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Secukinumab Use in Refractory Giant Cell Arteritis
In 2023, the phase 2 TitAIN study showed that the effectiveness and safety of secukinumab in 52 patients with giant cell arteritis (GCA) who had an inadequate response to tocilizumab.
MONITOR-PsA (n=218):
•36.5% had >1 csDMARD
•Of those, 49.2% tried combination (combo) csDMARDs
•63.6% of combo csDMARD users in MDA at 48wks
•61.1% stopped due to side effects—not inefficacy
Real-world support for csDMARD combos where biologics delayed. Abstract#OP0093 https://t.co/3Anme39VXk
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Comparative efficacy of tofacitinib vs. adalimumab in RA - metanalysis of 9 RCTs, 24,643 pts finds Tofa signif superior to ADA for ACR20 (RR 1.28), HAQ-DI, VAS, but no difference in adverse events (RR 0.96) or DAS28-CRP improvement https://t.co/5mVY2Qvdms https://t.co/czxnlYHEAl
Dr. John Cush RheumNow ( View Tweet)
Ph 2 open label RCT TOFA in RA-ILD 52 wks
39pts 92% AE 8% 3 deaths FVC decline -69 ml
No diff between UIP, NSIP or antifibrotic
No control group
#POS0619 #EULAR2025 @RheumNow https://t.co/3lqEUfObG9
Aurelie Najm AurelieRheumo ( View Tweet)
What’s worse for infection in GCA: tail end steroid taper, or a JAK inhibitor?
This is exactly SELECT-GCA in the second 6mo. What happened?
upa skews better on serious infection, worse on HZ
JAKi might have infection risk, but not like steroids. OP0057 #EULAR2025 @RheumNow https://t.co/FigxviOW3e
David Liew drdavidliew ( View Tweet)
Combination therapies in PsA not so far away:
-Case series of 22 patients from large PsA cohort.
-Combination therapy in PsA used when difficult to treat skin and msk involvement.
-Deucravacitinib was the agent mostly used in combination with bDMARDs.
-No major serious adverse https://t.co/YUyvuaJcsE
Links:
Adela Castro AdelaCastro222 ( View Tweet)
#OP0066 Danish registry study finds no increased risk of cancer recurrence with bDMARDs vs csDMARDs in RA patients with prior solid tumor in remission. IPTW-adjusted HR for any bDMARD: 0.92 (95% CI 0.38–2.21).
📉 TNFi, ,RTX also not associated with recurrence
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
Case series of 22 PsA pts treats w/ combination bioDMARDs & JAKi,TYK2i or APR
IL17i + JAKi 10.5 PY = 1 mild infectious stomatitis
IL23i + JAKi 3.7 PY = no AE
IL-17i + TYK2i 8.5 PY = 2 mild upper respiratory infections
IL-23i + TYK2i 8.3 PY = 2 mild URIs, 1 folliculitis
TNFi + https://t.co/Qg9HIwuslJ
Aurelie Najm AurelieRheumo ( View Tweet)
Worried about cancer risk with ts/bDMARDs in RA?
Real-world data from over 4,600 patients says: don’t be. No increased risk of cancer (incl. NMSC) for JAKi, IL6i, CD20i, or CTLA4-A vs TNFi in long-term registry follow-up.
Abstract#OP0065
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
What happens in pre-RA when you stop #abatacept after 1 yr Rx
At 6 yrs approx 60% on #Placebo
V
50% who initially got #ABA
Prolonged damped effect of development of #RA
NNT for 1 yr is ~10 with a range as low as 6
#EULAR2025 @RheumNow @eular_org
Abst#OP0004 https://t.co/1VOEaZ00Ia
Links:
Janet Pope Janetbirdope ( View Tweet)
Should we start strong in PsA?
In the SPEED RCT (Coates et al), both early TNFi and combo csDMARDs outperformed step-up care in moderate-severe PsA. TNFi showed the most sustained benefit through 48w.
Abstract#OP0089
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
First FcRn inhibitor in #IIM: In #ALKIVIA, SC efgartigimod PH20 improved TIS vs placebo at 24wks (50.45 vs 35.65, p=0.0004), with faster time to TIS≥20 (30 vs 71.5d) & TIS≥40 (113d vs NE). More major responders too (TIS>60: 34% vs 9.5%).
@RheumNow #EULAR2025 #OP0002 https://t.co/75BfbXoVpL
Mrinalini Dey DrMiniDey ( View Tweet)
#MTX in new #PMR?!
RCT of #MTX was negative in early #PMR - no effect on #steroid #tapering
ACR24 #1697
At #EULAR2025
👇
+RCT of #methotrexate in PMR <8wks #steroids #Rx MTX 25 mg/wk v #placebo
N=64
⬆️GC remission ✅80% v 46%
⬇️relapse w MTX
🤔
Abst0064 @RheumNow #EULAR2025
Janet Pope Janetbirdope ( View Tweet)
Risk of #VTE in #rheumatoid #arthritis
Is it better over last 25 yrs?
👎
Olmstead
County population study of #RA Pts vs matched controls
⬆️VTE in RA
⬆️VTE w active RA
But not change in rates of #DVT & #PE since 2000
Why? 🤔
Abst#OP0070 @rheumnow #EULAR2025 @eular_org https://t.co/eSyjfjVqtY
Janet Pope Janetbirdope ( View Tweet)
135 pts w/ neurologic autoimmune dz (MS, GBS, myasthenia gravis) who had cancer & Rx w/ checkpoint inhibitors (ICI) showed exacerbations in SOME - 18% of MS pts, but 67%of MG, latter often w/ hospitalization (50%) or death (17%). GBS faired well w/ ICI Rx. https://t.co/RksC6QXce0 https://t.co/mYjzgxbcdQ
Dr. John Cush RheumNow ( View Tweet)
Otilimab, GM-CSF mAb, may have potential in #RA. Metanalysis of 4 RCTs, w/ 3933 RA pts had Moderate evidence for ACR20 response (vs PBO) at 90 mg (RR 1.50) & 150 mg (RR 1.39). but neither dose had signif different adverse events vs PBO. OTIL was less effective than tofacitinib. https://t.co/2WajWNnxE9
Dr. John Cush RheumNow ( View Tweet)
Retrospective multicentre study of 122 anti-synthetase syndrome pts - 14 (11%) had cancer associated myositis (CAM). The CAM SIR= 5.4 (elevated vs gen. pop. p < 0.0001). These pts were older, often +Hx cancer, lower CK levels, less weakness, worse survival. CAM cluster= older https://t.co/nuKg3P89a8
Dr. John Cush RheumNow ( View Tweet)
While there are trials in progress, there is no RCT data on the use of JAK inhibitors in Noninfectious Uveitis (NIU). But there is this metanalysis of many small case reports suggesting their potential efficacy in NIU. https://t.co/pBNsSmVjOz https://t.co/JrIGQGZjHt
Dr. John Cush RheumNow ( View Tweet)
Positive results from Phase 2b RENOIR RCT of Rosnilimab, an agonist targeting PD-1+ T cells. 432 RA pts on MTX or csDMARDs, Rx w/ 6 mos of PBO vs ROS (100 or 200 mg q4wk or 600 mg q2wk). All 3 doses of rosnilimab achieved significant reductions DAS-28 CRP at Wk 12 https://t.co/g7lqQYXeJd
Dr. John Cush RheumNow ( View Tweet)
52 wk Phase 3 DBRPCT of daily anakinra (100 mg sc) vs PBO in 30 giant cell arteritis pts. At wk 16 (17 ANK vs 13 PBO) there was no significant difference in relapse rates (12% vs 23%; p = 0.63). Same at wk 52 (53% vs 49% relapse). ANK didnt reduce relapses or GC exposure https://t.co/RFkkaUchsW
Dr. John Cush RheumNow ( View Tweet)
