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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)
Only 32% of RA pts were satisfied with current txs. In a discrete choice experiment of 354 US pts, many preferred a vagus nerve stimulator over another biologic/JAKi, especially those with prior tx failures. Cost, function, and fatigue drove preferences.
@RheumNow #ACR25 A#0370
Jiha Lee JihaRheum ( View Tweet)
Icotrokinra, a first-in-class targeted oral peptide IL-23R inhibitor, cleared scalp (66%), genital (77%), and overall skin (57%) PsO vs placebo at Week 16. Basket trial design enabled targeted evaluation. Safety profile favorable. Abstract 0555 @RheumNow #ACR25
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Phenotypes of GCA:
Pt dx by PET compared to TA biopsy were:
- younger
-longer disease before dx
-more frequent extremity claudication (still overall low)
-less cranial / TA sx
@RheumNow #ACR25 Abstract 0759 https://t.co/ilwa3eYmRq
Brian Jaros, MD Dr_Brian_MD ( 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)
Can the blood reflect what’s happening in the joint? In early RA, 11 synovial proteins mirrored serum levels, forming an inflammatory signature linked to disease activity and csDMARD response. High-signature pts had stronger treatment responses (AUC>0.8)
@RheumNow #ACR25 A#0070
Jiha Lee JihaRheum ( View Tweet)
A systematic review by Dr. SRamiro et al evaluated efficacy of b/tsDMARDs on peripheral axSpA
Majority on bDMARDs (TNFi, n=24; IL-17, n=13)
Most of the SMDs were small --> b/tsDMARDs showed small to moderate effects on peripheral arthritis & enthesitis.
#ACR25 @RheumNow Abs0588 https://t.co/yGXcqhZ1Uv
sheila RHEUMarampa ( View Tweet)
Cool study using vasculitis patient-powered reserach network (VPPRN)
"SNOT-22" tool captures sinonasal symptoms; associated with disease activity (expected) but also worse among pts even in remission
Very important impacter of QOL in AAV
#ACR25 @RheumNow Abstr0725 https://t.co/NQBW8VnYFS
Links:
Mike Putman EBRheum ( View Tweet)
Miller et al. Fibrinogen for GCA diagnosis and flare identification. Similar to ESR/CRP in diagnosis. For flares, lower sensitivity (79%) but better specificity (96%) @RheumNow #ACR25 Abstr#750 https://t.co/SIkAkEeYh1
Richard Conway RichardPAConway ( View Tweet)
ASAS recommends standardised reporting for 20 key outcomes in axSpA trials, 10 for all studies, 10 specific to DMARD trials. Formats include mean (±SD), mean change, and categorical thresholds for ASDAS, ASAS-HI, and extra-musculoskeletal manifestations. 85% of ASAS members https://t.co/VQwPaTRIOl
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Poster evaluating representation in trials of AAV and GCA
Results mirror those observed in other fields; need to keep advocating for trials in all populations!
#ACR25 @RheumNow Abstr#0720 https://t.co/gDj5IQMJOc
Mike Putman EBRheum ( 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)
Fascinating: tDR-1, a microbial sRNA, appears protective for RA in at risk ACPA+ pts:
- tDR-1 higher = less develop RA
- can predict seropos RA development
- in vitro type 1 IFN mapping checks out
Useful in itself, but importantly: why does it happen?
#ACR25 ABST0775 @RheumNow https://t.co/ep99dNAzFV
Links:
David Liew drdavidliew ( View Tweet)
No seasonal pattern in GCA!
We have also looked at this in our data and similarly found no trends
It sure feels like GCA comes in waves, but data does not bear this out
#ACR25 @RheumNow Abstr#0754 https://t.co/4y2elYmCRT
Mike Putman EBRheum ( 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)
Novelli et al. Upadacitinib in male vs female PsA. Data from SELECT-PsA studies. Appears equivalent in males and females, contrasting with TNFi/IL17i data. @RheumNow #ACR25 Abstr#557 https://t.co/fMKsbCkju0
Richard Conway RichardPAConway ( View Tweet)
In a novel Geri-Rheum clinic, cognitive screening revealed 35% impairment among adults >55 yrs.
Common deficits: visuospatial, attention & recall.
Early geriatric screening = earlier intervention.
A model for age-friendly rheum care in action.
@RheumNow #ACR25 Abstract #0226 https://t.co/lIAcrZvL4H
Jiha Lee JihaRheum ( 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)
