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Cancer and TNF inhibitors
Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions. An oral presentation by Suarez-Almazor et al provided more supportive data on using TNFi in this population.
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Age does NOT affect the chance of getting irAE or the severity when using check point inhibitors to treat cancer. Data from #CANRIO database in #Canada #ACR 23 @ACRheum @RheumNow #1063 https://t.co/bqbiXzdAqr
Janet Pope ( View Tweet)
#irAE Baseline immune suppression does NOT protect against worsening synovitis flares when using check point inhibitors in Pts with established #inflammatory #arthritis #ACRbest #ACR23 @ACRheum @RheumNow abst1075 Data from #CanRIO database https://t.co/lOCf8Tbgta
Janet Pope ( View Tweet)
#ACR23 highlights from PlenaryII
🙉#RA #ILD seems that #TNFi is equal to other bDMARDs - was thought to worsen /cause it.
🙉Septra should be given with #rituximab and #steroids in #GCA to prevent #infections not just #PJP
#ACR23 @RheumNow @ACRheum #ACRbest
Janet Pope ( View Tweet)
@lastwalsh @KyleWalkerM @RheumNow Second question: do you ever give a PEXIVAS-standard style steroid taper?
I'm 100% in agreement that we should favor PEXIVAS over observational data in most cases
In practice it seems like some patients need a bit more immunosuppression, though
Curious to hear your thoughts!
Mike Putman EBRheum ( View Tweet)
#Infection rates are equal in #RWD #real #world #data using #biosimilars compared to previous use of #originators. BC database #0970 #ACR23 @RheumNow @ACRheum #arthritisresearchcanada #ARC https://t.co/eVSPgVfmQG
Janet Pope ( View Tweet)
#ACR23 Abs #2199 large RL study: SEC retention rates after 4 yrs approx. 50% in axSpA and PsA pts. Bio-naïve pts had higher retention, remission & response rates than pts with prior b/tsDMARD exposure, particularly in axSpA. https://t.co/Eq5BwILK3D @rheumnow https://t.co/slho6yAwtQ
Dr. Rachel Tate ( View Tweet)
SPARTAN referral recommendations for axSpA #ACR23 Abs #2214 https://t.co/VQedpNynpv support Abs #2207 https://t.co/8RB0D4ef7i findings discussing that non-rheums are less aware of IBP components/asking about them in CBP pts. @rheumnow https://t.co/23oUONsMfb
Dr. Rachel Tate ( View Tweet)
The presence of antibodies to 4 UH-axSpA peptides was confirmed in the Belgian Inflammatory Arthritis and Spondylitis (Be-Giant) cohort of newly diagnosed axSpA patients and could be of added value for axSpA diagnosis. #ACR23 Abs #2210 https://t.co/fV4PPbWF01 @rheumnow
Dr. Rachel Tate ( View Tweet)
1-PJP prophylaxis or not in ANCA?
2-MTX single dose or split dose?
3-IL6 blocker early on in GCA/PMR?
4-SGLT2 in DM/Lupus nephritis?
5-Cervical cancer screening in Lupus?
6-TNF induced ILD?
https://t.co/mzGXajmQqE
@RheumNow , Daily recap
#ACR23
Nouf Al hemmadi ( View Tweet)
PtGA and PhGA were aligned in most encounters in PsA. PtGA >PhGA disagreement was driven by pain, fatigue, and physical health being weighed more by Pts than Phs. PROs matter! #ACR23 Abs #2234 https://t.co/0r7gjx0JS6 @rheumnow https://t.co/BuGDicwBiB
Dr. Rachel Tate ( View Tweet)
Watch: Lupus and the Patient Perspective
Dr. Kathryn Dao talks with patient advocate Amanda Greene about her patient poster (PP03) on "Lupus with Slime: Improve QOL and Increase ROM in SLE with Slime" at #ACR23.
https://t.co/JKU3w7sz4j https://t.co/IWHLJEi0qG
Dr. John Cush RheumNow ( View Tweet)
C9n @RheumNow, excelente persona. Gracias!! https://t.co/pGZnMHApQH
José Navia Dongo ( View Tweet)
Crude drug retention at 1 year was 65% for JAKi, significantly lower than for other modes of action (74%) and TNFi (77%). These results are driven by the severity of the disease of patients on JAKi compared to other MOA. Aymon R Abst#1692 #ACR23 @RheumNow https://t.co/LPDpWdjoLg https://t.co/Ztaz94omd9
Dr. Antoni Chan ( View Tweet)
Obs study, bDMARDs & malignancy
TNFi w/lower risk than ABA/RTX/IL6i & numerically lower than JAKs
I'm a little skeptical... KM curves diverged w/~45 days, seems implausible?
Agree w/first author, possible channeling bias
@RheumNow #ACR23 Abstr 1678 https://t.co/1uL3j6kTSj
Mike Putman EBRheum ( View Tweet)
Sendaydiego et al. Comparative cancer safety b/tsDMARDs. 37,026 patient database cohort study. Compared to TNFi, RTX HR 2.2 (1.5, 3.3) ABA HR 1.7 (1.3-2.4), JAKi HR 1.3 (0.9-1.9). Abstr#1678 #ACR23 @RheumNow https://t.co/bTNtaNJrln https://t.co/qQBM2F2q8N
Richard Conway ( View Tweet)
Ritux (OR 2.2), ABA (OR 1.3), JAKi (OR 1.3) significantly increase risk of cancer vs. TNFi
Cohort of 37000+ RA pts starting bio/tsDMARDs (379 incident cancers)
True biologic effect or confounding by indication in a generally more comorbid population?
@RheumNow #ACR23 ABST1678 https://t.co/suj6mVBEC0
Aurelie Najm ( View Tweet)
#ACR23 Abstr#0840 Could combined JAK1/Tyk2 fare better than Tofacitinib in D2T #RA? Phase 2 RCT showed impressive results; > %50 pts in the higher doses TLL-018 arms achieved ACR50 vs TOF (42%). TOF non-responders at WK12 who switched to TLL-018 improved too @RheumNow #ACRBest https://t.co/Yw6Pvb2PH8
Md Yuzaiful Md Yusof ( View Tweet)
Abst #1584 TMP-SMX⬇️PJP ⬇️SIE,⬇️outpt infx in GPA on RTX. 919 patients: 31% had TMP-SMX, 40% on pred >20 mg/day followed median 496 days. SIE (aHR 0.5, 95%CI 0.3-0.8), outpt infx (aHR 0.7, 95%CI 0.5-0.9), & PJP. Thirteen PJP (all not on TMP-SMX). #ACRbest #ACR23 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
Starting soon! Join us tonight at 6pm PT/ 9pm ET for our daily #ACR23 recap. https://t.co/xIBJlYCMQM
Dr. John Cush RheumNow ( View Tweet)
