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#ACRbest Abstracts – Day 2
Our reporters have been prolific in finding the hot abstracts, those that were most attended or those that are getting the most buzz on social media. Here are RheumNow's #ACRbest abstract reports from Monday, November 13, 2023 at #ACR23, covering The Great Debate, SGLPT2 inhibitors in SLE, the SMART Study of MTX, TMP/SMX Prophylaxis, RA-ILD & TNF Inhibitors, cancer research and more.
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#Infection rates are equal in #RWD #real #world #data using #biosimilars compared to previous use of #originators. BC database #0970 #ACR23 @RheumNow @ACRheum #arthritisresearchcanada #ARC https://t.co/eVSPgVfmQG
Janet Pope ( View Tweet)
Obs study, bDMARDs & malignancy
TNFi w/lower risk than ABA/RTX/IL6i & numerically lower than JAKs
I'm a little skeptical... KM curves diverged w/~45 days, seems implausible?
Agree w/first author, possible channeling bias
@RheumNow #ACR23 Abstr 1678 https://t.co/1uL3j6kTSj
Mike Putman EBRheum ( View Tweet)
Sendaydiego et al. Comparative cancer safety b/tsDMARDs. 37,026 patient database cohort study. Compared to TNFi, RTX HR 2.2 (1.5, 3.3) ABA HR 1.7 (1.3-2.4), JAKi HR 1.3 (0.9-1.9). Abstr#1678 #ACR23 @RheumNow https://t.co/bTNtaNJrln https://t.co/qQBM2F2q8N
Richard Conway ( View Tweet)
Ritux (OR 2.2), ABA (OR 1.3), JAKi (OR 1.3) significantly increase risk of cancer vs. TNFi
Cohort of 37000+ RA pts starting bio/tsDMARDs (379 incident cancers)
True biologic effect or confounding by indication in a generally more comorbid population?
@RheumNow #ACR23 ABST1678 https://t.co/suj6mVBEC0
Aurelie Najm ( View Tweet)
There was a lower hazard ratio for incident cancer with exposure to TNFi compared to non-TNFi (RTX and ABA) and JAKi. Limits: potential for residual confounding by indication and small number of outcomes per drug class, Xavier S, Abst#1678 #ACR23 @RheumNow https://t.co/vJpFwl6Ivj
Dr. Antoni Chan ( View Tweet)
RA-ILD: the study that exonerates TNFi ?
TNFi vs. other BioDMARDs/JAK do not increase risk of death or hospitalization over 1 and 3 yrs follow up.
No subgroups stand out
VHA cohort, 50% smokers
No info on ILD patterns or disease trajectory
ABST1582 @RheumNow #ACR23 https://t.co/frv16oRLqv
Aurelie Najm ( View Tweet)
Dr. AMendel et al:TMP-SMX prophylaxis assoc w⬇️serious infexns in RTX treated GPA pts; BL (aHR 0.5;95%CI 0.3-0.8) & time-varying exposure (aHR 0.5; 95%CI 0.3-0.9)
A good thing to consider but weigh benefits/harms w/TMP-SMX prophy. More studies req'd?
#ACR23 ABST1584 @RheumNow https://t.co/dfsfpcQu2A
sheila ( View Tweet)
Izokibep, IL-17Ai, #ACR23 abs #1688 demonstrated ACR70 in 52%, PASI100 in 71% and enthesitis complete resolution in 89% at week 46. Well tolerated, no dose-related AEs, similar safety with other IL-17Ai https://t.co/TQAIVa9H2j @rheumnow https://t.co/ihzxnuAsWw
Dr. Rachel Tate ( View Tweet)
Non TNFi b/tsDMARDs vs TNFi in RA-ILD. New-User, Propensity Score Matched Study. 454 patients. No difference! resp-related hospitalisation aHR 1.22 [0.92, 1.60] No difference mortality. Abstr#1582 #ACR23 #ACRbest @RheumNow https://t.co/HzzVo9dJHi https://t.co/mZuHq4GShU
Richard Conway ( View Tweet)
Upcoming Plenary II session
Ab#1584 on Bactrim for GPA pts on RTX
Should you use this for prophylaxis after weaning the prednisone?
#ACR23 @RheumNow
Eric Dein ( View Tweet)
Rather unsurprising finding at this point, but valuable nonetheless
Per usual, joint efficacy for bimekizumab (IL17i) ~similar to TNF
New twist; similar loss in efficacy over time. Nice to have another IL17i; not sure this is a "blockbuster"
@RheumNow #ACR23 Abstr1437 https://t.co/4sVfSz7ZnK
Mike Putman EBRheum ( View Tweet)
Great Debate on the use of biologics in treatment of Giant Cell Arteritis and Polymyalgia Rheumatica!
Let's begin with Dr. Robert Spiera on why we should NOT use IL-6i
No evidence of disease modifying
Lose biomarker activity
Cost
@RheumNow #ACR23 #ACRbest https://t.co/XCT02wYb2s
Robert B Chao, MD ( View Tweet)
Here is the popular answer@to the #ACR23 debate of up front bDMARD in GCA and PMR Yes vs No. the audience has no consensus. Access is Impt, experience and criteria of who to use it in. @ACRheum @RheumNow https://t.co/7pxF4w926m
Janet Pope ( View Tweet)
Debaters and moderators acknowledge IL6i may not be the only steroid sparing agents that would work for #GCA. Abatacept, secukinumab, JAKi are being evaluated #greatdebate @rheumnow #ACR23
TheDaoIndex KDAO2011 ( View Tweet)
The order of use will affect the safety and effectiveness of drug Rx in #Rheumatoid #arthritis So if #Rituximab is used in later line #Rx - is looks worse@than ex #TNFi used early. Never forget prescribing bias / confounding the results. @RheumNow @ACRheum #ACR23 https://t.co/JJ8BY7n9VM
Janet Pope ( View Tweet)
More nuanced poll for #GreatDebate #ACR23
@RheumNow
How should we use biologics for PMR/GCA?
Eric Dein ( View Tweet)
#GCA Rx #bDMARD is established to #steroid spare and reduce relapses. #Tocilizumab #GiACTA Dr Seo said ‘biologics work and steroids are bad!’ @ACRheum @RheumNow #ACR23 #ACRbest https://t.co/JmSE1KKlf5
Janet Pope ( View Tweet)
Taiwanaise study of factors associated with 5 year mortality in patients after their first biological b,ts DMARDS
A highter risque mortality in RTX and lower in tsDMARD vs TNFi @RheumNow @Janetbirdope @Yuz6Yusof https://t.co/rjpo08Tg46
Dellal ( View Tweet)
#ACR23 Great debate: should we use biologics at PMR/GCA onset?
Dr Spiera (Cons)
-Need to agree on clin important diff & flares
-No evidence as disease modifying in GCA
- No need for disease modifying in PMR
-Most pts can be treated with steroid & rapid taper
-Cost @RheumNow https://t.co/ptM8E7EQzF
Md Yuzaiful Md Yusof ( View Tweet)
