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CAR-T

Taking CAR-T for a Test Drive

d Michael Putman, MD, MSCI

When the ACR Convergence 2024 abstract site went live, the first query I typed into the search bar was, “CAR-T.” I consider myself a CAR-T skeptic and would be surprised if the magical results from this NEJM case series replicate at scale, but it seems likely that CAR-T will revolutionize the care for (some) patients with rheumatic diseases. What new data will be presented at ACR?

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Are Emulation Trials a Fantasy?

d Janet Pope, MD, MPH, FRCPC

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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Meeting audience conference

ACR 2024 - Day 1 Report

d Jack Cush, MD

ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings.  The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.

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axSpA: Moving the needle in time to diagnosis

d Antoni Chan, MD, PhD

The journey to axial spondyloarthritis (axSpA) diagnosis is often prolonged and challenging. Understanding the factors contributing to the delays is important to improve the clinical, psychological, social and economic outcomes. Data from the SPACE cohort (abstract 0566), the ASAS-PerSpA study (abstract 0550) and the US Claims data (abstract 0558), allows us to highlight the barriers to early diagnosis of axSpA and identify opportunities for improving early diagnosis and treatment.

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RheumNow’s expanded coverage of the #ACR24 annual meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty.

Dr. John Cush RheumNow ( View Tweet)

In the @ACRheum MSK Ultrasound Guidance: In difficult-to-treat RA, MSUS can distinguish symptoms of active synovitis from other sources of pain. (consensus: mod) CURRENTLY do you often use ultrasound when RA gets difficult to treat, and synovitis isn't obvious? #ACR24 @RheumNow

David Liew drdavidliew ( View Tweet)

Phase 2 DBRCT of daxdilimab, an immunoglobulin-like transcript 7 to target plasmacytoid dendritic cells No difference in primary outcome... but kiiiinda looks like something there? I dislike Phase 2's; should go straight to Phase 3 if able #ACR24 @rheumnow Abstr#1542 https://t.co/osDWDskfnA

Links:

Mike Putman EBRheum ( View Tweet)
The DESIR cohort of Dr. Franc et al. showed that female pts with early axSpA had significantly lower AMH levels vs. general population reflecting low ovarian reserve & fertility. Mechanism? Bigger studies need to be done @RheumNow #ACR24 abs577 https://t.co/842rX79bq6

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sheila RHEUMarampa ( View Tweet)
@KDAO2011 help me out here; what is the point of analyses like this? NO difference in PROs comparing voclo vs plbo... ...but if you split by responder status its different Prescribing the drug doesn't help PROs, but when it works it works? 🤔 #ACR @RheumNow Abstr#1538 https://t.co/339drHwUuK

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Mike Putman EBRheum ( View Tweet)
This is very true. We showed a number of years ago that patients with gout have increased platelet activation at baseline, which then dramatically increases during flare. Treating gout properly may ameliorate this. #ACR24 @RheumNow https://t.co/VL8fy3ezjx https://t.co/9XdrG1NG9c

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Richard Conway RichardPAConway ( View Tweet)

Remote monitoring SHOULD increasingly be part of our care. BUT I don't think it neccessarily will. Just like with conferences reverting to non-virtual when facilitating virtual is logical from a learning perspective. There are other limiting interests in play #ACR24 @RheumNow https://t.co/UN3jGa7jVZ

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Richard Conway RichardPAConway ( View Tweet)

One situation I've seen MSK ultrasound have impact ++ in the real-world is showing patients their own RA disease activity. Arthritis might be the invisible disease sometimes, but seeing it in full Doppler colour on screen means a lot to many. #ACR24 MSK USS Guidance @RheumNow https://t.co/wd9s6FAfp4

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David Liew drdavidliew ( View Tweet)
A framework for critical conversations with patients (because the big decisions deserve high quality counselling, otherwise the consequences are real) #ACR24 16S17 @RheumNow https://t.co/fiwYY1DuMq

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David Liew drdavidliew ( View Tweet)
"Do not fear RPF." - John Stone Retroperitoneal fibrosis certainly feels challenging at times, and radiologic features might stay even after functional improvement but we've come a long way (although, despite B cell depletion, there's plenty more to do) #ACR24 16S26 @RheumNow https://t.co/2Y3buXrAFY

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David Liew drdavidliew ( View Tweet)
The @ACRheum RA outcome measures toolkit has all the relevant tools for measuring outcomes in rheumatoid arthritis (and exactly how to do it). https://t.co/GZ7tZ6fNMK Great for all US rheumatologists, but also very handy for all of us globally #ACR24 16S30 @JYazdany @RheumNow https://t.co/MSHA353MKR

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David Liew drdavidliew ( View Tweet)
Abstract 333 showed that in a cohort of patients with IIM-ILD increased age, PH, FVC decline at 1 yr, SOB at 2 years were predictors for mortality and lung transplant ! #ACR24 @RheumNow https://t.co/NgOj7WKeE3

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Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
Factors associated w/ secukinumab response in PsA? Analysis of 2.7k pt in EuroSpA Associated w/ favorable response ❗️elevated CRP >10 mg/L ❗️fewer prev tx Associated w/ lower response: ❗️smoking ❗️higher patient global score / HAQ @RheumNow #ACR24 Abstr 2325

Brian Jaros, MD Dr_Brian_MD ( View Tweet)

RheumNow Day 1 Recap: ACR Convergence 2024 Highlights https://t.co/xjCMpzXhTE

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Dr. John Cush RheumNow ( View Tweet)

RheumNow’s expanded coverage of #ACR24 is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty.

Dr. John Cush RheumNow ( View Tweet)

171 SSc pts w/ hand Xrays and US found 20% w/ Joint involvement. Active Synovitis & tenosynovitis predicted by CRP>10mg/L (p = 0.013), fibrotic tenosynovitis on US (p = 0.005), anti-RNA polymerase III antibodies (p = 0.043) https://t.co/DZrM5aQpJ7 https://t.co/CkGP6H8J6x

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Dr. John Cush RheumNow ( View Tweet)
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