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Xeljanz Cancer Risks Detailed
MedPage Today
The degree to which the oral rheumatology drug tofacitinib (Xeljanz) seems to promote new malignancies is now fleshed out in the latest, and at least somewhat reassuring, report from a landmark safety study.
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Tyk2 Inhibition Effective in SLE
Deucravacitinib, an oral, selective TYK2 inhibitor, has demonstrated efficacy in a phase II trial active systemic lupus erythematosus (SLE) patients.
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ACR 2022 Appraisal, Praise & Critique (11.18.2022)
It was great to be back at an ACR annual meeting, this one in Philadelphia - Philly was great. A walking town, rich in culture, history and good places to meet and mingle.
I loved the city, but not the convention center (not easy to navigate).
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Retrospective study looked at 47 adults w/ dermatomyositis treated with tofacitinib. While clinically similar, those on TOFA were were younger (53vs 61), shorter Rx duration (24 vs 53 mos);there was signif CDASI improvement. #ACR22 https://t.co/HrC1GLZQRR https://t.co/yiHsxhpiWe
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Dr. John Cush RheumNow ( View Tweet)
Do oral JAKs in atopic dermatitis cause VTE? Meta-analysis (15 RCTs, 466 993 pts) does NOT show increased risk of VTE associated with AD & JAK inhibitors (HR 0.95) w/ low VTE incidence (0.05%) w/ JAKi and (0.03%) placebo. https://t.co/vcvW8N11cm https://t.co/N5zx0I0lrn
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Dr. John Cush RheumNow ( View Tweet)
JAKi Regulatory Decisions - FDA, EMA, Canada
New download available!
https://t.co/92qbWQbMm3 https://t.co/lEjyjwxYMo
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Dr. John Cush RheumNow ( View Tweet)
Maya Buch on major adverse CV events in tofa vs TNFi. Post-hoc analysis of phase 3b/4 data looking at cohort enriched for CV events.
@RheumNow #ACR22 #LateBreaking
Julian Segan JulianSegan ( View Tweet)
L06 #ACR22 ORAL Surveillance Updates!
Composite of all ischemic CV events and HF did NOT show difference b/w TOFA vs TNFi
But, MACE numerically higher with Tofa w/ h/o ASCVD
Highest CV risk in TOFA 10 mg BID, 2/2 VTE risk
Most important risk is pt's individual risks
@RheumNow https://t.co/jPPX7f5GRE
Eric Dein ericdeinmd ( View Tweet)
Does tofacitinib work better in patients with PsA and AS who smoke?
Abstract #1036 #ACR22 @RheumNow
🚬519 ever smokers
🚭767 never smokers
💉In PsA only, TOF efficacy was greater in ever smokers vs. PBO
✋Overall, efficacy was generally comparable in ever v. never 🚬
Catherine Sims, MD DrCassySims ( View Tweet)
Post-hoc analysis of SELECT-COMPARE showing decreased residual pain at week 12 but not week 26 cf. ADA, regardless of residual inflammation. Does this just reflect differing onset of action?
@RheumNow ABST0297 #ACR22
https://t.co/9WyZAN3B16 https://t.co/fAC1bLw9EB
Julian Segan JulianSegan ( View Tweet)
Fleischmann et al. Safety of TYK2i Deucravacitinib in PsA/PsO in terms of labs. Really no effect on lab values other than increase in trigs. Guess this is why they don't have lab monitoring on label? @RheumNow #ACR22 Abstr#2132 https://t.co/ueIVKQc6jr https://t.co/u99QE71VQ5
Richard Conway RichardPAConway ( View Tweet)
Warren et al. TYK2i deucravacitinib in plaque psoriasis at 2 years. Sustained efficacy. No new safety signals seen. @RheumNow #ACR22 Abstr#2134 https://t.co/5SGKKrvwbc https://t.co/ynvfZiOrsp
Richard Conway RichardPAConway ( View Tweet)
New SLE Rx. Deucravitinib a TYK2i phase 2 RCT showed SRI4 endpoint. Subset of 3 mg bid was best vs 6 mg bid and 12 mg OD. Skin via CLASI-50 & other endpoints also positive. Awaiting phase III. Abst1117 #ACR22 @RheumNow https://t.co/fZI3AV5pML
Janet Pope Janetbirdope ( View Tweet)
Is #Tofacitinib an option in #PMR poly myalgia rheumatica? RCT of Tofa 5 mg bid vs prednisone 15 mg/d and tapering. Equal results. Needs a phase 3 trial but could be an option if needing to avoid prednisone ex osteoporosis, DM, etc. abst#1107 #ACR22 @RheumNow https://t.co/OgcgslwaB5
Janet Pope Janetbirdope ( View Tweet)
Kavanaugh et al. TYK2i deucravacitinib in PsA. Nice breakdown of MDA and its components over 16 weeks. MDA achieved 23-24% with deucravacitinib at 16 weeks vs 8% with placebo @RheumNow #ACR22 Abstr#2136 https://t.co/9IG8CeZzMh https://t.co/Vg8E20y7Z8
Richard Conway RichardPAConway ( View Tweet)
Mease et al. TYK2i Deucravacitinib in PsA. Phase 2 RCT 52 week results. PASDAS, DAPSA efficacy maintained through week 52. No new safety concerns. @RheumNow #ACR22 Abstr#1598 https://t.co/sRKkgkYtQJ https://t.co/YMXMEH3wsq
Richard Conway RichardPAConway ( View Tweet)
In RA pts initiating their first b/tsDMARD, Abs 1420 did not observe differences in 6- and 12-month effectiveness outcomes between ETN, ADA, and JAKi monotherapy. #ACR22 @RheumNow https://t.co/e8GA45Rrmd https://t.co/zooGxlTftO
Dr. Rachel Tate uptoTate ( View Tweet)
Pike et al. Deucravactinib (TYK2i) in SLE. + on SRI(4) week 32. + SRI(4),BICLA, LLDAS, CLASI-50, swollen and tender joint counts week 48. Strange, the lowest dose (3mg bd) seems best. @RheumNow #ACR22 Abstr#1117 #ACRbest https://t.co/o4902tvZs8 https://t.co/t8oeMRGUS7
Richard Conway RichardPAConway ( View Tweet)
TOFA and MTX: which one to withdraw first?
RCT in 100+ RA pts in remission after 1 yr, 1 yr follow-up
Withdraw MTX grp: Remission 30% LDA 40%
Withdraw TOFA grp: Remission 50% LDA 65%
diff NS small sample
8 SAEs, 72% recovery
https://t.co/tMnet32TWF
Abs#1586 #ACR22 @Rheumnow https://t.co/PWnkWYdlGk
Aurelie Najm AurelieRheumo ( View Tweet)
#abst2132 #acr22 @rheumnow safety of Deucravacitinib Ph2PsA&ph3PSO trial: no Δ from BL in hematology, chemistry, or lipid labs. JAK 1/2/3 Effects on hem, hepatic, CPK, and cholesterol lab parameters not observed over 16 wks of DEUC at doses up to 12 mg QD & in combo w/csDMARDs. https://t.co/bjGEYp4GcJ
Olga Petryna DrPetryna ( View Tweet)
