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Rheumatoid arthritis and the ‘big bang’ at the ACR!
Is there ‘bang for the buck’ using big data to help predict who will develop RA in at-risk populations and similarly to predict response to csDMARDs, TNFi and JAKi in RA?
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No seasonal pattern in GCA!
We have also looked at this in our data and similarly found no trends
It sure feels like GCA comes in waves, but data does not bear this out
#ACR25 @RheumNow Abstr#0754 https://t.co/4y2elYmCRT
Mike Putman EBRheum ( View Tweet)
Lindberg et al. Nationwide case-control study in Sweden. Big increase in risk of DVT/PE in AAV, most marked early after diagnosis @RheumNow #ACR25 Abstr#718 https://t.co/FpDcbX15hm
Richard Conway RichardPAConway ( View Tweet)
Novelli et al. Upadacitinib in male vs female PsA. Data from SELECT-PsA studies. Appears equivalent in males and females, contrasting with TNFi/IL17i data. @RheumNow #ACR25 Abstr#557 https://t.co/fMKsbCkju0
Richard Conway RichardPAConway ( View Tweet)
In a novel Geri-Rheum clinic, cognitive screening revealed 35% impairment among adults >55 yrs.
Common deficits: visuospatial, attention & recall.
Early geriatric screening = earlier intervention.
A model for age-friendly rheum care in action.
@RheumNow #ACR25 Abstract #0226 https://t.co/lIAcrZvL4H
Jiha Lee JihaRheum ( View Tweet)
Heydari-Kamjani et al. Risk of DILI with avacopan. Real world study, propensity score matching. Risk DILI 2% with avacopan vs 1.9% PBO @RheumNow #ACR25 Abstr#724 https://t.co/UhVkcXEYjF
Richard Conway RichardPAConway ( View Tweet)
Ogdie et al. Week 24 results of SOLSTICE study. Guselkumab in TNF-IR in PsA. Good efficacy on skin and joint disease. No difference seen in Q4 vs Q8 weekly doses. @RheumNow #ACR25 Abstr#563 https://t.co/ztK0O9iKb8
Richard Conway RichardPAConway ( View Tweet)
Observational study of fibrinogen for diagnosis of GCA
At a cutoff of 4.7, roughly similar diagnostic performance as compared to ESR/CRP
Kind of neat, but does not appear to have additive benefit
#ACR25 @RheumNow Abstr#0750 https://t.co/xy2qn4jHXP
Mike Putman EBRheum ( View Tweet)
ILD found in 30% of Sjögren’s pts w/ HRCT.
A new nomogram-based tool (AUC 0.8) predicts ILD risk using age, ESR, C3, hypergammaglobulinemia & anti-La/SSB.
Goal: guide HRCT referrals & catch ILD earlier.
@RheumNow #ACR25 Abstract #0510 https://t.co/FvAprq8eol
Jiha Lee JihaRheum ( View Tweet)
2-Year data from SELECT-GCA Phase 3 UPA in GCA
Re-randomization & 52 weeks extension UPA 15mg vs. PBO
-Risk of flare 90% lower
-Complete remission 70% vs 20%
-Cumulative GC 1g difference
-No new safety signal
The quick relapse after stopping UPA indicates we are really looking https://t.co/c1khywnPNv
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Immune-Mediated Necrotizing Myopathy @EleniTiniakou #ACR25
*Younger pts tend to have a more aggressive disease
*IVIG and RTX can be considered first-line rx for anti-HMGCR and anti-SRP+, respectively
*CYC and plasmapheresis may be options in cases of aggressive disease https://t.co/zWDX79gqlf
Rheumatology Quarterly RheumQuarterly ( View Tweet)
Abstract 0806
Compared to belimumab, Anifrolumab associated with:
↑ infection risk b (HR 1.40, 95% CI 1.05–1.88)
↑ herpes zoster (HR 3.94) & COVID-19 (HR 1.66)
No diff in mortality or hospital use
📈 3-yr infection: 38.3% vs 21.3%
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Real world effectiveness of voclosporin for SLE
Reduction in UPCR from 2.1 at b/l to 0.9 at 6 months, no improvement in eGFR; as expected based on trials
Wonder about market share of BEL vs voclo vs ANI - anyone seen pubs on this?
#ACR25 @RheumNow Abstr#0661 https://t.co/l7i7IWhLSe
Mike Putman EBRheum ( View Tweet)
#ACR25 Abstr#775 Previous study showed plasma tRNA-derived RNA (tDR-1), produced by bacteria from the phylum Proteobacteria, was assoc. with lower RA activity.
In 60 At-Risk CCP3+ people, Plasma tDR-1 improved prediction of RA. Need validation & adoption in practice @RheumNow https://t.co/XBmtohBEHc
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
From the FOREMOST study factors predicting progression from oligo to polyarticular PsA: Female sex, enthesitis and dactylitis found to increase the risk of progression. Among patients in FOREMOST receiving PBO, prior csDMARD use was protective. Abstract#0576 @RheumNow #ACR25 https://t.co/CFMhAFgFBa
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Accdg to this retro analysis of their prospective cohort study from Toronto, 47 pts (10%) had D2M axSpA of whom 14 had tx-refractory dse.
D2M pts - longer symptom duration; ⬆️ASDAS, BASDAI, BASMI, BASFI & ⬆️CRP
💡Consider non-dse factors in D2M pts
#ACR25 @RheumNow Abs0547 https://t.co/MUUyyELbw8
sheila RHEUMarampa ( View Tweet)
#0191 We found that in a large South London RA cohort, use of advanced therapy in moderate disease (DAS28 3.2-5.1) generally followed NICE guidance. Gaps often reflected telehealth limiting DAS assessment and patient hesitancy. Self-assessment tools may help. @RheumNow #ACR25 https://t.co/UMGtkfABHn
Mrinalini Dey DrMiniDey ( View Tweet)
Real-world T2T strategy from MONITOR-PsA cohort:
🎯 At 48 weeks - 33.6% (49/146) of pts achieved PASDAS 'moderate' response & 37% (54/146) achieved a 'good' response
This was close to the T2T outcomes of the TICOPA trial
Adapt a T2T approach in PsA tx
#ACR25 @RheumNow Abs0572 https://t.co/FPiFIiO8Oe
Links:
sheila RHEUMarampa ( View Tweet)
Albach et al. CAR T-cells in D2T RA. 6 patients. Safety looks ok. ACR20 in 4/6, ACR50 in 2/6. ACPA and RF disappeared. Results maybe not as positive as we might have anticipated? @RheumNow #ACR25 Abstr#471 https://t.co/TaEVWiWsNm
Richard Conway RichardPAConway ( View Tweet)
SELECT-GCA (upadacitinib in GCA for 52w)
we hoped it might have ongoing effect post-cessation
Do we need to continue upa?
Extension data (second year) flare survival curves are clear:
continuing upa far outperforms placebo
It seems >2y toci/upa for GCA
#ACR25 ABST0776 @RheumNow https://t.co/uJA3uQyWxb
David Liew drdavidliew ( View Tweet)
