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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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Md Yuzaiful Md Yusof
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#ACR25 Abstr#803 We need more data to justify biologics before conventional immunosuppressant in #SLE. Post-hoc analysis of 5 Phase 3 RCTs = improved efficacy & GC reduction in BEL+No IS vs PBO+IS. Potential selection bias as control group might be doomed to fail @RheumNow https://t.co/kXmrOUbJzj
Antoni Chan MD (Prof)
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Real-world Indian cohort of 290 axSpA patients, generic tofacitinib achieved low/inactive disease in 89% after 25 months. Most adverse events were mild (e.g., transaminitis 14.5%) and manageable. No serious infections or MACE reported. A cost-effective alternative to bDMARDs in https://t.co/JBHfNq7kYt
Mike Putman
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Nice SRMA evaluating HCQ dosing
>5mg/kg associated w/3.8x risk of retinopathy...
...but <5mg/kg associated w/1.8x risk of SLE flares
Morbidity from one of those is easily avoided by regular screening; morbidity from the other can be devastating
@RheumNow #ACR25 Abstr#805 https://t.co/1vJXxXqiRC
Janet Pope
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What is #nonadherence in #SLE associated with?
115 Pts w #lupus in Spain
Overall medication adherence 58%!
👇Reduced if
Male
Low education
No partner -NS adjusted analysis
Unemployed
Comorbidities
3 or more drugs/pills -NS adjusted
#ACR25 @RheumNow @ACRheum
#abst0216 https://t.co/CkG6gpiCw3
Mike Putman
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CE study BEL vs csDMARDs in TriNetX
Mortality ~3-4% for MTX/AZA/MMF vs ~1.5% for BEL, ~50% reduction in adjusted analysis
Pretty surprising given mediocre results from BLISS RCTs, but strong research group & lotsa fancy stats
Do you believe it?
#ACR25 @RheumNow Abstr#0804 https://t.co/Yex98EYDjP
Aurelie Najm
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Effect of BioDMARDs on Diabetes risk in 6400+ Psoriasis pts
IL-23i and IL-17Ai associated w/
-lower risks of diabetes
-Diabetic nephropathy
-Stage 3–5 CKD
and reduced risk compared to TNFi treated and bionaive pts
Adjustment on several variables, but not disease severity https://t.co/TDIHXJOC2T
David Liew
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Leflunomide - a perennial question in GCA, that we still haven’t answered (as this meta-analysis shows), despite clear potential.
We are getting a clearer idea of the strengths/limitations of MTX in GCA, is it now time to get better clarity for LEF?
#ACR25 ABST0731 @RheumNow https://t.co/ycuvPx8Xdg
David Liew
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Avacopan in the real world: we need to be braver
If we want to get steroid-sparing benefit in AAV, we need to trust it
claims data shows modest PNL reduction with avacopan
some manifestations are harder to taper in, but others we just need to be bolder
#ACR25 ABST0726 @RheumNow https://t.co/51nGdpR2db
sheila
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A systematic review by Dr. SRamiro et al evaluated efficacy of b/tsDMARDs on peripheral axSpA
Majority on bDMARDs (TNFi, n=24; IL-17, n=13)
Most of the SMDs were small --> b/tsDMARDs showed small to moderate effects on peripheral arthritis & enthesitis.
#ACR25 @RheumNow Abs0588 https://t.co/yGXcqhZ1Uv
Antoni Chan MD (Prof)
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ASAS recommends standardised reporting for 20 key outcomes in axSpA trials, 10 for all studies, 10 specific to DMARD trials. Formats include mean (±SD), mean change, and categorical thresholds for ASDAS, ASAS-HI, and extra-musculoskeletal manifestations. 85% of ASAS members https://t.co/VQwPaTRIOl
Md Yuzaiful Md Yusof
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#ACR25 Abstr#776 2-Year SELECT-GCA RCT showed that #GCA patients receiving continuous UPA15 to 2-yr maintained their remission (69%) vs those who switched to PBO after in remission for ≥24 weeks (29%). Lower serious infection but higher herpes zoster in UPA15. One VTE @RheumNow https://t.co/FCTNqCVxiZ
Richard Conway
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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
Aurelie Najm
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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
Rheumatology Quarterly
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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
Mike Putman
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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
David Liew
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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
Mrinalini Dey
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#0776
In the 2-yr SELECT-GCA trial, continued upadacitinib 15mg maintained remission in 69% vs 29% who switched to PBO, cutting flare risk by 90% and reducing steroid exposure by ~1g.
No new safety signals in older adults (mean 71yrs). @RheumNow #ACR25 https://t.co/KC9sm3ic3q
Richard Conway
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Singla et al. In secukinumab phase 3 trials, fungal (inc candida) infections uncommon. 5.51 for sec vs 3.39 for PBO per 100PY. @RheumNow #ACR25 Abstr#585 https://t.co/g78zUsxD5a
Richard Conway
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Schmidt et al. 2 year results of SELECT-GCA, upadacitinib in GCA. Remission 69% if upa continued vs 29% if stopped. 90% lower risk of flare, 1G less steroid @RheumNow
#ACR25 Abstr#0776 #ACRBest https://t.co/MgRo7kIgIw
