.co/c4jlEPRwen
Mrinalini Dey DrMiniDey ( View Tweet)
#2282
🔬 Personalised Approach to TNFi in RA
📊 N=50👇; 43 responders
🔑 Findings
💥TNFR2 rs1061622 polymorphism linked to TNFi response
💥 MR/RR alleles ⬆️ 10X odds non-response v. MM allele (OR = 10.1,p=0.04)
🎯Genotyping may guide personalized RA therapy.
#ACR24 @RheumNow https://t.co/MQKZUCEPxj
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
#1474
🔬Severe PsA? Guselkumab (GUS) has promise!
➡️In bionaive pts with severe disease activity,
GUS v. PBO resulted in:
🔴73% improvement in joints
🔴53% lower disease activity
🔴63% better PtGA by 2 years
➡️Rapid results by W2, sustained through W100.
#ACR @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Improved fertility in women with RA when treated with a Treat-to-Target (T2T) approach aimed at remission.
Key findings:
- Shorter time to pregnancy (TTP) in PreCARA cohort (84 days) vs. PARA cohort (196 days).
- Increased TNF-inhibitor use and lower NSAID/prednisone use in the… https://t.co/YyD2lpXVRC https://t.co/LH5LMOH8al
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
The post hoc analysis of the SURPASS study evaluated predictors of radiographic spinal progression in axial spondyloarthritis patients treated with IL-17A (secukinumab) or TNF inhibitors over 2 years.
Key findings:
- New syndesmophytes: 18.2% (SEC 150 mg), 15.8% (SEC 300 mg),… https://t.co/jke6OHdPjZ
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Race of b/tsDMARDs in RA, the “JAK-pot” study.
JAKi and TNFi with more rapid early improvement in CDIA, HAQ, and pain compared to ABA or IL-6 inhibitors…..although effects blunted after adjusting for patient and RA characteristics
#ACR24 @RheumNow ABST#0501 https://t.co/8M4wX3LAbW
Jiha Lee JihaRheum ( View Tweet)
Abstract #0805
Data from OTIS Registry shows Certolizumab pegol (Cimzia) exposure during pregnancy was not associated with increased risk of major birth defects, structural defects, or adverse pregnancy outcomes. #ACR24 @RheumNow
Akhil Sood MD AkhilSoodMD ( View Tweet)
Is it safe to administer rotavirus vaccine to infants exposed in utero to TNFi?
Abstract#0806 shows no significant ↑ in the risk of diarrhea-related healthcare events among TNFi-exposed infants who received the vaccine compared to those who did not
@RheumNow #ACR24 https://t.co/HpTCgywE4H
Akhil Sood MD AkhilSoodMD ( View Tweet)
❔Can rheum drugs have beneficial effects on cognition?
💊Possible benefits with MTX and TNFis but certainly an active area of research and more studies needed
#ACR24 @RheumNow https://t.co/lCnIRLwNjK
Mrinalini Dey DrMiniDey ( View Tweet)
Switching vs cycling - which is better? In PsA & axSpA, a real-world analysis shows that switching to IL-17Ai after TNFi discontinuation may lead to similar or better outcomes compared to cycling to another TNFi. Data from the CorEvitas PsA/SpA Registry. Abstr#0585.… https://t.co/AJP4NBjmzr
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Courvoisier et al. JAK-pot study analysis. Which therapies work quicker in RA? JAKi (as expected) and TNFi (what!?) faster than IL6 and abatacept. @RheumNow #ACR24 Abstr#0501 https://t.co/7DPPwHlqpP https://t.co/3mOJ62hZhp
Links:
Richard Conway RichardPAConway ( View Tweet)
#0585 🔬PsA/axSpA: TNFi Cycling v IL-17Ai Switch
➡️470 pts: Switchers to IL-17Ai had similar/better outcomes v TNFi cyclers @ 6 mo
➡️PsA: Switchers had improved arthritis/psoriasis(-5.0, p=0.02)
➡️axSpA: Switchers had improved fatigue(-9.4, p=0.01)
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Serrano-Combarro et al. Abatacept in RA-ILD. 343 patients. In 23.3% ILD progressed on abatacept. Is that good or bad? We need comparative studies! @RheumNow #ACR24 Abstr#0475 https://t.co/nUEDdjGguA https://t.co/sXEF72MafK
Links:
Richard Conway RichardPAConway ( View Tweet)
PRO-SPIRIT trial data on 1192 PsA pts showed IL-17Ai seemed better than IL-12/23i and IL-23i improving cDAPSA at 3m and as effective as TNFi and JAKi. No much differences seen at 12m. Abst#0076 #ACR24 @RheumNow https://t.co/dScwsmkDOe
Adela Castro AdelaCastro222 ( View Tweet)
With many treatments for #PsA and #PsO, what are the prescribing trends?
Abstract 0604: TNF inhibitors remain the most common (~60%), but over the past 10 years, IL-17i use rose from 0.2% to 19%, and IL-23i from 0.1% to 39.7%! #ACR24 @RheumNow https://t.co/4TnCAkHfuY
Akhil Sood MD AkhilSoodMD ( View Tweet)
