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CareRA trial:
3 months addition of LEF vs. ETA in pts resistant to COBRA-Slim regimen (MTX 15 mg/w + step-down prednisone):
After 2 years, no difference in dis control but those who received ETA early were treated more frequently w/ csDMARD monotherapy #EULAR23 @RheumNow OP0129 https://t.co/YwSoZWi375
Aurelie Najm AurelieRheumo ( View Tweet)
Don’t be ‘rash’, get adult immune compromised Pts vaccinated against #shingles #varicella #zoster K Winthrop has research re #HZ #vaccination with #Shingrix in #Upadacitinib at #EULAR2023 #OP0225 Bottom line-get #immunecompromised Pts with #rheumatoidarthritis jabbed! @RheumNow
Janet Pope Janetbirdope ( View Tweet)
#EULAR2023 #POS0115 Can we minimise placebo response in #lupus trials? Post-hoc analysis of Phase 2 RCT Dapirolizumab (CD40-CD40L-i) showed greater response in acute flare with Normal Complement levels in the PBO group. Could Low Complement be used for trial entry? @RheumNow https://t.co/8aRq5tWi97
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
“You don’t need MTX with TCZ for RA”
Err, well:
- just like TNFi, you def can get ADAb to TCZ
- they definitely lead to lower response rates
- MTX co-admin reduces ADAb
Seems like a good idea to me, but your call 🤷♂️
Bitoun, Mariette et al POS0630 #EULAR2023 @RheumNow https://t.co/2jOAqA6YZ3
David Liew drdavidliew ( View Tweet)
The risk of demyelination with TNFi is low but real. Slight increase of risk was found in male RA patients. The small number of events is reassuring. Careful consideration is recommended in individuals at highest risk of demyelinating diseases Abst#OP0135 #EULAR2023 @RheumNow https://t.co/YT6ZrJTjU0
Dr. Antoni Chan synovialjoints ( View Tweet)
In polyrefractory RA patients, half did not have any PDUS change on ultrasound and/or had normal CRP levels, showing that in the other half, new mechanisms of action for treatment is required by David P, Abst#OP0134 ##EULAR2023 @RheumNow https://t.co/TaY7uGU0bg
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2023 #OP0142 From #Lupus to #Sjogren. A phase 2 RCT in China showed more patients on Telitacicept (BAFF/APRIL-i) achieved significant reduction in ESSDAI at Wk24 vs PBO. Trend to improvement in glandular function. Intriguing option & will await Phase 3 global RCT @RheumNow https://t.co/BCiohuAfP3
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
No relationship between MTX-PG levels in terms of efficacy by SDAI remission but higher MTX-PG levels related to adverse events by Tamai H, Abstr #OP0128 #EULAR2023 @RheumNow https://t.co/TiO5eeYlnS
Dr. Antoni Chan synovialjoints ( View Tweet)
JAKi have superior effectiveness at 6 months compared to TNFi and the efficacy was similar in those with and and without safety risk (increased age, CV risk, smoker) by Hannah Bower, Abst#0133 #EULAR2023 @RheumNow https://t.co/Pt6EoN6323
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2023 #OP0143 Promising therapy. A Phase 2 RCT of Dazodalidep (CD40L-i) in #Sjogren showed significantly more patients on DAZ group met reduction in ESSDAI vs placebo. Interesting to see higher hurdle ESSDAI favoured DAZ Group. Phase 3 RCTs are underway @RheumNow https://t.co/I9uHxvRlnr
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
We’re getting better at understanding different types of refractory RA (D2T RA)
We see differences with refractory RA subtypes:
PIRRA (persistently inflamm on USS), and
NIRRA (non-inflamm)
hopefully moving to data-driven Rx approaches for D2T RA?
OP0134 #EULAR2023 @RheumNow https://t.co/vX5IK5O9Wm
David Liew drdavidliew ( View Tweet)
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)