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EULAR 2024: New drugs for RA?
Several abstracts are presenting new compounds, targeting either RA well-known inflammatory pathways or offering new mechanisms of action or therapeutic sequences; these are summarized below.
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OP0018 @RheumNow #EULAR2024
🔎 Study looked at early RA patient trajectories through time-independent disease state
📊 Authors demonstrated 4⃣ trajectories in early RA
🦴 Inflammation in joints, blood & poor response are main discriminatory factors https://t.co/IeDIU3jg9B
Mrinalini Dey DrMiniDey ( View Tweet)
➡️ OP0064 @RheumNow #EULAR2024
➡️ Non-articular pain (NAP) at early RA diagnosis & evolution over the first yr of RA treatment
➡️ NAP, esp regional NAP, common in early RA during 1st yr
➡️ NAP in axial, both upper quadrants and both lower quadrants common https://t.co/FOGcS05Z25
Mrinalini Dey DrMiniDey ( View Tweet)
OP0086 #EULAR2024 @RheumNow #EULARBest
Pain & remission/low disease activity at 3m in pts with #RA in RA-BE-REAL
Pts taking #baricitinib more likely to achieve pain control vs TNFi/other mode of action
1/2 pts achieving remission/LDA & had bari achieved ≥70% pain relief.
Mrinalini Dey DrMiniDey ( View Tweet)
TOLERA trial in RA
RTX/ABA sequence versus RTX alone
10pts each group
Primary outcome was ambitious: ACPA seroconversion
No difference between ttmts (and also no seroconversion)
No diff in disease activity
No diff in ACPA change wt wk52
@RheumNow OP0069 #EULAR2024 https://t.co/0EM7XRzfNo
Aurelie Najm AurelieRheumo ( View Tweet)
AMPLIFIED RCT, 300+ pts
ABA NOT (!) superior to ADA
in dual seropositive SE+ MTX IR RA pts
ACR50 rate high in both gps ABA 59% vs ADA 64%
No new safety signal
Defeating the encouraging data from smaller trials
Abstr#OP0007 #EULAR2024 @RheumNow https://t.co/PvRUnpthHl
Aurelie Najm AurelieRheumo ( View Tweet)
Reminder of relevance of #Rheumatoid factor
⬆️RF also predicts
cardiovascular events ⚠️
⬆️disease activity
❗️Worse outcomes
#EULAR2024 #RF #RA https://t.co/kXwh682ONp
Dr Gurdeep S Dulay gurdeep_dulay ( View Tweet)
What is new in RA at #EULAR2024?
Below 👇🏻 my article summarising some of the exciting new MoA, therapeutic strategies and drugs that might (or not) shape RA future!
https://t.co/ttYdElWlBY
@RheumNow
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
🚨New(ish) MoA in RA
Abiprubart anti-CD40 mAb
Blocks T cell activation
Reduction DAS28-CRP Wk 12 -2.2 vs. -1.6 PBO
Small sample n=25 per gpe
Safety profile acceptable
To be continued...
Abstr#OP0036 #EULAR2024 @RheumNow https://t.co/su4L7A7nGJ
Aurelie Najm AurelieRheumo ( View Tweet)
Substudy of SELECT-COMPARE trial
Week 60 immunogenicity RZV RA treated UPA 15 mg + MTX
✔️ HUmorale response 71%
✔️ Cellular response 65%
✔️ No serious AEs
✔️ One event of HZ occurred during follow up
Abstr#OP0020 #EULAR2024 @RheumNow https://t.co/8OMwGuIZFx
Aurelie Najm AurelieRheumo ( View Tweet)
Novel B cell depleters! Bispecific T cell engagers (BiTEs) being studied for #SLE & #RA as a way to get CAR-T cell like responses but more accessible w/less risk for CK release syndrome. #EULAR24
T cell-engaging therapies — BiTEs and beyond | Nature Reviews Clinical Oncology
TheDaoIndex KDAO2011 ( View Tweet)
Nordic country analysis of mortality in RA (n 1145), RA-ILD (239), population ILD (378) & nl controls (1890) shows most mortality in pop ILD (HR 8.3), but less in RA-ILD (HR 3.6). Why is death less in latter; could it be RA therapies? Abstr #POS0022 # EULAR2025 https://t.co/wFZq49rIiW
Dr. John Cush RheumNow ( View Tweet)
More data from Jak-pot, the real-world multinational RA study, this time looking at infection in 14 national registries
JAKi (vs TNFi) had no signal for general/serious infection (excluding HZ)
Somewhat reassuring post-ORAL Surveillance infection data
#EULAR2024 OP0092 @RheumNow https://t.co/ocAbc4NiV2
David Liew drdavidliew ( View Tweet)
Nice idea from Erlangen: B cell then T cell suppression for ACPA+ RA. A tolergenic reset of sorts. Sounds interesting…
small study, but sadly no difference over ritux only. Does seem broadly safe though - maybe will be a strategy for another disease!
#EULAR2024 OP0069 @RheumNow https://t.co/mXUS4kpRCK
David Liew drdavidliew ( View Tweet)
OP0053 #EULAR2024 @RheumNow #EULARBest
Effect of #RTX in preclinical #RheumatoidArthritis
RA-risk pts given 1 dose PBO or 1000mg RTX
RTX in RA-risk pts delayed onset of RA by 1yr; no benefit on QoL
Pts developing RA: RTX didn't alter PROs or disease severity when developing RA
Mrinalini Dey DrMiniDey ( View Tweet)
Shingrix in upadacitinib + MTX RA, in SELECT-COMPARE RCT:
data now out to 60w
good humoral and cellular response in most, even without MTX withheld
(& good safety too)
Important for our JAKi-treated patients to get the protection they need #EULAR2024 OP0020 @RheumNow https://t.co/FqVCCwUJOg
David Liew drdavidliew ( View Tweet)
AMPLIFIED study:
abatacept vs adalimumab in RF+ACPA+ early RA
Not a single blink of difference.
Maybe for high CCP titre but the inverse for low CCP.
Sadly, theoretical mechanistic benefit doesn’t always wash out. We’ll keep on looking for predictors #EULAR2024 OP0007 @RheumNow https://t.co/IswCub9lLn
David Liew drdavidliew ( View Tweet)
@Janetbirdope @RheumNow #EULAR2024 JAK-i Debate
@drdavidliew (NOT in support of regulation)
- is the signal real? Query about replicability & data came from N. America. Not reflected on real-world data of enriched cohorts
- is the warning justified?
- are there unintended consequences?
@RheumNow https://t.co/TXUf90fqwN
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Asking the quintessential Australian question at #EULAR24 by @drdavidliew - does the ORAL surveillance study for JAKi *truly* pass the pub test?
@eular_org @Janetbirdope @RheumNow
What does #MedTwitter think? https://t.co/bqwPU8XX5S
Benjamin Sutu benjaminsutu ( View Tweet)
#EULAR2024 JAK-i Debate.
@Janetbirdope [Pro Regulatory Safety Measures]
- to do no harm esp since there are other alternatives
- supported by RCT
- although JAK-i have different structures, data from individual RCT + LTE showed similar rates of malignancy & MACE @RheumNow https://t.co/jQKQmHE9Fg
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)