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#ACRbest Yrin Preview @ACRheum
J Bathon
Take home
Symptomatic #Rx of ACPA+ people WITH #DMARD is too late to alter risk of #RA when drug is d/c
AI to read joint erosions on X-ray May be ‘too little too late’
#Steroids in #RA increase #MACE even after d/c
#ACR23 @RheumNow
Janet Pope ( View Tweet)
#ACR23 Yr in Preview
J Bathon
Shared decision making w tradeoffs showed sex differences for concerns & preferences in #RA present
dependent on how you ask the questions
Unmet needs (I think 🤔)
biomarkers of flare for #inflammatory #arthritis
Rx select’n/retention
@RheumNow
Janet Pope ( View Tweet)
Watch: Assessment and Treatment of Cardiovascular Risks in Rheumatoid Arthritis
Dr. Antoni Chan discusses abstract 0387 and abstract 0391 presented at #ACR23
https://t.co/avnarOGZui https://t.co/4CeAumv31b
Dr. John Cush RheumNow ( View Tweet)
Telitacicept a recombinant fusion protein targeting, neutralizing BLyS and APRIL, phase 3 study in RA MTX-IR at 24 wk, ACR20 (60% vs 27% PBO), ACR50 (21% vs 6% PBO), reduced DAS28-ESR, no radiographic progression, Wang L Abst#L20 #ACR23 #ACRBest @RheumNow https://t.co/nuvizqQZsR https://t.co/PRtlea3AqU
Dr. Antoni Chan ( View Tweet)
Abstract 2583 at #ACR23
👉Possible predictive model of at risk of RA patients with ACPA positivity based on baseline levels of peripheral blood lymphocyte sub-populations:
⭐️High % of B cell and low % of NK cells increase the probability of developing arthritis in ACPA + pts… https://t.co/3KEOI4eul0 https://t.co/irX6InWMbl
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
A model for prediction of progression to RA
Factors asso w/ progression
-ACPAs
-High % B cells
-Low % NK cells
Only in ACPA+ individuals
Low ACPA titers, High % NK cells and Low B cells = 76% non progressors
@RheumNow #ACR23 ABST2583 https://t.co/vNIwyrOJtJ
Aurelie Najm ( View Tweet)
JAKi, especially BARI, may be useful and safe in controlling both pulmonary and joint disease in RA-ILD patients, even in refractory cases. Evolution of FVC and DLCO remained stable in first 12 months. Serrano-Combarro A, Abst#2174 #ACR23 @RheumNow https://t.co/82mMn5oh15 https://t.co/e7wrgmTOTA
Dr. Antoni Chan ( View Tweet)
Fecal microbiota - can it predict development of RA?
Sadly, no. Despite promising mouse work. Despite relative control of exposure & genetic enrichment incl SE. Not even Prevotella. Maybe if you compare the most extreme cases
but it’s not all the gut.
#ACR23 ABST2584 @RheumNow https://t.co/VgDZaH9kvo
David Liew drdavidliew ( View Tweet)
Pre-clinical RA trials roundup, but also:
Great use (and acknowledgment) of RheumNow slide in the abstract background. Glad to see it being helpful there!
#ACR23 ABST2585 @RheumNow https://t.co/sK6bDJrYjV
David Liew drdavidliew ( View Tweet)
Treatment of RA-ILD patients with ABA at any time of the course in the ILD seems to prevent interstitial lung progression. The evolution of FVC and DLCO for 48 months remained stable with ABA therapy. Serrano-Combarro A, Abst#2173 #ACR23 @RheumNow https://t.co/QE61wzKWXi https://t.co/xd3wvMXUlA
Dr. Antoni Chan ( View Tweet)
L20 #ACR23 @RheumNow
Telitacept - Recomb Fusion targets BlyS, APRIL in RA w inadeq MTX response
ACR 20 60% v 27% PBO (p<0.001), ACR 50 21% v 6% PBO (p<0.001)
DAS28-ESR <3.2 15% v 5%, reduct -1.6 v -1.0
Better PROs, less jt damage prog at w24
Safety SAE 6.4 v 6.7%, no ifn signal https://t.co/PsA6AxUHVW
Eric Dein ( View Tweet)
#ACR23 Late-Breaking Abstr#L20 Phase 3 RCT in China: Telitacicept (BAFF-APRIL-i) in MTX-IR #RA met ACR20 response vs PBO.
+ve: less radiographic damage
-ve: lower rate ACR50 (21%), homogenous population, no H2H active comparator
Unclear its place in current Mx @RheumNow https://t.co/SAc4B1aRD1
Md Yuzaiful Md Yusof ( View Tweet)
Telitacicept (BlyS/APRIL inhibitor) ph3 in RA
wholly in China, after SLE approval there (SLE trial now w global sites)
Efficacy okay, no better than other b/tsDMARDs
What's the hook here, in a crowded RA market incl biosimilars?
Safety does look good though
#ACR23 L20 @RheumNow https://t.co/UzQ0f18E2A
David Liew drdavidliew ( View Tweet)
Interesting late breaker!
Telitacicept - recombinant fusion protein targeting BLyS and APRIL for treatment of RA
Phase 3 study - at wk 24, reached ACR20, ACR50, DAS28-ESR, no radiographic progression
No difference in safety profile compared to placebo
@RheumNow #ACR23 #ACRBest https://t.co/bxWPagGixt
Robert B Chao, MD ( View Tweet)
Telitacicept (BlyS/APRIL inhibitor) in MTX-IR RA. Phase 3 RCT. 479 patients. ACR20 60.0% vs 26.9%. ACR50 21.4% vs. 5.9%. Radiographic benefit also. Safety looks ok. Abstr#L20 #ACR23 #ACRbest @RheumNow https://t.co/qcinGeRX2d https://t.co/SIKKW7xhwV
Richard Conway ( View Tweet)
Tommasi et al. MTX (vs SSZ) lowers BP in RA in RCT. At 6 months, significant reduction in SBP (mean difference -4.0±10.8 mmHg, p=0.038), MAP (mean difference -4.3±17.9 mmHg, p=0.023). Abstr#2151 #ACR23 @RheumNow https://t.co/wAX3dCztxH https://t.co/mPG5TdeHTu
Richard Conway ( View Tweet)
New MoA in RA 🚨
Dual inhibition BAFF/BLys Telalicept MTX IR pts Ph3 vs. PBO
ACR20 60 vs. 27%
ACR50 21 vs. 6%
DAS28<3.2 15 vs. 5%
Less Rx prog
Safety similar infection rates
@RheumNow #ACR23 ABSTL20 https://t.co/WHysLSKyo0
Aurelie Najm ( View Tweet)
Serrano-Combarro et al. JAKi in RA-ILD. 73 patients on JAKi (74% Bari). Many had prev received abatacept/rituximab. HRCT improved/stable in 76%. Dyspnoea stable/improved in 95%. Abstr#2174 #ACR23 @RheumNow https://t.co/j6SiEzSRif
Richard Conway ( View Tweet)
Long-term abatacept in UIP RA-ILD. 233 patients, median 22 month follow-up. Sustained benefits to previous data. ABA was withdrawn in 50 patients (21.5%) (ILD worsening 20, joint worsening 15, serious infections 7, others 8) Abstr#2165 #ACR23 @RheumNow https://t.co/SinE4GgFRE https://t.co/M1Nnce58OE
Richard Conway ( View Tweet)
Window of opportunity for abatacept in RA-ILD. Early treated patients (<6 months vs >2 years) appear to do better in terms of FVC. Abstr#2173 #ACR23 @RheumNow https://t.co/14IsA1KbAk https://t.co/ZbZEwzaOu0
Richard Conway ( View Tweet)