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Mitigating Immunogenicity When Using Uricase Therapies as ULT

Alexa Meara MD

ACR20 convergence highlights a shift in gout management and uric acid lowering therapy (ULT). The new biologics pegdriticase and pegloticase are associated with risk of immunogenicity and loss of biological effects.

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How comfortable do you feel managing auto inflammatory conditions?

Olga Petryna DrPetryna ( View Tweet)

How comfortable do you feel managing auto inflammatory conditions?

Olga Petryna DrPetryna ( View Tweet)

How often do you order LDH, AST and triglycerides in AOSD cases?

Olga Petryna DrPetryna ( View Tweet)

@RheumNow #ACR20 abs1151 screening for inflammatory hyperferritinemia may be feasible but requires additional info: inflammatory huperferritinemia more likely to correlate with ⬆️IL18, AST&thrombocytosis while high CRP+ferritin more often seen in infectious etiology https://t.co/wiFPXepxpz

Olga Petryna DrPetryna ( View Tweet)

How many new Adult Onset Still's Disease patients have you seen in the past year? @RheumNow #ACR20

Bella Mehta bella_mehta ( View Tweet)

European Rheum Consortium (SHARE) recommendations for Rx of systemic JIA: 1) Systemic JIA - AOSD; 2) STEROIDs, 3) IL-1 inhibitors; 4) TCZ, 5) MTX & TNFi mainly for arthritis. Should be aware of risk for MAS and ILD #ACR20 Abstr#1148 https://t.co/mgZvLKNljs

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Dr. John Cush RheumNow ( View Tweet)

What biomarker do you think is the most important in diagnosis of Macrophage Activation Syndrome/ secondary HLH @rheumnow #ACR20

Bella Mehta bella_mehta ( View Tweet)

@RheumNow #acr20 abs0098 CCL2&CCR2 may play role in inflammatory response in AOSD, high levels in active AOSD subside with six resolution. Correlate with CRP, neutrophil count& ferritin levels. Does not correlate w/ Clincial markers of disease activity

Olga Petryna DrPetryna ( View Tweet)

Interim analysis of the RELIANCE registry studying effect of canakinumab (CAN) in 80 patients w/ febrile CAPS. Efficacy of CAN assessed w/ AIDA (inflam index) showing ~70% were in low activity (<9) @ACR20 Abstr#1479 https://t.co/UC2eJbpVLM https://t.co/M71s8gXZY9

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Dr. John Cush RheumNow ( View Tweet)
Crystal Arthritis and Gout Highlights at ACR: Dr. Nicola Dalbeth Gout specialist Dr. Nicola Dalbeth from Aukland, New Zealand provides a preview perspective on crystal arthritis and gout studies and sessions at #ACR20. https://t.co/QfVSpeVXlf https://t.co/cBwKF5P5eb

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Dr. John Cush RheumNow ( View Tweet)
Autoimmune Disease Outcomes of Women with Breast Implants: A Population-Based Study https://t.co/Z6R8zRezfN #breastimplants #IMID an old chestnut

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Peter Nash drpnash ( View Tweet)

Reducing Immunogenicity of Pegloticase (RECIPE) w/ concomitant use of MMF in pts w/ refractory gout is a phase II double blind RCT that shows sustained serum urate lowering effect in addition to decrease in monthly rate of flares. #ACRbest #Abst0952 @RheumNow Practice changing? https://t.co/Z7GwCXZftE
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Next up! #Autoinflammatory diseases: mechanisms and management. First: CRMO & SAPHO with Dr. Polly Ferguson Highlights: 📍The *many* names of CRMO/CNO 📍Clinical features 📍Rx options (NSAIDs, bisphosphonates, TNFi) 📍Role of innate immunity in etiology #ACRambassador https://t.co/qP3IySJKGC
Danny Soulsby dsoulsMD ( View Tweet)
Genotype analysis define new illnesses such as VEXAS. ”Somatic mutation may account for a significant fraction of adult-onset inflammatory disease” says Dr. Dan Castner. Science enthusiasm at 3S038. Autoinflammatory Diseases. @petercgrayson #ACR20 <TK https://t.co/gyTxF8NWtO
ARD & RMD Open ARD_BMJ ( View Tweet)
Fascinating and engaging talk by Dr. Kastner on the discovery of VEXAS using a genotype-first strategy. Definitely one to go back and watch if you missed it! #ACR20 https://t.co/D090V7HiG2
E. Sloan esloanmd ( View Tweet)
Dan Kastner giving an absolute tour de force of the discovery of VEXAS in autoinflammatory diseases: mechanisms and management session now. If you aren't listening, watch it back! #ACR20 @rheumnow https://t.co/zell5e2Brt
Richard Conway RichardPAConway ( View Tweet)
Excellent session on #autoinflammatory syndromes #SAPHO syndrome -IL-1 role in disease pathogenesis and something that I ve not come across clinically #Majeed Syndrome @RheumNow #ACR20 #3S038 https://t.co/vnfjPD6Zx9
Bella Mehta bella_mehta ( View Tweet)
Dr Merriman presents on role of diet in gout. It is minor, especially compared to urate lowering therapy. Average attributable fraction approximately 10-fold greater for ULT than following healthy-eating guidelines. @rheumnow #ACR20 Abstr#951 https://t.co/1tftswOEJq
Richard Conway RichardPAConway ( View Tweet)
Dr Cai presents risk of CVD in gout in study 450,000 patients. Gout was independently associated with an increased risk of CVD events HR = 1.24 for women; 1.21 for men. @rheumnow #ACR20 Abstr#950 #ACRbest https://t.co/089aKtN5a7
Richard Conway RichardPAConway ( View Tweet)
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