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Difficult to treat #rheumatoid #arthritis is a grab bag of multi drug failures or intolerant with high or LOW disease activity 3 groups and diff reasons for failure and diff risk factors. ? Sunset the D2T Pts? OP0117 #EULAR2023 @RheumNow @eular_org https://t.co/1qPMq32kVz
Janet Pope Janetbirdope ( View Tweet)
The overall risk of cancer and cardiovascular disease were decreased in RA treated with JAKi but there was no comparison with TNFi, Sung Soo Ahn, Abst#00132 #EULAR2023 @RheumNow https://t.co/9Bi6t6uuig
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2023 #OP0141 CAR T cell therapy to treat refractory #lupus took centre stage in 2022. Up to 2yrs data on 7 patients showed continued drug-free remission despite repopulation of naive B cells. No safety concerns. Intriguing to learn even longer-term follow-up @RheumNow https://t.co/lINDT32VBj
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #OP0139 Should we aim for dual blockade in #lupus? A Phase 2 RCT showed more patients on ABBV-599 HD (elsubrutinib (BTK-i) + Upadacitinib (JAK-i)) and UPA monotherapy met primary & secondary endpoints vs Placebo at 48Wks. No major malignancy or VTE concerns @RheumNow https://t.co/HEUbkzZwyl
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Biologic dose reduction based on disease activity resulted in 40% reduction in TNFi and did not seem to cause disease deterioration from the 10 year DRESS Study by N van Herwaarden, Abst#OP00131 #EULAR2023 @RheumNow https://t.co/ncGPF9ODcF
Dr. Antoni Chan synovialjoints ( View Tweet)
JAKi are NOT associated w worse safety vs bDMARDs when adjusting for confounding. Did regulators get it wrong? #EULAR2023 @RheumNow #OP0116 https://t.co/ZNk0NI7Ky5
Janet Pope Janetbirdope ( View Tweet)
#EULAR2023 #OP0137 Most impressive Delta difference vs Control in #lupus! In Phase 3 RCT in China, more patients in Telitacicept, BAFF/APRIL-i met SRI-4 (delta 44% if data imputed; 34% without) vs placebo. No major safety. Global Phase 3 RCT is in progress @RheumNow https://t.co/DUFRQ7pNUA
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Abatacept use in individuals at risk of RA reduced the rate of progression to RA during the treatment phase and împrovement in clinical symptoms over 2 years in the APIPPRA trial by Cope A, Abstr#OP0130 https://t.co/k0SFDHBRE9
Dr. Antoni Chan synovialjoints ( View Tweet)
#JAKi May decrease #cancers - age, male, #diabetes had more #cancer but NOT associated w drug prescribed AND LESS #malignancy & LESS #CVE in JAKi vs csDMARDs in huge admin database. Diff from other results OP0140 @RheumNow #EULAR2023 EFFECTIVE Rx of RA LOWERS CVE & cancer w JAKi! https://t.co/oQ3QeUZz3E
Janet Pope Janetbirdope ( View Tweet)
In insufficient responders, additional Etanercept for 24 weeks (bio-induction) did not show a higher response of DAS28-CRP compared to the standard COBRA-SLIM regime from the CARERA2020 study by Delphine Bertrand, Abstr#00129 #EULAR2023 @RheumNow https://t.co/BR1GusPGRP
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2023 #OP0136 New Biomarkers in #lupus nephritis? Indoxyl sulfate and cytosine metabolite serum levels were associated with kidney damage but not SLEDAI and reduced following therapy with anifrolumab in Phase 2 RCT @RheumNow https://t.co/URiKx9rmmU
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #POS0627 Researchers in Manchester identified several proteins associated with subclinical cardiovascular abnormalities on Cardiac MRI in Scleroderma using proteomics. Need validation. Could be useful for stratification and identify therapeutic targets @RheumNow https://t.co/55eNGhMu5f
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Get Un ‘DRESSED’? Use of #etanercept or #adalimumab for #rheumatoidarthritis. #RCT of dose optimization-observational f/u over 10 yrs with attempts to lower and even d/c Rx in #RA You CAN lower dose in many Pts & even d/c Rx and recapture. X-rays OK @RheumNow #EULAR2023 #OP0131 https://t.co/PGK5SQJ1WU
Janet Pope Janetbirdope ( View Tweet)
As Jack himself pointed out - we’re looking at patients without loads of inflammation. For me, to get anything out of this population is very interesting. Adding this to ARIAA, it does make us think about which pre-RA might benefit from abatacept, and how.
#EULAR2023 @RheumNow https://t.co/UKHfc1X8QM
David Liew drdavidliew ( View Tweet)
@RheumNow Safety is pretty good too - this is abatacept we are talking about here. Cost is a different question, as is the pharmacoeconomics, but at least it’s safe. One other thing about the study ⬇️ #EULAR2023
@RheumNow https://t.co/H3AdBsK8t9
David Liew drdavidliew ( View Tweet)
What’s more - if you have arthralgias and more autoantibodies than just ACPA IgG, then maybe abatacept might actually make a substantial difference. There is prob a population in whom abatacept substantially prevents RA developing.
Is it safe? ⬇️
APIPPRA #EULAR2023 @RheumNow https://t.co/94Y7HrBuEp
David Liew drdavidliew ( View Tweet)
Well certainly, despite the absence of synovitis, these pre-RA patients felt better on their 12m of abatacept. They could do more and hurt less.
That does count for something for many patients.
But wait, there’s more ⬇️
#EULAR2023 @RheumNow https://t.co/3naNdWGMuX
David Liew drdavidliew ( View Tweet)
Abatacept for 12m in ACPA pos arthralgias probably doesn’t impact RA progression that much once the abatacept stops…
but are there other reasons you might want to give it? Read on in the next tweet⬇️
APIPPRA study #EULAR2023 OP0130 @RheumNow https://t.co/68CViUeWHy
David Liew drdavidliew ( View Tweet)
How much MTX do we need with adalimumab in RA? Can blood concentrations help?
MTX RBC polygluts:
- don’t seem to match to efficacy
- do seem match to safety, a bit
(no ADAb data here)
*One day* we’ll get better at what MTX dose is needed with TNFi #EULAR2023 OP0128 @RheumNow https://t.co/OGM3hxr4fG
David Liew drdavidliew ( View Tweet)
#EULAR2023 #POS0618 This is cool! Researchers from Switzerland are developing new Quantitative Radiomic Risk Score (from HRCT) to stratify response to Anti-Fibrotic in #ILD. Data presented in pre-clinical study & paralleled molecular effects. Human study is in progress @RheumNow https://t.co/qAsWew4FEO
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)