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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)
Sarilumab in PMR
SAPHYR Phase 3 RCT
Underpowered (<50% target recruitment)
-% remission sustained from wk12 to wk 52
28% vs 10% PBO
-Risk of flare reduced HR 0.56
-Improvement of several PROs
No new safety signal
LB0006 @RheumNow #EULAR2022 https://t.co/n7WdQxQaHo
Aurelie Najm AurelieRheumo ( View Tweet)
SAPHYR phase 3 RDBPCT study: #sarilumab vs PCB for relapsing #PMR on pred 7.5+ mg/d. Study met endpoints (whether of or not CRP was included). Time to first flare was longer w/SARI, less steroid use, and also better PROs. AE: #EULAR2022 LB0006 @rheumnow 1/2 https://t.co/lIspLKlveb
TheDaoIndex KDAO2011 ( View Tweet)
#LB0002 #EULAR2022 An interesting study design looking at flare rate following withdrawal of drug after WK12. Phase 3 RCT of Baricitinib in paediatric JIA showed 76% met ACR30 at WK12. The Double-blind withdrawal showed less patients on Bari flared vs PBO (17% vs 51%) @RheumNow https://t.co/T0mSDkoHJo
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Ramanan et al Baricitinib in JIA. Double blind withdrawal study of prior responders. Earlier flare with PBO vs bari (HR 0.24 [95%CI 0.13,0.45], p<0.001. Less flares with bari vs PBO (17.1% vs 50.6%) p<0.001 @RheumNow #EULAR2022 LB0002 https://t.co/22rp70njRu https://t.co/LtJE9dz0GT
Links:
Richard Conway RichardPAConway ( View Tweet)
Kohm et al. Efficacy of IL12/23i ustekinumab independent of MTX in PsA. No additive benefit of MTX on joint, skin, QoL, function @RheumNow #EULAR2022 POS1059
Richard Conway RichardPAConway ( View Tweet)
Phase 3 compared Bimekizumab to PCB and Humira; it met all endpoints for PsA; the drug inhibits both IL17F & IL-17A. Safety signal: increase fungal (candidal) infx #EULAR2022 LB0001 @rheumnow https://t.co/MJJwj44YgU
TheDaoIndex KDAO2011 ( View Tweet)
McInnes @IainBMcInnes1 et al. Bimekizumab (IL17A/Fi) in PsA. BE OPTIMAL 852 patient RCT vs PBO vs ADA. Looks same for joints, better for skin than ADA (not stat sig) @RheumNow #EULAR2022 LB0001 https://t.co/oKEHJE3tGn https://t.co/H7nPnbEWUB
Links:
Richard Conway RichardPAConway ( View Tweet)
Novel ePROMS use. Use of ePROMS RAPID3/PASS and asking patients if they had a flare had high diagnostic accuracy identifying those not needing DMARD or steroid intensification up and eligible to skip their next outpatient clinic visit. Seppen et al #EULAR2022 @RheumNow POS0381
Dr. Antoni Chan synovialjoints ( View Tweet)
Bimekizumab (BKZ) vs PBO at 16 week BE COMPLETE for PsA with inadequate response to TNFi ACR50 44% vs 7%,PASI90 69% vs 7%, ACR20 67% vs 16%, ACR70 27% vs 0.8%, PASI 100 60% vs 5%, MDA 44% vs 6%, no new safety signals #EULAR2022 @RheumNow OP0255 Merola et al https://t.co/riU2sIXGs9
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2022 LB002
P3 Double-Blind W/d study: Baricitinib for JIA
⭐️All pts start in open label w good benefit (1/2 with ACR70)
⭐️PBO W/d led to 50% flare vs 17% in BARI group, flares earlier
@RheumNow https://t.co/apSSLqu1mp
Eric Dein ericdeinmd ( View Tweet)
#LB0005 #EULAR2022 Phase 3 RCT of Bimekizumab, dual IL17A and 17F inhibitor in bDMARDs-naive PsA showed significant improvement in ACR50 and PASI90 scores vs Placebo. No major safety signals. Skin response is excellent! @RheumNow https://t.co/yhgB8LGXh6
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Redondo-Rodriguez et al. Abatacept in RA-ILD. Prospective study 38 patients. 73.6% improved/stablised with abatacept at median 17 month follow-up @RheumNow #EULAR2022 POS0654 https://t.co/D2du0hAXIy
Richard Conway RichardPAConway ( View Tweet)