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TNFi cycling in axSpA: Results from CorEVITAS Registy study
Data presented at ACR22 shows that cycling through TNFi in axSpA patients with primary lack of efficacy with first line TNFi has limited additional benefit in controlling disease.
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Ab1011 #ACR22
@SMerjanah: Fracture rates among vets with AS
Increasing fx incidence for AS and comparator groups over time
There was increase in fractures during TNFi era 2004-2021 compared to pre-TNFi, does not show fx sparing effect
@RheumNow https://t.co/fTSYbFcxqo
Eric Dein ericdeinmd ( View Tweet)
Abs 1011 examined fracture incidence rates in AS patients over time in VA cohort
- Rate of fractures in AS pts 2.1 per 1000 PY --> 22.8 (1999 --> 2021) vs Comparators 0.4 --> 8.3
- Post TNF era fracture rates increased AS > comparators
@RheumNow #ACR22 https://t.co/eUxoTavHGV
Akhil Sood MD AkhilSoodMD ( View Tweet)
What delays diagnosis of AS? #ACR22 @RheumNow
Abstract #0328
Diagnosed faster if:
👨🦳Older age at back pain onset
🧬HLA-B27+
✋🦶peripheral arthritis
📍Higher socioeconomic vulnerability had diagnostic delay
👁 uveitis more common in patients with > 4 years dx delay
Catherine Sims, MD DrCassySims ( View Tweet)
Analysis from Abs 0954 shows that mainly fatigue and back pain have an impact on the mean BASDAI during pregnancy. #ACR22 @RheumNow https://t.co/l5VGKqF2ar https://t.co/fpkl8VRRJP
Dr. Rachel Tate uptoTate ( View Tweet)
Dr PMease et al looked into impact of TNFi cycling in their #axSpA cohort:
💠After 6mos on 2nd TNFi, only 15% had ASDAS-LDA, 7% MCID in ASDAS, 8% >50% improvement
💠Cycling to 2nd TNFi limited benefits
⬇️sample size, worth further investigation
#ACR22 @RheumNow ABST#1499 https://t.co/OVJxezdipW
sheila RHEUMarampa ( View Tweet)
Post hoc analysis of 3 PsA/SPA trials: no effect of tobacco 🚬 on TOFA efficacy But numerically higher TEAEs
Contrasting w/ data from real world TNF
Interesting data but small sample size & events N
https://t.co/gv8uvcThMD
Abs#1036 #ACR22 @Rheumnow https://t.co/HCJT0XF1tg
Aurelie Najm AurelieRheumo ( View Tweet)
DANBIO registry: 1600+ pts RA, AxSpA, PsA
Infiximab biosimilar to biosimilar switch (CT-P13 -> GP1111)
Maintenance at 1yr:
>80%
> withdrawal in original IFX naive, but higher BL DA
Do second time switchers do better because of past switch experience?
Abs#1112 #ACR22 @RheumNow https://t.co/IgjhGLVESz
Aurelie Najm AurelieRheumo ( View Tweet)
Biosimilar to biosimilar effective in treatment of RA/PsA/AxSpA.
Large study looking at infliximab biosimilar switching - resulted in high retention rates and virtually no change in disease activity.
@RheumNow #ACR22 Abs#1112 https://t.co/uNRXLewo4M
Robert B Chao, MD doctorRBC ( View Tweet)
Abstr #1494 determinants of clinically important worsening (CIW) of early axSpA
- CIW = ASDAS ↑ > 0.9 b/w 2 visits
- Tender Joint count and ASAS-NSAID score associated w/ CIW
- MRI SI Jt inflammation & structural damage predictive of CIW
@RheumNow #ACR22 https://t.co/Dgeh25BaWM
Akhil Sood MD AkhilSoodMD ( View Tweet)
BASDAI and ASDAS performed similarly in axPsA pts, both demonstrating weak correlations w/ peripheral arthritis and moderate/strong correlations w/ pt fatigue and pain. Abs 1037 #ACR22 @RheumNow https://t.co/WRQx1hkIll https://t.co/kJVIWyVv2w
Dr. Rachel Tate uptoTate ( View Tweet)
Osteoporotic fx in AS
Abstract #0388 #ACR22 @RheumNow
🦴2k adults in RISE, mean age 68y, 44% female, 76% white
🦴Higher risk with: older age, increased comorbidity index, OP history, chronic use of opioids, low BMI
🦴Men and women were equally likely to fracture
Catherine Sims, MD DrCassySims ( View Tweet)
Early TNFi use and cardiovascular events in AS
Abstract #0415 #ACR22 @RheumNow
📍17.6k patients, 91% male, 80% white
📍TNFi initiators were younger with lower prev. of HTN and DM
📍TNFi was associated with higher risk of incident CVD, CVA, and MACE https://t.co/7bCkfk7EYY
Catherine Sims, MD DrCassySims ( View Tweet)
axPsA and AS adult pts exhibit different genetic risk factors & serum IL-17 levels. GUS demonstrated significant pharmacodynamic effects and clinical improvement in axPsA and non-axPsA pts. Abs 1038 #ACR22 @RheumNow https://t.co/9Rjw7usO8J
Dr. Rachel Tate uptoTate ( View Tweet)
What neonatal factors could affect development into axSpA? Turns out antibiotic exposure (6.2x more likely).
Mode of delivery, early diet (milk vs. formula), maternal smoking (!!) did not show association.
@RheumNow #ACR22 Abs#0868
#ACRBest https://t.co/roCAj5YsCt
Robert B Chao, MD doctorRBC ( View Tweet)
Other potential mechanisms for survival selection against the plague via MHC presentation to CD8 T cells. May be associated with SpA/HLA B27
@RheumNow @HRheuminations #ACR22 #rheuminations https://t.co/Rv117B4IYp
Julian Segan JulianSegan ( View Tweet)
Deodhar et al. Bimekizumab (IL-17A/Fi) in nr-axSpA. Efficacy shown across all outcomes. Confirms bimekizumab works across spectrum of axSpA (not surprisingly). @RheumNow #ACR22 Abstr#0544 https://t.co/XVGBgBQpTH https://t.co/39zW5Ex9xh
Richard Conway RichardPAConway ( View Tweet)
Proft @ProftDr et al. NSAIDs+golimumab no better than golimumab monotherapy in reducing spinal progression in AS. But... for high risk patients there may be some benefit - see figure. @RheumNow #ACR22 Abstr#0546 https://t.co/xo9Uy6aX71 https://t.co/vZgaoeEQn4
Richard Conway RichardPAConway ( View Tweet)
Weinstein et al. GO-BACK. Another TNFi withdrawal study in nr-axSpA. Again showing it doesn't work. 12 months. Only 34% of withdrawal group in remission vs 84% full dose and 68% reduced dose group. @RheumNow #ACR22 Abstr#0545 https://t.co/Fa5YgT9FYk https://t.co/9C8ShI9qjk
Richard Conway RichardPAConway ( View Tweet)
IL17A/Fi BImekizumab BKZ to Wk 24 achieved reduction in
◦ total spinal pain (SP)
◦ nocturnal SP
◦ morning stiffness (BASDAI)
◦ fatigue (FACIT-F)
Deodhar et al, BE MOBILE 1,2 Abst 0409 https://t.co/vpCrG2COuB
#ACR22 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
