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#ACR21 @RheumNow
Abst#0364 by Wetterslev et al. sought to identify axSpA characteristics of patients tapered off TNFI and showed clinical and radiographic improvement.
🔽52% were tapered off
⭐️The highest predictor of success is a low physician global VAS score
swethaann23 swethaann23 ( View Tweet)
Year 2 f/u on PsA, axSpA, or RA using CT-P13, an infliximab (IFX) biosimilar. Pts either naive to IFX or switched from IFX:
💠IFX-naive: improved disease activity
💠IFX-switched: maintained stable disease
💠No new safety concerns
https://t.co/VGBicnq15w
#ACR21 Abst#0817 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
A study at #ACR21 by Charite-University Medicine Berlin researchers suggests taking tumor necrosis factor inhibitor (TNFi) #biologics earlier in the course of disease could slow down spinal progression in #AxialSpondyloarthritis patients. https://t.co/lDkaMkOcez
CreakyJoints.org CreakyJoints ( View Tweet)
Abst1344 #ACR21 @RheumNow observational study of pts w/PsA treated w/b&tsDMARD:pts who achieve MDA (22.8% of pts at 6 mo) more likely to maintain the initiated bDMARD or tsDMARD Rx & less likely to switch from the initiated bDMARD/tsDMARD https://t.co/egFDHV3eQs
Olga Petryna DrPetryna ( View Tweet)
Study on enthesitis response to biologic Rx
⭐️TNFI caused a 2❎ 🔽mean ActiveMASEI score compared to secukinumab
⭐️ 🔽PASI and DLQI score more in TNFI than Secukinumab
🔰Superiority of TNFi versus secukinumab in regards to active enthesitis
Abst#1356 #ACR21 @Rheumnow https://t.co/wdzMYmn8AJ
swethaann23 swethaann23 ( View Tweet)
Dr Elliott presenting on US assessment of enthesitis with TNFi vs secukinumab. Surprisingly TNFi showed a more marked decrease in US enthesitis. Abstr#1356 #ACR21 @RheumNow https://t.co/XXgYMgkMyP
Richard Conway RichardPAConway ( View Tweet)
Effect of BMI on PRO treatment response in PsA. Increasing BMI associated with lower response. More pronounced in TNFi than IL-17 or JAKi. Abstr#1327 #ACR21 @RheumNow https://t.co/qhgVlW72uM
Richard Conway RichardPAConway ( View Tweet)
In this study,
⭕AS pts w/>=2 #comorbidities were associated w/ poorer outcome measures after 2 yrs of ffup vs. pts w/ no comorbids
⭕Pts w/ >=2 comorbids were likely to dc 1st anti-TNF
Address comorbidities, ⬆ chances of better outcomes & QoL
@RheumNow #ACR21 abs1309 https://t.co/sTnjaC1a1l
sheila RHEUMarampa ( View Tweet)
ACR21 Best Abstracts - Day 2
The RheumNow faculty reporters have been scouring and reporting on the best abstracts from the ACR. Here is a sampling of their choice abstract presentations reported during ACR 2020 Day 2 (#ACRbest).
Read Article
TNF inhibitors and radiographic progression in axSpA
A remaining challenge for clinicians is the ability to delay, if not completely stop, structural progression in patients with axSpA, whether they are diagnosed with radiographic (r-axSpa) or non-radiographic (nr-axSpA) disease.
Read Article
As old saying but updated goes: Wise man/woman/prefer not to answer says IF you STOP drugs they usually STOP working. True with TNFi in most diseases (RA, axSpA, etc). Also tue with #plaquenil in large #SLE study #ACR21 abst#0959 https://t.co/O6Ejg5sjjK
Janet Pope Janetbirdope ( View Tweet)
⭐️C-OPTIMISE:
Early, active AxSpA on certilozumab (CZP) 200mg q2w x 48w. Then, if remission, randomized to CZP q2w vs q4w vs PBO x 48w
➡️No flare in PBO BUT w/ ↑:
*️⃣ASDAS + BASDAI
*️⃣CRP + fecal calprotectin
Thus, keep some dose of CZP on!
Abst#0916 #ACR21 @RheumNow https://t.co/DT8FKHAhr0
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
What to do if pt on a TNFi develops cancer? Can you safely restart TNFi later? Depends on cancer, timing - how long ago was cancer, Rx and patient preference. Data diff from RABBIT registry vs British bio registry @RheumNow #ACR21 #ACRBest 7S413 Have a look https://t.co/q9SFKlFJzg
Janet Pope Janetbirdope ( View Tweet)
Does concomitant SJS affect tx effectiveness in RA?
Abst#0839 suggest yes!
➡️RA+SjS have an inferior response to TNFi than RA patients w/o SjS
BUT, RA/SJS pts w/ longer RA dz duration & ↑ DAS28 + HAQ-scores.
What's your clinical experience with this?
#ACR21 @Rheumnow https://t.co/TIc3raMOSJ
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
A worthwhile point:
despite historic concerns, in the modern era TNFi can used safely & well in HIV pts
18y follow-up, all pts high CD4
(their starting criteria: CD4>200, VL <60,000)
no reported opportunistic infx
good arthritis response
#ACR21 ABST0965 @RheumNow @CCalabreseDO https://t.co/5pbRg63ubr
David Liew drdavidliew ( View Tweet)
*️⃣CT-P13=1st monoclonal biosimilar to infliximab (IFX)
⭐️ReFLECT: 1370 French pts (142 RA, 411 axSpA, 96 PsA)
→2 groups: IFX-naïve starting CT-P vs switching from IFX to CT-P
*️⃣CT-P13 induced improvement in IFX-naïve & maintained dz in pts switched
Abst#0817 #ACR21 @RheumNow https://t.co/bASmGvhuIS
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Abstr 0983 mRNA SARS-CoV-2 Vaccine in RA Patients
Rubbert-Roth and colleagues found:
- RA patients developed anti-S1 antibodies slower and lower compared to controls
- Reduced titers among Abatacept & JAKi users
#ACR21 @RheumNow https://t.co/sXW8d53O8m
Akhil Sood MD AkhilSoodMD ( View Tweet)
Post-Hoc of ASCORE trial:
➡️RA w/ mod-high dz on SQ ABAtacept as 1st line tx w/ better retention vs receiving it as 2nd line tx independent of b/l duration of dz
➤Do you use ABA as 1st line treatment for RA, when/if insurance allows? Comment below!
Abst#0816 #ACR21 @RheumNow https://t.co/TRJga4OfiW
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
NORD-STAR Trial: outcomes in tx-naïve, early RA pts after 48w of csDMARDs+GC vs bDMARD (ABAtacept, CerToliZumab, or ToCiluZumab)+MTX
➡️ Superior CDAI remission rates w/ ABA+MTX & CZP+MTX but not TCZ+MTX vs csDMARD+GC
➡️Imaging progression low in all
Abst#0825 #ACR21 @RheumNow https://t.co/QaFIF4WNEG
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#Abs0588 Effectiveness of TNFi vs non-TNFis in obese patients with #rheumatic disease @MilenaGianfran:
👉🏼>16000pts @ACRheum RISE
👉🏼Abatacept➡️larger decreases in CDAI in obese pts
👉🏼Tocilizumab➡️larger decreases in CDAI in non-obese pts
@RheumNow #ACR21
https://t.co/bL5xnG1iNh
Mrinalini Dey DrMiniDey ( View Tweet)