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#ACR25 Abstr#LB14 Deep blood & tissue depletion are not just confined to CAR-T. Exploratory analysis of REGENCY showed Obinutuzumab induced near-complete depletion & significantly reduced plasma in kidney tissue vs PBO @RheumNow https://t.co/r1danWBM7D
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
After melanoma, should RA patients stop DMARDs?
These VA data (n=644) showed no mortality signal, and trending to survival benefit with b/tsDMARDs
Provisos over methotrexate, invasive disease etc, but don’t hold off treating the RA because of melanoma
#ACR25 ABST2237 @RheumNow https://t.co/l9n1V6YVln
David Liew drdavidliew ( View Tweet)
#IL2 #Rx in active #SLE?
Maybe 🤔
IL2 is tricky - low dose May help #SLE but too much of a good thing may have a neg impact.
RCT of IL2i in #SLE gave a good dose response and improved TRegs.
#ACRBest #ACR25 @RheumNow @ACRheum #LB01 https://t.co/F61qz5x5We
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Janet Pope Janetbirdope ( View Tweet)
Adverse events from avacopan the WHO pharmacovigilence database (VigiBase)
Not a lot new - infections happen, hepatic events happen but seem to be somewhat rare
Pharmacovigilence is hard; most events go unreported & we often have the classic "denominator problem" (ie we saw https://t.co/28tYkXv0Lz
Mike Putman EBRheum ( View Tweet)
In the CLOSE-UP study of UPA in RA
- 61% in remission with responses sustained to 24 mo
- Benefit consistent irrespective of prior DMARD use
- No new safety signals
@RheumNow #ACR25 Abstract#2281
Jiha Lee JihaRheum ( View Tweet)
#ACR25 Abstr#LB10 Promising 4-Year data of Deucravacitinib in blinded phase 2 RCT +LTE study showed efficacy inc. LLDAS and CLASI-50 response were maintained/improved over time in #SLE No concerning safety signal. Looking forward to Phase 3 results next year @RheumNow https://t.co/fZv82zJ6Q4
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Serrano-Combarro et al. Abatacept in RA-ILD. 343 patients. Progressive ILD in 23%. Similar to the numbers progressing on baricitinib by same group. Previous MTX treatment appears to REDUCE risk (OR 0.45). Disease activity increases risk (OR 1.29). @RheumNow #ACR25 Abstr#2265 https://t.co/0tl0kGgm5p
Richard Conway RichardPAConway ( View Tweet)
#ACR25 How hard will you go & at what cost? A study in China using CD20/BCMA Bispecific autologous CAR-T showed profound depletion, normalisation of abs and good response in #SLE (10/11 had LN). But 2 had G3 infections & cytopenia. Presenters said some had IVIG @RheumNow #ACRBest https://t.co/TF0wpib5rr
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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Starting biologic early could save more than joints. In 329 RA pts, first-line anti-TNF reduced testing and hospitalization costs vs csDMARDs across Europe. Earlier targeted therapy pay off in outcomes and economics.
@RheumNow #ACR25 Abstract#2271 https://t.co/zZ32CpT36d
Jiha Lee JihaRheum ( View Tweet)
#1747 Serious infections ~2× more common in RA-LD, esp RA-ILD. Pulmonary, bacterial, viral & fungal infections all increased, underscoring need for tailored prevention and vaccination. @RheumNow #ACR25 https://t.co/soyzqLk7Vj
Mrinalini Dey DrMiniDey ( View Tweet)
#1746 In large US RA cohort, elevated GDF-15 & pentraxin-3 levels linked to prevalent RA-ILD; high GDF-15 predicted future ILD risk.
Other fibrosis-related mediators from IPF or heart failure were not associated, suggesting RA-ILD has distinct pathogenic pathways @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
New insights into Pre-RA: It ranges from asymptomatic individuals with ACPA positivity to those with symptomatic pre-clinical synovitis. Predicting who will develop RA is difficult, and there is a need for reliable biologic tools. Focusing on high-risk patients could https://t.co/SPOP7f0t7y
Dr. John Cush RheumNow ( View Tweet)
When every option fails, bold moves remain.
In 5 multi-resistant RA pts, TNFi + JAKi combo brought remission in most without major AEs.
Not standard, not risk-free, but in young, low-infection-risk pts, it may offer a path forward.
@RheumNow #ACR25 Abstract#2272
Jiha Lee JihaRheum ( View Tweet)
Post hoc eval of relapses from MANDARA, MEPO vs BEN in EGPA
30% of pts had relapse, 81% of which were asthma +/- sinonasal disease
Remainder were mostly muscle involved, only a few mononeuritis
Mostly as expected; useful epi data for clinic
#ACR25 @RheumNow Abstr#1769 https://t.co/IKKolMZJlF
Links:
Mike Putman EBRheum ( View Tweet)
Late Breaker: Phase 2 RCT of low dose IL2 in SLE
Dose dependent response in SRI4 over 12 weeks
& surprisingly high rates of LLDAS
Too early to know if useful, but worth evaluating in a phase 3
#ACR25 @RheumNow Abstr#LB01 https://t.co/oPOLG82nwi
Mike Putman EBRheum ( View Tweet)
Late breaking: secukinumab out-performs ustekinumab in PsA pt who have failed TNF therapy
RCT of 119 pt
57.1% response at wk 28 in SEC
27% response at wk 28 in UST
Numerically lower adverse events leading to d/c in SEC
@RheumNow #ACR25 #ACRBest Abst LB06 https://t.co/wDxtscP2ku
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Serrano-Combarro et al. Baricitinib in RA-ILD. Observational, 42 patients. Progressive ILD in 26%. More frequent in women. @RheumNow #ACR25 Abstr#2229 https://t.co/ZXfgxKoau7
Richard Conway RichardPAConway ( View Tweet)
Cutaneous vasculitis: who is most likely to have systemic disease?
430 pt w skin vasculitis examined in case-control
Associated with risk for systemic vasculitis/CTD:
- GI sx
- ulcerating/necrotic lesions
- constitutional sx
- hematuria
@RheumNow #ACR25 Abst 2525 https://t.co/lRjLKRYxDW
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
To be continued (or discontinued?): Abstract 2360: Compared to TNFi, IL-17i & JAKi users had 🔹 Higher odds of med switching <180 days 🔹 Shorter time to discontinuation @RheumNow #ACR25 #axSpA https://t.co/IOHaFSJqHn
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Interesting study evaluating the "CALLY" index (serum albumin × lymphocyte count / CRP / 10,000) for predicing mortality in AAV
I typically dislike these because (1) they are often cumbersome to calculate & (2) they often perform poorly
This one piqued my interest; pretty https://t.co/ziroQOH5Cq
Mike Putman EBRheum ( View Tweet)
