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ACR21 Best Abstracts - Day 1
The RheumNow faculty have been glued to their monitors all day, watching video, and running down abstract presentations to find the best – several of these stood out as #ACRBests. Here is a listing of “Best” they saw on Day 1.
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Work participation in patients with axial spondyloarthritis
Patients with axial spondyloarthritis (axSpA) often have increased absence from work as well as reduced productivity at work, which can have profound impacts for not only the affected individual and their families, but also lead to wider economic and social burden.
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The Influence of Obesity on Choice of Biologic Agent in Rheumatoid Arthritis
In rheumatoid arthritis we have a wide range of options available to us when we progress to a biologic treatment option. We have little to differentiate between these agents based on the clinical trials.
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Opening Day Report
The opening of ACR2 Convergence was a hit for all who signed up and viewed in. The day included the presidential address by outgoing president Dr. David Karp (UT Southwestern) and a keynote talk and interview with Dr. Seema Yasmin (Stanford).
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@MilenaGianfran @JYazdanyMD present on differential effects of biologics on CDAI in obese patients with rheumatoid arthritis. Abatacept better than TNFi in obese. Tocilizumab better than TNFi in non-obese. Abstr#0588 #ACR21 @RheumNow #ACRBest https://t.co/UcEpMAmNVw
Richard Conway RichardPAConway ( View Tweet)
No significant difference in effectiveness/treatment survival of different TNFi in axSpA
Failure of 1st TNFi did not diminish effectiveness of a second TNFi
Abs#938
#ACR21 @RheumNow
https://t.co/SLrOV7wmvU https://t.co/fkpmseVwF6
Robert B Chao, MD doctorRBC ( View Tweet)
Abstr 0579
Kim & Colleagues examined predictors of Tx change among RA patients w/ TNFi as 1st line biologic agent
- Females & GC use more likely to switch agent
- Vitamin D use & hx of other immune-mediated diseases (eg. Psoriasis, IBD) less likely to switch
#ACR21 @RheumNow https://t.co/FM5mSWmSNA
Akhil Sood MD AkhilSoodMD ( View Tweet)
No evidence to show increased risk of incident hypertension w/ TNFi use, after accounting for baseline & time-dependent confounding factors, in prospective AS cohort. Abs 0910 #ACR21 #RheumNow @RheumNow https://t.co/1SpQ51ftlK
Dr. Rachel Tate uptoTate ( View Tweet)
French, real-world axSpA cohort analysis shows SEC and TNFi retention rates similar. What do you see in your practice? Abs 0911 #ACR21 #RheumNow @RheumNow https://t.co/vu3zUwfktl https://t.co/v6DLjWJMn4
Dr. Rachel Tate uptoTate ( View Tweet)
@rheum_cat presenting a really well designed study looking at association between TNFi use and incident hypertension in axSpA. No association found. Abstr#0910 #ACR21 @RheumNow https://t.co/w7o1oDreVL
Richard Conway RichardPAConway ( View Tweet)
And here is ORAL-Surveillance, small increase in MACE and malignancy with tofacitinib vs TNFi. 1 extra MACE per 319-567 patient years, 1 extra malignancy per 275 patient years. Abstr#0831 #ACR21 @RheumNow https://t.co/wMJnspTTBy
Richard Conway RichardPAConway ( View Tweet)
Drug retention of TNFi vs. secukinumab in AxSpA pts
Abs#911
⭐️46% discontinued either treatment
⭐️TNFi with slightly better drug retention
⭐️Age, BASDAI, BMI did not favor any group
⭐️inefficacy - main reason
#ACR21 @RheumNow https://t.co/ynoomYrTvX
Robert B Chao, MD doctorRBC ( View Tweet)
So it's day 2 at #ACR21, and you know what that means - it's ORAL Surveillance day!
This is the figure everyone will be talking about, leading up to details in the plenary.
Why are the other bars higher than the pink bars?
ABST0831
plenty of @RheumNow coverage coming on this https://t.co/B80cSmhNV7
David Liew drdavidliew ( View Tweet)
ORAL Surveillance
In mod-severe RA pts >50yo, with CV RF & no hx malignancy, patient-years of exposure required for one event (vs TNFi):
MACE
tofa 5mg bid: 567
tofa 10mg bid: 319
malignancy
tofa 5mg bid: 276
tofa 10mg bid: 275
#ACR21 ABST0831 @RheumNow https://t.co/9vyXPTMFzj
David Liew drdavidliew ( View Tweet)
ADACTA & MONARCH both showed IL6i monoRx > TNFi monoRx for RA in DBRCTs.
What about in real-world data?
Looking at CorEvitas, less so
LDA: aOR 0.99
MCID in CDAI: 1.06
Even without MTX, both great drug classes for RA
Equally so?
#ACR21 ABST0834 @RheumNow https://t.co/6wvzVrXTW6 https://t.co/fYEktJhZuV
David Liew drdavidliew ( View Tweet)
In Australia, there's free choice of originator vs biosimilar for etanercept.
Real-world data shows exactly what you'd expect over >48 months - and sometimes it's what you expect that's exactly what you want to see...
OPAL data #ACR21 0840 @RheumNow https://t.co/YJA2Cua9cw
David Liew drdavidliew ( View Tweet)
#ACR21 Abst#0910 by @rheum_cat. Do TNFi ⬆️ risk of incident HTN in AxSpa?
⭐️PSOAS cohort: Prosp study from 2003-2018
▶️When adjusted for confounders (obesity, disease activity, NSAID use), insufficient evidence to show ⬆️ risk of HTN w TNFi
https://t.co/DCZ3W8CkOa @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)
TNFi + JIA = watch the skin! A nearly 3fold increase of paradoxal psoriasis in JIA patients exposed to TNFi reported in the CARRA registry w/ incidence rate the highest on children receiving adalimumab.
#Abst0241 @RheumNow #ACR2021 https://t.co/uXOwV2RlGu https://t.co/8f8mvVUkV2
Aurelie Najm AurelieRheumo ( View Tweet)
@JointMD shares his thoughts on IL23, IL17, TNF inh- where/when/how we might use them. @RheumNow #acr21 https://t.co/mVw05iFPhF
TheDaoIndex KDAO2011 ( View Tweet)
2 year study of AxSpA pts in clinical remission who tapered TNFi.
⭐️52% successfully tapered to either 2/3, 1/2 or 1/3 dose
⭐️Baseline physician global score independent predictor of successful tapering
Abs#364
#ACR21
@RheumNow
https://t.co/9Kti5JGMYr https://t.co/y1Uj2dTABC
Robert B Chao, MD doctorRBC ( View Tweet)
