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Do We Stop or Continue Treatment?

Kathryn H. Dao, M.D.

Remission had been a dream, an elusive concept. But then, with the introduction of biologics, conventional synthetic and targeted synthetic DMARDS, patients are able to live longer and with a better quality of life. While these therapeutics have been helpful, they are expensive and carry potential side effects. The big question looms: Do we stop or continue treatment?

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Choices

JAKi and TYK2i: What to use and when?

Janet Pope, MD, MPH, FRCPC

You can see that the JAKi/TYK2i have both approved or potential seropositive and seronegative indications. There are also improvements in PsO for the class and studies in CTDs. So, it is difficult to know which to choose.

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back, LBP, spine, AS

Can Rheumatologists Accurately Diagnose axSpA in Patients with Chronic Back Pain?

Sheila Reyes, MD

Chronic low back pain is a common complaint that brings patients to the doctor’s attention. Although the majority of low back pain is mechanical in nature, an important minority is inflammatory in nature.

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uveitis eye iritis

Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab

Meral K. El Ramahi, MD, FACP, FACR

Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated. 

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IV Secukinumab for AxSpa The FDA recently announced approval for intravenous secukinumab (Cosentyx) for adults with psoriatic arthritis, ankylosing spondylitis, and non-radiographic spondylitis. https://t.co/JhOvPIXOMN https://t.co/GoV62NjSmf

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Dr. John Cush RheumNow ( View Tweet)
Watch: SpA Insights: New Therapies https://t.co/fkFYpEnDoX https://t.co/bcVJfl2un2

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Dr. John Cush RheumNow ( View Tweet)
Secukinumab vs. Adalimumab Biosimilar on Radiographic Progression in AxSpA Dr. Robert Chao (Tysons, VA) discusses Abstract 0522 presented at the 2023 ACR Convergence meeting in San Diego, CA. https://t.co/UmcbplfGhB https://t.co/R5Lr6Q0qHI

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Dr. John Cush RheumNow ( View Tweet)
RHEUM Survey Question: Your choice of a biologic in patients with SpA is mostly influenced by? CLICK here to answer: https://t.co/afJmqzzPYi

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Dr. John Cush RheumNow ( View Tweet)

Part 2: Clinical Year in Review #ACR23 https://t.co/Yb8Xh2UKFY
Mithu Maheswaranathan, MD  ( View Tweet)
Anterior uveitis incidence across different axSpA treatments Large review and meta-analysis on TNFi, IL-17i, JAKi Immunomodulatory therapy protective against uveitis flare Greatest in TNFi and JAKi @RheumNow #ACR23 Abs# 2550 https://t.co/l3BTL3GuRt
Robert B Chao, MD  ( View Tweet)
Dr. @drpnash @RheumNow ➡️Difficult to treat Axial SpA ; 23,0000 🧍‍♀️🧍: 1-Failure of 3 biolo - targ synth, or different mechanism of action. 2- Around 10% of patients. 1-Female. 2-Peripheral arthritis. 3-Psoriasis 4-Lipid , HTN, Smoking. https://t.co/B99TcXjjiF… #ACR23

Nouf Al hemmadi  ( View Tweet)

A#2545 IV SEC for SpA #ACR23 @Rheumow Approved by FDA, though diff dose Who: Medicare/cost/QoL benefit for IV or obese (wt based dose) W16: 41% ASAS40 v 23% PBO W16, PBO switched to SEC. Efficacy W52 (SEC 67%, PBO/Sec 75%) SAE 6%, discontinuation 3.5% #ACRBest https://t.co/ruW0ys49gk
Eric Dein  ( View Tweet)
A#2546 Anti-IFX Ab in AS #ACR23 @RheumNow Anti-IFX in 45% in f/u, 85% in 1st yr MTX decr anti-IFX (18 v 42%) Anti-IFX - higher inflamm markers, infus rxn, lower serum levels and Rx fail Pt w/o anti-IFX Ab more likely to tolerate tapering https://t.co/eN9SqGyGgm
Eric Dein  ( View Tweet)
A#2547 #ACR23 @RheumNow Diff 2 Treat (D2T) AxSpa D2T: fail 2+ b/tsDMARDs w 2 MoA Very D2T: failure of Rx in less than 2 yrs 28% D2T, 3.8% Very D2T (Compare to 7-10% D2TRA) More likely: peripheral, uveitis, higher BASDAI, FM Very D2T also w IBD, higher CRP, longer dis duration https://t.co/HcIXnDRrIq
Eric Dein  ( View Tweet)
Another infusion option for axSpA! INVIGORATE-1: Phase 3 RCT of IV Secukinumab in axSpA Efficacious - ASAS40 response sustained thru 52 weeks Safety profile similar to subq version @RheumNow #ACR23 Abs#2545 https://t.co/biC8p3p6dl
Robert B Chao, MD  ( View Tweet)
Who uses #cannabis in #rheumatic #diseases? Those who smoke, have higher pain, more anxiety, poor sleep are more likely to have used cannabis for their rheumatic disease. Half of the >2900 respondents have tried #cannabis. Use of #biologics reduced use. #980 @RheumNow @ACRheum https://t.co/DQDRQN40zR
Janet Pope  ( View Tweet)
Super interesting SpA phenotypical type world map. #ACR23 Abs #2195 continues to prove how heterogenous this disease is and the need for additional therapeutic agents for improved patient outcomes. https://t.co/hpKY7usUUb @rheumnow https://t.co/xJ1bx6wOC0
Dr. Rachel Tate  ( View Tweet)
In this older grp of pts w/ chronic LBP, significant overlaps of deg & inflamm features on spinal imaging of DC, DISH & axSpA pts were seen Also, +comorbids: HTN in DC; DM in DISH; smoking in axSpA THM? DC & DISH are also axSpA mimics #ACR23 ABST1862 @Rheumnow @rheumarhyme https://t.co/uNIwRchF1g
sheila  ( View Tweet)
Will postpartum BME ⏩axSpA-like structural lesions? Study by Varkas et al show there was no significant dev't of axSpA-like lesions on MRI in postpartum women 5 yrs after delivery. Postpartum BME likely sec to transient mech stress-induced SI BME #ACR23 ABST1892 @RheumNow https://t.co/KJ3DngmkbI
sheila  ( View Tweet)
Always refreshing to hear from another specialist's point of view Cardiologist @Bweber04 on CVD and rheumatologic diseases Increased risk of death, MI and HF exacerbation in our pt population Increased all cause mortality @RheumNow #ACR23 https://t.co/yOkPOmxU4N
Robert B Chao, MD  ( View Tweet)
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