Article
Data presented at ACR22 shows that cycling through TNFi in axSpA patients with primary lack of efficacy with first line TNFi has limited additional benefit in controlling disease.
All News
Article
The RheumNow faculty reporters have been scouring the meeting and online presentations to find the best abstracts from ACR22. Here are some of their choice abstracts reported today on day 1 of ACR 2022 (#ACRbest).
Catherine Sims, MD
Tweet
Early TNFi use and cardiovascular events in AS
Abstract #0415 #ACR22 @RheumNow
📍17.6k patients, 91% male, 80% white
📍TNFi initiators were younger with lower prev. of HTN and DM
📍TNFi was associated with higher risk of incident CVD, CVA, and MACE https://t.co/7bCkfk7EYY
Dr. Rachel Tate
Tweet
axPsA and AS adult pts exhibit different genetic risk factors & serum IL-17 levels. GUS demonstrated significant pharmacodynamic effects and clinical improvement in axPsA and non-axPsA pts. Abs 1038 #ACR22 @RheumNow https://t.co/9Rjw7usO8J
Robert B Chao, MD
Tweet
What neonatal factors could affect development into axSpA? Turns out antibiotic exposure (6.2x more likely).
Mode of delivery, early diet (milk vs. formula), maternal smoking (!!) did not show association.
@RheumNow #ACR22 Abs#0868
#ACRBest https://t.co/roCAj5YsCt
Julian Segan
Tweet
Other potential mechanisms for survival selection against the plague via MHC presentation to CD8 T cells. May be associated with SpA/HLA B27
@RheumNow @HRheuminations #ACR22 #rheuminations https://t.co/Rv117B4IYp
Richard Conway
Tweet
Deodhar et al. Bimekizumab (IL-17A/Fi) in nr-axSpA. Efficacy shown across all outcomes. Confirms bimekizumab works across spectrum of axSpA (not surprisingly). @RheumNow #ACR22 Abstr#0544 https://t.co/XVGBgBQpTH https://t.co/39zW5Ex9xh
Richard Conway
Tweet
Proft @ProftDr et al. NSAIDs+golimumab no better than golimumab monotherapy in reducing spinal progression in AS. But... for high risk patients there may be some benefit - see figure. @RheumNow #ACR22 Abstr#0546 https://t.co/xo9Uy6aX71 https://t.co/vZgaoeEQn4
Richard Conway
Tweet
Weinstein et al. GO-BACK. Another TNFi withdrawal study in nr-axSpA. Again showing it doesn't work. 12 months. Only 34% of withdrawal group in remission vs 84% full dose and 68% reduced dose group. @RheumNow #ACR22 Abstr#0545 https://t.co/Fa5YgT9FYk https://t.co/9C8ShI9qjk
Dr. Antoni Chan
Tweet
IL17A/Fi BImekizumab BKZ to Wk 24 achieved reduction in
◦ total spinal pain (SP)
◦ nocturnal SP
◦ morning stiffness (BASDAI)
◦ fatigue (FACIT-F)
Deodhar et al, BE MOBILE 1,2 Abst 0409 https://t.co/vpCrG2COuB
#ACR22 @RheumNow
Dr. Antoni Chan
Tweet
JAK and TYK-2 inhibitors and indications in SpA:
● Tofacitinib ➣ Pan JAKi (AS, PsA)
● Baricitinib ➣ JAK1,2
● Upadacitinib ➣ JAK1 (AxSpA, PsA)
● Deucravacitinib ➣ TYK2 (PsA)
Carol Langford, Year in Review #ACR22 @RheumNow https://t.co/EMLEvptySS
sheila
Tweet
Differences between #uveitis pattern in AS vs. PsA and IBD 👇
This is always asked to our rheum fellows during Kelley's hour 🤓
#ACR22 @RheumNow @rheumarhyme @trishiemd @RheumaRamblings @RheumaRambolMD https://t.co/gWxQ9xdb06
Dr. Antoni Chan
Tweet
Across 9 trials of Upadacitinib in RA, PsA and AS, 40%–50% of patients had ≥ 2 CV risk factors, ≥ 65 years 6%–23%. Rates of adjudicated MACE and VTE with UPA were infrequent, consistent with background rates in RA, PsA, and AS Abst 0510 https://t.co/HDkQ6ELnAy #ACR22 @RheumNow https://t.co/SRJYdFFNIQ
Akhil Sood MD
Tweet
Abstr 0383 evaluated the use of previously developed AI algorithm to detect sacroiliitis in a new axSpA cohort. The neural network achieved
-Sensitivity 82%; specificity 81%
-PPV 0.89; NPV 0.70
https://t.co/PDSsiMIQUc
@RheumNow #ACR22 #AI #MachineLearning #AxSpA https://t.co/mXUHUowGhQ
Dr. Rachel Tate
Tweet
SELECT-AXIS 2 subgroup analysis. UPA demonstrated improved efficacy vs PBO at Wk 14 across all evaluated subgroups of pts with bDMARD-IR AS. No new safety signals. @XBaraliakos et al, Abs 0414 #ACR22 https://t.co/lTfm68XlEY https://t.co/PaWdrOljMO
Robert B Chao, MD
Tweet
Interesting data on TNFi use in ankylosing spondylitis.
Early TNFi use, compared to no TNFi associated with higher CVD, stroke and MACE.
@rheum_cat any thought on why? and why there were so many non-TNFi users (15k vs. 2k)?
Abs#0415 @RheumNow #ACR22 https://t.co/PVkt8gPHFW
Dr. Rachel Tate
Tweet
@rheum_cat et al Abs 0415 TNFi initiation early in AS dz course (compared to no initiation) showed higher risk of incident CVD, stroke & MACE individually! Residual confounding by indication cannot be excluded. Were TNFi tx pts sicker? #ACR22 @RheumNow https://t.co/ERoDhS2yOY https://t.co/8tto5AIUSP
Catherine Sims, MD
Tweet
Can I use BASDAI to asses disease in #pregnant AS patients?
Abstract #0374 #ACR22 @RheumNow; 50 women
🫃Back pain and fatigue beyond 4.5 months = not reliable
🫃BASDAI in 3rd trimester = not reliable
🫃Morning stiffness remains reliable marker of disease in pregnancy
Dr. Rachel Tate
Tweet
Wanna know more about SpA in female patients? Just ask @Sineadm15! Check out my interview with her at #ACR22 @RheumNow https://t.co/NSM4pJeb6g
Patricia Harkins
Tweet
👁 What causes worse outcomes in our SpA uveitis pts? 👁
🚬 smoking Hx
🦴 ax + peripheral disease
✏️ BASDAI >4
👩🔬 HLA B27 +ve
🙋♀️ females
🧪CRP ⬆️
👁 bilat eye involvement
Abst#0373
#ACR22 @RheumNow
