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Key Psoriatic Arthritis topics and updates at EULAR 2022
At EULAR 2022, I have been looking at topics and presentations in psoriatic arthritis (PsA). Here are my top picks from this year's meeting.
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EULAR 2022 – Day 3 Report
By now, those of us attending the meeting know how to find a free coffee or sprite, have found comfortable meeting nooks and know our way around! PAnd congrats to you virtual Rheums for mastering the multi-screen, multitask simultaneous consumption posters, tweets and oral abstract presentations.
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Bimekizumab: IL-17A and F inhibitor for tx of PsA - BE OPTIMAL trial reached primary endpoint: ACR50 44% vs. placebo
Efficacy as early as 2 weeks
No MACE, uveitis, IBD, deaths
@RheumNow #EULAR2022 ABST#LB0001 https://t.co/sHRRwLlChi
Robert B Chao, MD doctorRBC ( View Tweet)
In vitro study shows Upadacitinib inhibits enthesis T cell derived TNFa and IL-17A, disrupting the prominent IL-23/IL-17/TNFa axis driving SpA.
@RheumNow #EULAR2022 ABST#POS0331 https://t.co/pNL3Zlgmt7
Robert B Chao, MD doctorRBC ( View Tweet)
Phase 3 compared Bimekizumab to PCB and Humira; it met all endpoints for PsA; the drug inhibits both IL17F & IL-17A. Safety signal: increase fungal (candidal) infx #EULAR2022 LB0001 @rheumnow https://t.co/MJJwj44YgU
TheDaoIndex KDAO2011 ( View Tweet)
McInnes @IainBMcInnes1 et al. Bimekizumab (IL17A/Fi) in PsA. BE OPTIMAL 852 patient RCT vs PBO vs ADA. Looks same for joints, better for skin than ADA (not stat sig) @RheumNow #EULAR2022 LB0001 https://t.co/oKEHJE3tGn https://t.co/H7nPnbEWUB
Links:
Richard Conway RichardPAConway ( View Tweet)
Bimekizumab (BKZ) vs PBO at 16 week BE COMPLETE for PsA with inadequate response to TNFi ACR50 44% vs 7%,PASI90 69% vs 7%, ACR20 67% vs 16%, ACR70 27% vs 0.8%, PASI 100 60% vs 5%, MDA 44% vs 6%, no new safety signals #EULAR2022 @RheumNow OP0255 Merola et al https://t.co/riU2sIXGs9
Dr. Antoni Chan synovialjoints ( View Tweet)
#LB0005 #EULAR2022 Phase 3 RCT of Bimekizumab, dual IL17A and 17F inhibitor in bDMARDs-naive PsA showed significant improvement in ACR50 and PASI90 scores vs Placebo. No major safety signals. Skin response is excellent! @RheumNow https://t.co/yhgB8LGXh6
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2022 LB0001
Bimekizumab (IL-17F and IL-17A) in bionaive PsA
BE OPTIMAL phase 3 trial, 24 weeks
⭐️Met Primary endpt - ACR50
⭐️Met other ACR and PASI endpts
⭐️Safety: higher fungal infections
@RheumNow https://t.co/x8u6B93FNl
Eric Dein ericdeinmd ( View Tweet)
BE OPTIMAL Phase 3 RCT
Bimekizumab dual IL17A & F inhibitor in bionaive PsA
⭐️ACR50 wk 16 43.9% vs 10% PBO
⭐️PASI 90 wk 16 61% vs. 3% PBO
⭐️separation from wk 4
Safety: fungal injections BKZ > ADA
@RheumNow
LB0001 #EULAR2022 https://t.co/7ZwV1XDSNb
Aurelie Najm AurelieRheumo ( View Tweet)
CorEvitas PsA Registry (1000+ pts)
Analysis of biologics prescription according to disease domains
No real surprise to see that IL-17i were prescribed more frequently in pts w/ PsO BSA>10% at BL
Overall first line TNFi 40% > IL-17i 14%
POS0309 @RheumNow #EULAR2022 https://t.co/dkLxl8d6ug
Aurelie Najm AurelieRheumo ( View Tweet)
Castrejon et al. BIOBADASER registry study. Cancer risk with various bDMARDs. Overall I don't think there is a difference here. Lowest in IL17i and highest in abatacept but older and comorbidity confounders @RheumNow #EULAR2022 #POS1439 https://t.co/gfv78ouOTJ
Richard Conway RichardPAConway ( View Tweet)
Izokibep - potent and small molecule IL-17A inhibitor Phase 2 study in PsA patients
Fast onset, met ACR50 primary endpoint
AE included site reaction and candida infection
@RheumNow #EULAR2022 ABST#OP0258 https://t.co/vZ4xmnhyhl
Robert B Chao, MD doctorRBC ( View Tweet)
52 wk trial using MSK Ultrasound study on PsA receiving secukinumab showed an early and continued improvement in GLOESS scores.
Synovial hypertrophy most responsive.
Hands and feet, wrist and knees most affected and responsive.
@RheumNow #EULAR2022 ABST#OP0260 https://t.co/jeQezIWLxa
Robert B Chao, MD doctorRBC ( View Tweet)
Merola et al. BE COMPLETE trial of bimekizumab (dual 17A/17Fi) in TNF-IR PsA. Week 16 ACR50: 43.4% BKZ vs 6.8% PBO. Rapid response with separation from week 4. @RheumNow #EULAR2022 OP0255 https://t.co/ZaxAeePP6L https://t.co/D5mDdkno3c
Links:
Richard Conway RichardPAConway ( View Tweet)
Behrens et al. Izokibep (small molecular size IL17Ai, suggested to abrogate issues with tissue distribution of monoclonal abs) in PsA. ACR50 52% in 80mg, 48% in 40mg, 13% in PBO. @RheumNow #EULAR2022 https://t.co/FUS50ax79C https://t.co/e1n1RbNw1b
Links:
Richard Conway RichardPAConway ( View Tweet)
BE COMPLETE RCT
Bimekizumab vs. PBO in TNFiIR PsA pts
meets its primary criteria at 16wks w/
-ACR50 43%
-PASI 90 69%
and MDA achieved in 40+% pts
No new safety signal.
@RheumNow #EULAR2022 OP0255 https://t.co/QazYlzDqIc
Aurelie Najm AurelieRheumo ( View Tweet)
Real world study of over 6500 patients from a French Health Insurance database by Pina Vegas et al showed higher persistence of IL17i than TNFi for PsA and PsO. IL17i had better persistence than IL12/23 for PsA and no difference for PsO over 3 years #EULAR2022 @RheumNow POS0075 https://t.co/hBI8tgb5Jb
Dr. Antoni Chan synovialjoints ( View Tweet)
No significant difference in malignancy risk in patients with rheumatic disease and a prior history of malignancy, who started bDMARDs or tsDMARDs. Interestingly IL-17i had 0 malignancy events and CD-20i were next lowest.
@RheumNow #EULAR2022 ABST#OP0138 https://t.co/Mq3YvOrSY8
Robert B Chao, MD doctorRBC ( View Tweet)
Large French study of over 23k patients with either PsA or PsO showed a longer persistence (time of initiation to discontinuation) in those who took IL-17i vs. TNFi for PsA and PsO pts. IL-17i longer than IL-12/23i in PsA pts.
@RheumNow #EULAR2022 ABST#POS0075 https://t.co/rH1g4fPUYC
Robert B Chao, MD doctorRBC ( View Tweet)
