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For the last several years, conversations about JAK inhibitors have often started and ended with safety. The shadow cast by ORAL Surveillance has made clinicians more cautious and regulators more restrictive.
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Antoni Chan MD (Prof)
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In POETYK PsA-1, deucravacitinib showed sustained efficacy through Week 52 in PsA, improving joint, skin, PROs, and radiographic progression. Safety remained favorable with no new signals. TYK2 inhibition continues to show promise. Abstract#LB20 @RheumNow #ACR25 https://t.co/sGkk062HqJ
David Liew
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Questions #ACR25 LB20 to Paul Emery on rosnilimab:
Fleischmann: could be induction therapy? (Not intent, but could be)
Choy: Depth of changes with translational data
Tanaka: Safety given peresolimab ph2b here (diff epitope, membrane proximity, targeted depletion PD-1hi)
@RheumNow
Richard Conway
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Mease et al. 52 week results deucravacitinib in PsA. Approx ACR20 60%, ACR50 40%, ACR70 25%. Sustained radiographic benefit. No new safety signals @RheumNow #ACR25 Abstr#LB20 https://t.co/vKqjb08mI8
David Liew
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PD-1 agonist as an induction therapy in refractory RA??
Rosnilimab ph2b:
- still responding 3mo after Rx stopped
- no difference between type of prior b/tsDMARD failure
- safety here looks good *so far*
A lot of cautious excitement in the room for this
#ACR25 LB19 @RheumNow https://t.co/CmfPlP4g0N
Jiha Lee
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A new approach in RA:
Rosnilimab targets & depletes PD-1–high pathogenic T cells, acting upstream of cytokine pathways. In Ph2b, all doses improved DAS28-CRP & ACR responses vs placebo, with durable efficacy & good safety.
@RheumNow #ACR25 Abstract#LB19 https://t.co/cIxi7NEu6C
Md Yuzaiful Md Yusof
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#ACR25 Abstr#LB19 New T-cell therapy on the block! In Phase 2b RCT of #RA (~50% b/tsDMARD-IR), Rosnilimab, PD-1 agonist met its endpoint (DAS28-CRP) at WK12. Effective despite type of previous therapy. No safety concern/malignancy/death. To proceed to Phase 3 @RheumNow #ACRBest https://t.co/MecTYMpH0o
Richard Conway
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Emery et al. Rosnilimab, selective T cell (PD-1high Tph/Tfh, Teff) monoclonal antibody in RA. Phase 2 RCT. 424 patients. 41% prior bDMARD. 69% CDAI LDA week 14. Week 12 ACR20 70%, ACR50 40%, ACR70 21%. @RheumNow #ACR25 Abstr#LB19 https://t.co/479q6COWvk
Jiha Lee
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b/tsDMARD in RA + CKD (eGFR <60)
From >12K pts in CorEvitas:
- overall effective but 30% ↓ CDAI-emission (HR 0.71)
- Findings consistent across TNFi, IL-6i, ABA BCDT, JAKi
@RheumNow #ACR25 A#2640 https://t.co/UOP9ejZKoA
Md Yuzaiful Md Yusof
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#ACR25 Abstr#LB14 Promising therapy BMS-986353, a CD19 CAR-T in Severe Refractory Idiopathic Inflammatory Myopathies. 11/12 had evaluable data; muscle, skin and ILD improved. 1 x G2 CRS, 1 G3 ICANS. Longer FU needed and larger sample @RheumNow https://t.co/zAG23tAsbL
sheila
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Cohort study comparing 3yr safety outcomes of JAKi vs. TNFi in AS pts
JAKi use: ⬆️incidence of HZ infxn but not significant; ⬆️all-cause mortality (HR 4.94) and GI bleed (p=0.04)
Individualize tx. consider potential complications
#ACR25 @RheumNow Abs2633 https://t.co/pjKAazQFwW
sheila
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Sex differences in 💊 d/c in axSpA from the RISE registry
🔅Females - ⬆️discontinuation risks for TNFi
🔅No sex differences seen in dc risks for IL17i and JAKis
🔅Young females discontinued faster than males
Gender diff in SpA can guide tx decisions
#ACR25 @RheumNow Abs2634 https://t.co/kcXfZrU4zI
Aurelie Najm
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We often see patients with MTX lab abnormalities but How frequent is MTX toxicity?
Retrospective study 2500pts
Rochester Epidemiology Project cohort
60% w/ ever lab abnormalities, but 4% attributed to MTX 0.87/100 patient year
Organ injury event 0.02/100 patient year = 5 in https://t.co/w8oYUjj5Yp
Antoni Chan MD (Prof)
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Head to head study of Secukinumab vs Ustekinumab. In TNFi-experienced PsA patients, the AgAIN trial shows secukinumab performed better than ustekinumab in HAQ-DI response (57.1% vs 27.0%, p=0.002) and across all endpoints (joint counts, pain, and skin outcomes). Fewer https://t.co/CDCWkLF5TW
Akhil Sood MD, MS
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Abstract 2360: Single-center lupus pregnancy cohort found that:
🔹 Absence of DORIS remission associated w/ adverse pregnancy outcomes (Pre-term, Pre-eclampsia)
🔹 This is along with known risk factors: antihypertensive use, prior nephritis, active disease
@RheumNow #ACR25 https://t.co/STg1NBeFPo
Antoni Chan MD (Prof)
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In a retrospective TrinetX analysis of 3 year safety outcome in AS, JAKi use was linked to higher mortality and GI bleeding vs TNFi, but lower malignancy risk. Infection rates were similar, with a trend toward more herpes zoster in JAKi users. Abstract#2633 @RheumNow #ACR25 https://t.co/pPY0wpAKA3
David Liew
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DMARD exposure overall during pregnancy is not associated with severe maternal or neonatal morbidity, in this Ontario cohort.
We’re getting better at finding a balance with DMARDs that is safe for both mother and baby. Blanket resistance is harmful
#ACR25 ABST2627 @RheumNow https://t.co/oDOpySGS3N
sheila
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Predictors of retinopathy progression after HCQ discontinued?
In the chart review of 28 pt records who had retinopathy, 35% progressed despite d/c
Age - significant assoc'n with progression
✳️monitor toxicity more closely esp in older pts
#ACR25 @RheumNow Abs2444 https://t.co/9rf2RQAgRQ
Aurelie Najm
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A new IA drug in OA 🚨
Cell therapy of apoptotic PBMCs ENX-CL-05-001
RCT Ph2A moderate to severe OA
134 pts 3 injections vs. PBO
Pain improvement 24%
Better response in people > 60 and more so 65yo
Potential improvement for > 6mo
Safety mainly local reactions to compound https://t.co/m2MZN3i22b
sheila
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Post-hoc analysis of CARE study comparing effect of Cenerimod 4mg vs. PBO
Mos. 4-6: >10% improvement in alopecia w/Cenerimod
Mos. 2-6: >10% improvement in mucosal ulcers w/ Cenerimod
Early improvement in alopecia & ulcers w/Cenerimod
Promising?
#ACR25 @RheumNow Abs2440 https://t.co/mAqmIQashr
