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ACR23 – Day 3 Report
These year’s annual ACR Convergence has been a success with the return of an insanely active Poster Hall! F2F learning amidst miles of research and many young talented aside wizened establish presenters is such a welcome return to ACR, the way it should be.
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Should We Change How We Prescribe Methotrexate?
For as long as I can remember, methotrexate has been the anchor drug treatment of rheumatoid arthritis. We also know it has limited oral bioavailability at doses greater than 15mg. There are subcutaneous forms that offer better bioavailability, but its subcutaneous nature can sometimes sway patients away from trying it in addition to its higher cost. Split dosing of methotrexate can be a solution to attain higher bioavailability; however, its effect on clinical efficacy is unknown.
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Would intraarticular steroids for knee OA be better with a sustained release formulation?
ph3, TLL599 (liposomal delivery dexamethasone) vs normal dex vs placebo
some gains over normal dex
well tolerated
New options always welcome in OA!
@ProfDavidHunter #ACR23 L19 @RheumNow https://t.co/TUrhppHMiD
David Liew drdavidliew ( View Tweet)
L20 #ACR23 @RheumNow
Telitacept - Recomb Fusion targets BlyS, APRIL in RA w inadeq MTX response
ACR 20 60% v 27% PBO (p<0.001), ACR 50 21% v 6% PBO (p<0.001)
DAS28-ESR <3.2 15% v 5%, reduct -1.6 v -1.0
Better PROs, less jt damage prog at w24
Safety SAE 6.4 v 6.7%, no ifn signal https://t.co/PsA6AxUHVW
Eric Dein ( View Tweet)
Sustained relief for knee OA
TLC599 - liposomal formulation of dexamethasone sodium phosphate
Single injection provided relief for 24 weeks, repeat injection with benefit up to wk 52
@RheumNow #ACR23 Abs#L19
#ACRBest https://t.co/BNGb3nHw8C
Robert B Chao, MD ( View Tweet)
#ACR23 Late-Breaking Abstr#L20 Phase 3 RCT in China: Telitacicept (BAFF-APRIL-i) in MTX-IR #RA met ACR20 response vs PBO.
+ve: less radiographic damage
-ve: lower rate ACR50 (21%), homogenous population, no H2H active comparator
Unclear its place in current Mx @RheumNow https://t.co/SAc4B1aRD1
Md Yuzaiful Md Yusof ( View Tweet)
Telitacicept (BlyS/APRIL inhibitor) in MTX-IR RA. Phase 3 RCT. 479 patients. ACR20 60.0% vs 26.9%. ACR50 21.4% vs. 5.9%. Radiographic benefit also. Safety looks ok. Abstr#L20 #ACR23 #ACRbest @RheumNow https://t.co/qcinGeRX2d https://t.co/SIKKW7xhwV
Richard Conway ( View Tweet)
#ACRbest Peter Merkel as Distinguished Investigator said Data are good.
Need data to develop questions, understand #vasculitis Hx of #vasculitis - great minds & drugs -
now challenged by funding and comparators
Session 15W127 #ACR23 @RheumNow @ACRheum https://t.co/5leIeLWZ6O
Janet Pope ( View Tweet)
Tommasi et al. MTX (vs SSZ) lowers BP in RA in RCT. At 6 months, significant reduction in SBP (mean difference -4.0±10.8 mmHg, p=0.038), MAP (mean difference -4.3±17.9 mmHg, p=0.023). Abstr#2151 #ACR23 @RheumNow https://t.co/wAX3dCztxH https://t.co/mPG5TdeHTu
Richard Conway ( View Tweet)
#vasculitis clinical trials are accelerating. Need the right time - early studies have lessons learned re feasibility and design/endpoints #ACR23 @RheumNow @ACRheum Great lecture - P Merkel 15W127 great graphs of vasculitis developments https://t.co/YRdPiaflxY
Janet Pope ( View Tweet)
Knee OA, to inject or not to inject: the great debate 📣
A thread👇🏼👇🏼👇🏼
Maglette Klotenburg argues in favor, with moderation
IA GC improves pain
Repetitive injections can be harmful
@RheumNow #ACR23 https://t.co/3p4UVLngpx
Aurelie Najm ( View Tweet)
#ACR23 Abstr#2576 Promising therapy in Dermatomyositis. Phase 2 RCT showed rapid improvement in skin, muscle & patient reported outcomes as fast as Week 4 in PF-06823859 (anti-IFN-B) vs PBO. Could be useful to treat in either skin or muscle predominant patients @RheumNow #ACRBest https://t.co/Rj1k1z0Tsz
Md Yuzaiful Md Yusof ( View Tweet)
L20 @ #ACR23
New therapy on the horizon for RA pts that failed MTX?
⭐️Telitacicept = recombinant fusion protein targeting & neutralizing BLyS & APRIL
➡️ placebo-controlled, phase III trial, 24w
👉at wk 24, PBO pts switched to drug arm for 24 more wks
➡️ 479 pts w/… https://t.co/94MyC8sdaG https://t.co/x3MUmFJPK6
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
What happens when you stop #steroids and/ immunosuppressive Rx in Pts in remission for at least 1 yr in #IgG4 disease?
You are likely guessing correctly
Pts flare! Don’t stop Rx
?taper 🤷♀️
Like RA Rx - if stop Rx = flares
Large RCT from China L16 #ACR23 @RheumNow @RheumNow
Janet Pope ( View Tweet)
#IA Injection in #knee #OA.
TLC599 vs #dexamethasone vs saline #RCT-blinded.
Both active #Rx better than #PBO. Some differences in average daily pain between active drugs.
Not sure where it may fit in? After IA steroid failure?
L18 #ACR23 @ACRheum @RheumNow https://t.co/rLh6ISBpUw
Janet Pope ( View Tweet)
#ACR23 Abstr#2578 AI to phenotype sporadic IBM vs AI Myositis
-Anti-NT5c1A assoc with dysphagia
-Anti-Ro52/TRIM21: female
-Anti-VCP: male
-Anti-NT5c1A + clinical markers: high accuracy in separating SIBM vs AIM
Need longitudinal data for clusters to be meaningful @RheumNow https://t.co/fu0a074XAZ
Md Yuzaiful Md Yusof ( View Tweet)
#ACR23 BEST Abstracts from San Diego – Day 1
From hundreds of online presentations, the poster floor and the plenary podium, here are some of the best abstracts from 11/12/23. You can spot these on Twitter by looking for the (#ACRbest) hashtag.
https://t.co/h4RvFy66z9 https://t.co/LEhAUaw6Cj
Dr. John Cush RheumNow ( View Tweet)
Palliative Care & Rheum - #ACR23 @RheumNow
Consider Pall Care for Serious Illness: "high mortality risk & negatively impacts function or QoL OR strains caregivers" - thats a lot of rheum pt
@HopkinsBayview-led session, always pt-centric
@kekuchinad @MymaAlbaydaMD @jhrheumatology https://t.co/1j4lrkb5Ra
Eric Dein ( View Tweet)
Clinical Year in Review at #ACR23
By @philseo (@jhrheumatology)
Review some of the most impactful scientific studies in #Rheumatology in the past year! 🍕 https://t.co/ystEjzrU8u
Mithu Maheswaranathan, MD ( View Tweet)
