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Evaluation of Bimekizumab in PsA
Bimekizumab (BKZ) is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)‑17A and F. There have been more updates on the 2 year data on BKZ at #ACR24, and this is a summary of four studies being presented this year at ACR24.
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Pharmacologics:
Cannabis absorption and metabolism is variable
Inhaled absorption 10-35%
THC is 97% protein bound, lipophilic and deposits in fat and spleen
Liver function is critical for THC metabolism
16S18 @BharatKumarMD
#ACR24 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
Quinn @KQuinnRheum @petercgrayson et al. FDG-PET is not particularly useful in monitoring GCA on tocilizumab. Toc reduces but often not eliminate PET inflammation. PET activity does not predict relapse or vascular progression @RheumNow #ACR24 Abstr#0742 https://t.co/1qcJCGV118 https://t.co/6mBCgcbYo6
Links:
Richard Conway RichardPAConway ( View Tweet)
Prevalence of HLH among pts w/SLE: lower than consults would suggest!
Observational study using NIS: 139 cases out of >100k pts w/SLE (0.13%); 6 fold increase in mortality
Fits my priors; HLH is overdiagnosed, but bad when it happens
@RheumNow #ACR24 Abstr#0619 https://t.co/iz3BlUOJb9
Mike Putman EBRheum ( View Tweet)
#Abstract0649
Acetylated albumin at K402 as a possible predictor for newly diagnosed lupus nephritis, distinguishing incident LN from SLE, treated LN & healthy controls.
@RheumNow #ACR24 https://t.co/aCRzt9TtoK
Akhil Sood MD AkhilSoodMD ( View Tweet)
Harkins @DrTrishHarkins et al. Serum disease activity markers in PMR. ROC analysis for active vs remission - fibrinogen (1.000), ESR (0.986), Haptoglobin (0.976), CRP (0.986), ALP (0.854). @RheumNow #ACR24 Abstr#0741 https://t.co/f8cX68Ov9Y https://t.co/zp5c7aQwxr
Links:
Richard Conway RichardPAConway ( View Tweet)
#0066
🧬Epigenetics, Gut Microbiota & RA
🔬 110 RA patients v 110 controls
🦠 Collinsella abundance a/w DNA methylation changes (PRHOXNB, TBC1D22A) in RA, correlating with disease activity.
💡❔Role of gut microbiota & epigenetic markers as RA biomarkers
#ACR24 @RheumNow https://t.co/yZn0KkRpE6
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Is biologic response different in men vs women with axSpA?
A Meta-analysis of 11 studies including 11,199 axSpA pts evaluated sex-related response to bDMARDs
-Male pts more likely to achieve BASDAI 50 and ASDAS low disease activity responses compared to females.
#Abst0599… https://t.co/FopBLS4bF6 https://t.co/PpoZB9HwZN
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Adela Castro AdelaCastro222 ( View Tweet)
Dunn et al. Are the medications recommended for RA-ILD by the ACR guidelines used in the real-world. NO! 4108 RA-ILD patients. Only 12% on one of the first line recommended therapies! @RheumNow #ACR24 Abstr#0214 https://t.co/OzW90OA1Vd https://t.co/S1MKmEDrLF
Links:
Richard Conway RichardPAConway ( View Tweet)
The METEOR study reveals distinct clinical features in spondyloarthritis (SpA) patients with vs. without IBD.
Key features of those with IBD:
- Lower male prevalence
- Higher uveitis rates
- Lower psoriasis rates
- More structural damage in SI joints
Mirroring gut… https://t.co/EyBZQ91DDn
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Another abstract #0650 highlighting the impact of tubulointerstitial inflammation predicting risk of CKD/ESRD in lupus nephritis
@RheumNow #ACR24 https://t.co/XYwO0xnWNR
Akhil Sood MD AkhilSoodMD ( View Tweet)
RheumNow’s expanded coverage of the #ACR24 Annual meeting is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow & its faculty.
Dr. John Cush RheumNow ( View Tweet)
IV or inhaled THC:
Works quickly with high peak, feel euphoric but not sustained response
Oral is much better for medicinal usage
@RheumNow #ACR24 https://t.co/3PatgEFjZh https://t.co/wrrLMpfL5D
Links:
Eric Dein ericdeinmd ( View Tweet)
Cool data from the JAK-POT study
Have heard JAKs faster than TNF; perhaps not the case!
If anything, TNFs outperformed the others in this study
Trying not to over-read this, but supports my re-emerging preference for TNF
#ACR24 @rheumnow Abstr#0501 https://t.co/NDyPwju3ds
Links:
Mike Putman EBRheum ( View Tweet)
How to take cannabis?
Do NOT rec inhaled
- makes drug level go up high/fast, benefit for rec use but not for medicinal
- bronchitis, ?oral cancer
Other risks: psychosis - risk in youth, memory loss (poor studies), dependence, respiratory if inhaled
Clauw 16S18 #ACR24
@RheumNow https://t.co/coYNl7VOT3
Eric Dein ericdeinmd ( View Tweet)
#0513
🔬 Rituximab in RA: IgG levels & infection
➡️ 164 patients (mean age 59, IgG 14g/L, dx duration 13yrs)
🧬 IgG levels ⬇️over time (6 years/25 infusions)
⚠️ Infection-related hospitalizations peaked year 1 ⬆️risk w/ concurrent steroid(HR 2.1,p=0.002)
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Older adults with RA receive less DMARDs, the standard of care. Dr. Bruno Fautrel shows TOC tolerance in older adults is comparable to younger patients. Let's treat the patient, not their age! #ACR24 @RheumNow ABST#0516 https://t.co/054RWGh3a7
Jiha Lee JihaRheum ( View Tweet)
Discrimination in #SLE is a chronic stressor - Asians had substantial levels along with association of worse mental health and SLE activity
Data from the California Lupus Epidemiology Study (CLUES) using the Everyday Discrimination Scale (EDS) @JYazdany @RheumNow #ACR24 abst#0171
Bella Mehta bella_mehta ( View Tweet)
Clauw: think of THC and CBD as “completely different”
Cannabidiol - safe, not psychoactive, “can use liberally”
THC - psychoactive with effects on CB1 and CB2 receptors. CB1 affects the brain where CB2 is more in inflammation
#ACR24
@RheumNow https://t.co/A0TgSpAO64
Links:
Eric Dein ericdeinmd ( View Tweet)
Cardiology 🤝 Rheumatology
#Abstract0611 highlights Subclinical atherosclerosis (carotid plaque > 1.5 mm) associated with ↑ risk of CV events in SLE longitudinal cohort
@RheumNow #ACR24 https://t.co/jLLYNOfFZ2
Akhil Sood MD AkhilSoodMD ( View Tweet)