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Polymyalgia rheumatica immunological puzzle further illustrated
Infiltrating macrophages expressing IL-6 and GM-CSF may drive the subacromial bursitis often seen in polymyalgia rheumatica, according to new research (abstract OP0015) prese
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SLE trials update
Translating targeted therapy from bench to bedside has been more problematic in SLE than other autoimmune diseases, with many theoretically well-founded agents appearing to have failed in clinical trials as a result of inefficacy, problem with trial design and/or safety issues.
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Are TYK2 inhibitors ‘ticked’ to be part of the JAK family?
Are TYK2 inhibitors JAK inhibitors? Are they effective in PsA? Are they safer than JAKi? Read on to learn more.
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JAKi for nonradiographic axSpA
One area of continued interest for many rheumatologists is the field of non-radiographic axial spondyloarthritis. Furthermore, the question of the utility of JAK inhibitors for the treatment of axial spondyloarthritis has been on the rise.
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Updates in Psoriatic Arthritis at EULAR 2022
At EULAR 2022, I look forward to key topics and presentations in psoriatic arthritis (PsA). Here's a preview of nine studies I'm particularly interested in at this meeting.
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Dougados et al. MACE in tofa clinical programme. Baseline CV risk important. Overall MACE IR 0.38 [0.26-0.54]. MACE IR lower than in ORAL Surveillance in CV enriched pop 0.72 [0.46-1.09]. @RheumNow #EULAR2022 OP0264 https://t.co/lGTTEx0X5p https://t.co/MvD6kjkpse
Links:
Richard Conway RichardPAConway ( View Tweet)
🧫 JAKi and NK
cells activation:
JAKi and particularly TOFA impacts NK cells:
*phenotype
*function
*impairs the control of proliferation of lung cancer and lymphoma cell lines
An explanation for the increase of cancer events in ORAL surveillance?
@RheumNow #EULAR2022 OP0265 https://t.co/LzMLdzcsDU
Aurelie Najm AurelieRheumo ( View Tweet)
MACE events no diff in German RA Rabbit registry of only humans shows #baricitinib and #tofacitinib vs #TNFis @RheumNow @eular_org #EULAR2022 OP0135 https://t.co/O8iOA7jpal
Janet Pope Janetbirdope ( View Tweet)
Was ORAL Surveillance really a surprise?
Let's look post-hoc at all the other tofacitinib RCTs (ph 1-3b/4 +LTE)
Cardiovascular risk-enriched pts were always in the same MACE ballpark with tofa
ORAL Surveillance was worse, but clues were always there
OP0264 #EULAR2022 @RheumNow https://t.co/rB5SwVX2oc
David Liew drdavidliew ( View Tweet)
Montastruc et al. VigiBase study of CV and VTE events in JAKi vs TNFi. >270000 events. DECREASE in MACE ROR=0.87 [95%CI 0.80-0.95]. INCREASE in DVT: ROR=3.99 [3.15-5.04], PE: ROR=3.47 [2.90-4.13] @RheumNow #EULAR2022 OP0268 https://t.co/lUin7ciXWt https://t.co/Gr4Kvd8F7R
Links:
Richard Conway RichardPAConway ( View Tweet)
MACE in JAKi vs TNFi: did spontaneous reporting pharmacovigilance pick it?
Vigibase: MACE (really MI) & VTE signals there before the scare
Always chance regulatory warnings cause stimulated reporting
but signal here was clear before RCT-driven alerts
OP0268 #EULAR2022 @RheumNow https://t.co/hTJD1gMgyy
David Liew drdavidliew ( View Tweet)
Video: Further Considerations of the ORAL Surveillance Study
Further Considerations of ORAL Surveillance Study - this week there are new analyses and sub-analyses that further explain findings and who this data applies to. #EULAR2022
https://t.co/a2XKthtMbs https://t.co/kYNS1AesHT
Links:
Dr. John Cush RheumNow ( View Tweet)
Are TYK2 inhibitors ‘ticked’ to be part of the JAK family?
Are Tyk2 inhibitors JAK inhibitors?
Yes, no, maybe
Check out all of Dr. Janet Pope’s TYK2 Q&A.
https://t.co/IqeGqt6M4t https://t.co/kjWLVKVFP7
Links:
Dr. John Cush RheumNow ( View Tweet)
GM-CSF increased in patients with active ankylosing spondylitis, correlates with disease activity, not duration. TNFi does not affect GM-CSF levels. Could explain efficacy of JAKinibs and response for residual inflammation during TNF blockade.
@RheumNow #EULAR2022 ABST#OP0107
Robert B Chao, MD doctorRBC ( View Tweet)
JAKi for nonradiographic axSpA
One area of continued interest for many rheumatologists is the field of non-radiographic axial spondyloarthritis. And the question of the utility of JAK inhibitors for the treatment of axSpA has been on the rise.
https://t.co/xq8ICyKKv0 https://t.co/o2iUgyU60A
Links:
Dr. John Cush RheumNow ( View Tweet)
#EULAR2022 ASAS/EULAR AxSpA Recs
⭐️Last: 2016
▶️All: education, exercise, 🚭
▶️❌csDMARD for axial disease
▶️TNF/IL17 (or JAK) with high disease: ASDAS>/=2.1
▶️Monoclonal TNF for uveitis/IBD, high PsO: IL-17
▶️Sustained remission: tapering of bDMARD "can be considered"
@RheumNow https://t.co/3yYU0Vb37r
Eric Dein ericdeinmd ( View Tweet)
RABBIT registry data on CV events with JAKi. Incidence rate low 0.41/100PY. No increase compared to TNFi RR 0.94 (0.39-2.38). No increase in high-risk group RR 0.90 (0.37-2.17). Reassuring with wide CI's. @RheumNow #EULAR2022 OP0135 https://t.co/vBSsnfeBoR https://t.co/iYDZsNwMye
Links:
Richard Conway RichardPAConway ( View Tweet)
#EULAR2022 OP0135:
German RABBIT 🐇 Registry:
⭐️ Observational, 46% Tofa, 54% Bari
No increased rate of CVD in JAK vs TNF inhibitor
🚨Unlike the ORAL Surveillance
@RheumNow https://t.co/O4IXg22Ybc
Eric Dein ericdeinmd ( View Tweet)
RABBIT registry and MACE in RA
No difference between
*JAKi (Tofa and Bari) and *TNFi in both unselected and high CV risks patients.
🧨 different than ORAL surveillance
but Observational and overall Low incidence (28 events).
#EULAR2022 @RheumNow OP0135 https://t.co/o8rngHrwQF
Aurelie Najm AurelieRheumo ( View Tweet)
Upadacitinib shows promising response in the treatment of nr-AxSpA in the SELECT-AXIS 2 study. Deodhar et al showed the ASAS40 response rate for UPA was twice vs placebo (45% vs 23%). 12/14 of the secondary endpoints were also met #EULAR2022 @RheumNow OP0016 https://t.co/dOWVJdLRtG
Dr. Antoni Chan synovialjoints ( View Tweet)
