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We’re in the #EULAR2022 highlights: basic/translational first. Wait, don’t go…
because Temra cells are cool. Up in RA pts who are TNFi-IR, & may actually be more than a bystander.
Understanding TNFi resistance is path to:
predicting it
knowing best what to do with it
@RheumNow https://t.co/22Y6iinSbH
David Liew drdavidliew ( View Tweet)
Psoriasis and Psoriatic arthritis patients have different circulating microRNA signatures compared to healthy controls.
(miRNAs: non-coding RNAs controlling gene expression)
PsO/PsA miRNAs involved in bone metabolism
@RheumNow #EULAR2022 ABST#POS0314
Robert B Chao, MD doctorRBC ( View Tweet)
#EULAR2022 POS0283: Do Rheums have Gout Stigma?
⭐️Stereotypes about pt related factors
⭐️Rheumatologists feel diet, exercise, wt loss more important in gout than RA, pharmacologic therapies less important than RA
@Rheumnow
Eric Dein ericdeinmd ( View Tweet)
Li et al. Orelabrutinib in SLE. 60 patient phase 2 RCT. Week 12 SRI(4) 50.0%/61.5%/64.3% in orelabrutinib groups vs 35.7% PBO. @RheumNow #EULAR2022 LB0005 https://t.co/u0UUWKal7n https://t.co/aYFf7Lpx1L
Links:
Richard Conway RichardPAConway ( View Tweet)
PMR on the podium @profbdasgupta, with a positive phase 3!
Sarilumab in relapsing PMR (SAPHYR):
sari q2w+14w taper vs placebo+52w taper
underrecruited 118/280 (COVID) but still hit primary, almost all secondary
Better outcome + steroid-sparing: big
LB0006 #EULAR2022 @RheumNow https://t.co/nd3TSibYa0
David Liew drdavidliew ( View Tweet)
#LB0005 #EULAR2022 Phase 1B/2A dose-ranging RCT of Orelabrutinib, a BTK-inhibitor showed BTK occupancy in all doses in #lupus. SRI-4 response was higher in all doses vs PBO. Effects were better in SLEDAI=>8. Well tolerated & no major safety. Promising early data @RheumNow https://t.co/vJBLRQgYBP
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Tofacitinib had faster and larger impact on improvement of fatigue compared to placebo in treatment of ankylosing spondylitis pts.
Note 100% fatigue resolution roughly same vs. placebo
@RheumNow #EULAR2022 ABST#POS0305 https://t.co/Doep91QIRa
Robert B Chao, MD doctorRBC ( View Tweet)
#EULAR2022 LB0005
Orelabrutinib- BTKi- for SLE, PIb/IIa
⭐️Improved SRI-4 and SLEDAI-2K vs PBO, dose response for SRI-4
⭐️Improved proteinuria
@Rheumnow https://t.co/bmREhmL7sq
Eric Dein ericdeinmd ( View Tweet)
SAPHYR trial of sarilumab for relapsing PMR @profbdasgupta et al. Sarilumab+14 week steroids vs 52 week steroid monotherapy. Sustained remission 28.3% vs 10.3% P=0.0193. Flare after remission 16.7% vs 29.3% HR 0.56 (0.35–0.90) P=0.0158 @RheumNow #EULAR2022 https://t.co/oopWKjciWG https://t.co/xi4ELJiCXa
Links:
Richard Conway RichardPAConway ( View Tweet)
Upadacitinib effective in treatment of ankylosing spondylitis pts refractory to biologic tx - phase 3 trial
Primary endpoint (ASAS40) and secondary endpoints met
No malignancy, MACE, VTE, death
@RheumNow #EULAR2022 ABST#POS0306 https://t.co/UL4hUJ0rQV
Robert B Chao, MD doctorRBC ( View Tweet)
Another possible Rx for #SLE:
Phase Ib/IIa orelabrutinib (irrevers BTKi) for SLE shows promise. Improvement in SRI-4, SLEDAI2K, proteinuria, dsDNA, C3/C4; dec in IgG/M/Bcells. Safety: lymphopenia w/ORE #EULAR2022 LB0005 @rheumnow https://t.co/etZ9hMYNfn
TheDaoIndex KDAO2011 ( View Tweet)
#EULAR2022 POS0280
Gout is associated with higher mortality in Women
⭐️Higher all cause and CV mortality
RR 1.28 risk of mortality in pts without CHD, with gout compared to controls (No CHD or gout)
@Rheumnow https://t.co/6o1EKSp2F8
Eric Dein ericdeinmd ( View Tweet)
MIVAC I & II RCTs from India:
for AZ vaccine (ChAdOx1), withhold MTX for 2w after:
hold both dose 1&2
or hold just dose 2
(vs continue)
Endpoint: Ab titre
both hold approaches better than continue, to a similar magnitude
- similar to German study w mRNA
#EULAR2022 @RheumNow
David Liew drdavidliew ( View Tweet)
Orelabrutinib Bruton’s
tyrosine kinase inhibitor in SLE
RCT phase Ib/IIa
SRI(4) wk 12 50mg 50% 80mg 61% and 100mg 64% and 37.5% PBO
Trend ⬇️ proteinuria, anti-dsDNA & IgG
Safety: 3SAEs in OLE group
LB0005 @RheumNow #EULAR2022 https://t.co/4r16NTaZvT
Aurelie Najm AurelieRheumo ( View Tweet)
Sreekanth et al. 2 studies re holding MTX after both doses vs only 2nd dose of AZ COVID vaccine. Either holding strategy increased ab titres. Only holding 2nd non-inferior to holding both with decreased flares @RheumNow #EULAR2022 LB0003 https://t.co/aCOEdXp4ol https://t.co/XAZyBojryK
Links:
Richard Conway RichardPAConway ( View Tweet)
#EULAR2022 LB0006
SAPHYR: P3 trial, 52 wk: Sarilumab in relapsing PMR
Study terminated early due to COVID recruitment
⭐️Sustained remission: 28 vs 10%, primary endpt
⭐️HR of flare 0.56 on Sarilumab
⭐️Less steroid usage, glucocorticoid tox score
@Rheumnow https://t.co/5PP1YP7YtU
Eric Dein ericdeinmd ( View Tweet)
#LB0006 #EULAR2022 Therapy for relapsing polymyalgia rheumatica. 118/280 recruited re:COVID impact. Phase 3 RCT of Sarilumab+14Wk Steroid taper showed more pts had sustained remission at Wk52 vs PBO+52Wk Steroid Taper(28% vs 10%) even if CRP excluded. PRO improved too! @RheumNow https://t.co/P11iXIAfGn
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
ECLIPSE UK primary care dataset: 23 million pts @DrMaxYates1
1.
in >55yo, PMR prevalence 2.2%
(10,000 new dx/y)
2.
1/4 take PNL for >4y
(PMR = 18% of all pts on PNL)
3.
mean 3.5 comorbid dx (steroids worsen)
Now tell me we don't need better PMR therapies.
#EULAR2022 @RheumNow
David Liew drdavidliew ( View Tweet)
Does treating spondyloarthritis early matter?
Systematic review showed in nr-axSpA tx with biologics may lead to better outcomes compared to established axSpA
axSpA - no difference in response between early vs. established disease
@RheumNow #EULAR2022 ABST#POS0302
Robert B Chao, MD doctorRBC ( View Tweet)
#EULAR2022 LB003: W/d MTX w COVID vax
MIVAC 1: hold MTX both vax vs continuing
MIVAC 2: hold after 2nd dose only vs continuing
⭐️MTX hold: improved Ab titers, no diff in MIVAC1/2
⭐️Higher reported flare for holding with both doses (36%) vs just 2nd dose (12%)
@Rheumnow
Eric Dein ericdeinmd ( View Tweet)