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A largely understudied area:
Impact of peri-menopause in PsA
Toronto Cohort 473pts, HRT 1.5%
Peri menopause =
increase DAPSA, TJC, SJC, FACIT-fatigue, HAQ
compared to pre- and post-menopause
No association w/ BMI, but with fatigue
Less impact when education level increases https://t.co/bSuGxZCbGn
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Functional MRI studies have been out there for a while, but mechanisms and significance underlying fMRI findings are unclear
fMRI study in 38 active PsA pts w/ significant fatigue
Altered functional connectivity between posterior insula to cerebellum & superior frontal gyrus https://t.co/3s9CJUg2uN
Aurelie Najm AurelieRheumo ( View Tweet)
How many patients do you need to treat to prevent one RA conversion in at-risk individuals?
APPIPRA and ALTO Interception studies, long term data
Number Necessary to Treat to prevent 1 RA conversion across time:
1yr = 4
2yrs = 7
3, 4, 5 yrs = 9
6 yrs = 11
#ACR25 #ABSTRACT1678 https://t.co/GBzUJG8jVk
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
So who with inflamm arthralgias might benefit from abatacept, in terms of delaying RA onset?
ALTO study (APIPPRA continuation)
1y abatacept then follow
If autoAb x5 (RF, ACPA IgG, IgA, anti-CarP, AAPA): sustained delay of RA
If not: benefit only on Rx
#ACR25 ABST1678 @RheumNow https://t.co/3Pc5ZLzVf6
Links:
David Liew drdavidliew ( View Tweet)
#ACR25 Abstr#1401 Sjogren’s #SjD is definitely not a benign disease! Real world study using US database showed high disease burden within 12 mths of diagnosis (i.e. healthcare resource use). GC use was high (~50%). Better therapy is needed to improve outcomes @RheumNow https://t.co/MI3vQ5LByr
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
TNFi induction first year in RA leads to:
- less D2T RA at 5y
- more sustained remission from 10y onward
- less DMARD utilization
- less healthcare utilization
in these real-world matched cohorts
given biosimilar prices, this might be worth considering
#ACR25 ABST1677 @RheumNow https://t.co/uL9nHtLkXZ
Links:
David Liew drdavidliew ( View Tweet)
Early TNFi treatment leads to
-Less D2T at 5 yrs
-More sustained remission at 10yrs
-Less bDMARD escalation at 5yrs
-More DMARD free remission at 5yrs and 10 yrs
-20% reduction annual healths costs
-11 mo delay in ttmt escalation
Safety data were not presented
#ACR25 https://t.co/jPMGUGPtqP
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
SELECT-COMPARE RA UPA vs. ADA
What do we learn from 7 years data? Not much
Patients who did well on the first drug, keep doing well
Patients who required switching for primary failure don't do as well, w/ 26% pts reaching DAS remission in UPA + MTX vs. 16% in ADA + MTX gp
No https://t.co/JLUTRZuZOm
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
In case you missed it in @ACR_Journals: HCQ for 1y does not prevent RA development in people with CCP3 >2x ULN, either:
- during 1y of treatment
- in 2y follow-up
https://t.co/gtzNiSmutb
but StopRA will give us plenty of insights - data is never wasted
#ACR25 ABST1674 @RheumNow https://t.co/DDZib5VGtX
Links:
David Liew drdavidliew ( View Tweet)
Start strong, stay strong.
With early anti-TNF induction (vs csDMARD T2T)
- At 5 yrs: D2T RA in <1% vs 7% (OR 0.11, p=0.03)
Drug-free remission 13% vs 6% (p=0.049)
- At 10 yrs: more sustained remission (62% vs 45%) & fewer multi-MoA failures.
@RheumNow #ACR25 Abstract #1677
Jiha Lee JihaRheum ( View Tweet)
Implantable vagal stimulator led to benefit in TNF-inadequate responder RA in this sham-controlled double-blind RCT (RESET-RA study)
- 82% off b/tsDMARDs at 12mo
- also with benefit to control group after crossover at 3mo to an active device
#ACR25 1675 @RheumNow https://t.co/yYwWCKm6HF
David Liew drdavidliew ( View Tweet)
This study evaluated effectiveness of SEC in PsA prevention of a subgroup of pts from SELENA: PsO pts w/o PsA & nail dse (n=292)
At 5 yrs:
🎯98.3% didn't develop PsA (yEAIR 0.49)
🎯 Sustained PASI, PGA 0/1
💡Longterm SEC effective for PsA prevention?
#ACR25 @RheumNow Abs1463 https://t.co/t7P1Oerbrw
sheila RHEUMarampa ( View Tweet)
12 year follow up radiographic data in axial SpA - ASAS definition of early stage does not significantly influence long term radiographic outcomes. Abt#1432 #ACR25 @RheumNow https://t.co/fFP2CW6X0B
Bella Mehta bella_mehta ( View Tweet)
Survival outcomes in patients with axial SpA and concomitant cancer are the same as those without. #abst1429 #ACR25 @RheumNow https://t.co/wicN3s9JrR
Bella Mehta bella_mehta ( View Tweet)
Global survey from the 2024 Adelphi Lupus Dse Specific Programme evaluated pt burden & MD/Pt Tx preferences:
Efficacy & safety - top 2 MD-reported reasons for tx initiation
OD, oral dosing-most preferred mode by MD & Pts
Shared decision-making is key
#ACR25 @RheumNow Abs1551 https://t.co/rmpCATCa78
sheila RHEUMarampa ( View Tweet)
This poster is absolutely bonkers & I LOVE it
Huge table. Frequency of everything over time
Really interesting to see which activity persists / how much damage is accumulated
Every trial should be obligated to share this (esp SLE!)
#ACR25 @RheumNow #ACRBest Abst#1608 https://t.co/blRrvwi3qP
Mike Putman EBRheum ( View Tweet)
Mease et al. What agent to use after failure of first TNFi in PsA. Real world study, 320 patients. Switching to upadacitinib led to better joint responses than second TNFi or IL17i @RheumNow #ACR25 Abstr#1453 https://t.co/SQnN0skw7r
Richard Conway RichardPAConway ( View Tweet)
Interim analysis of Ph3 TULIP-SC trial:
Anifrolumab 120mg SC or PBO weekly + SOC x 52wks
Primary endpt met: BICLA response w/Anifrolumab (60.3%) vs. PBO(43.9%)[p=0.014]
Pts on Ani had sustained BICLA response upto wk 52 (HR 2.1)
Promising results.
#ACR25 @RheumNow Abs1545 https://t.co/nqse1BiGq2
Links:
sheila RHEUMarampa ( View Tweet)
What can we use to better predict MACE in RA patients?
ESPOIR cohort showed value of two cardiac biomarkers:
- hs-cTnT
- soluble ST2
Combined, predicted MACE even after adjusting for disease activity/traditional CV RF. We need something like this!
#ACR25 ABST1334 @RheumNow https://t.co/EUNDuuMaYD
David Liew drdavidliew ( View Tweet)
Getting RA patients into remission: have we plateaued?
@MayoClinic data: early and later into the biologic era, and still median time to RA remission is >3y
Surely we can aspire to more? Let’s target barriers to implementing better
#ACR25 @ElHasbaniG @MyasoedovaElena @RheumNow https://t.co/JLTuL5cIet
David Liew drdavidliew ( View Tweet)
